Patient: Im male 23, had chicken pox when i was younger and i now have shingles in the usual “waistline” area. 2 patches (no bigger than 2″ by 1/2″) on my left waist and 1 on my back (same line). I’m on the 3rd day of the blistering phase (nothings popped yet) and i was wondering:
1: can the rash spread anymore once its in this phase? (ie if a blister pops and oozes down my side can that area then blister up?)
2: even though it’s clearly just on the common waist nerve line, is there any chance of it popping up on my face? or would that be it’s own shingles outbreak? (that i would feel the sharp itch/pain days before any sign of rash)
3: once they begin popping, what should i do to make sure it doesnt get infected? what treatments should i put on it to make sure it heals fine?
thank you so much for any of these questions u can answer
Doctor: Hey Carl,
Shingles occur when the herpes virus hidden in the dorsal nerve root ganglia flare up- therefore the lesions appear along the concerned dermatome. We cannot predict the dermatome thats going to be affected, because we cannot know, where all the virus remains hidden.
Regarding your 3rd qs-
Do not ever scratch the vesicles.. This may increase the risk of secondary infection and scarring. Antihistamines and topical creams can relieve the itching.
Keep the area clean with mild soap and water. Application of petroleum jelly can aid in healing. Wear loose clothings.
Antiiviral medications, such as Acyclovir (Zovirax), Valacyclovir (Valtrex), and Famciclovir (Famvir), can decrease the duration of skin rash and pain . You can start this in consultation with the physician.
Hope this helps??
Patient: Great thank you, so just to clarify,
you said the dorsal nerve root ganglia flares up causing the rash.
for example, lets say the nerve line in my shoulder is clear of the virus.
A blister from my waist pops and i take the pus and rub it on my shoulder.
would the pus alone cause shingles or some rash on my shoulder?
Doctor: The mechanism of virus spread would be a long topic to discuss. in gist- just remember that, the herpes virus is already present in the nerve ganglia( from your last chicken pox ).
Dermal spread is also known.
The virus that causes shingles (varicella zoster) is present in the fluid within the blisters . Transmission of this virus maiy occur through direct or indirect contact with the fluid in the blisters