herpes zoster (HZ), commonly known as
shingles, is a painful viral infection that
significantly affects older adults’ morbidity
and quality of life.
Up to 1 million new cases of HZ
occur each year in the United States.
HZ is caused by
the reactivation of the varicella virus, the same virus that
causes chickenpox.
Almost everyone in the United
States has this virus in their body either from having
chickenpox during childhood or from the chickenpox
vaccine.
The virus remains dormant on dorsal horn
nerve cells near the spinal column but becomes
reactivated when given the opportunity.
This opportunity presents when a person’s immune system
is compromised either by age, negative life events,
disease, medicines, or treatments albeit it is not
predictable.
With each decade of life, the incidence
increases because of the gradual decline of the immune
system as part of the natural aging process.
Despite HZ being common, many patients do not
understand its risk, complications, treatments, or prevention.
NPs have an obligation to educate their patients,
debunk any myths, and provide informational resources
as part of the treatment plan.
The purpose of this article is
to discuss the clinical management of HZ and provide a
practical approach to address patient education.