A red blistered rash is a common clinical problem faced by Dermatologists such as myself. Let’s take a look at possible diagnoses that can underlie blisters in these areas, which can include both Herpes Zoster (Shingles) and Herpes Simplex, and options for both testing and treatment, my perspective being that of a Board-certified Memphis Dermatologist for over 30 years, with Rheumatology and Dermatology, 8143 Walnut Grove Road, Cordova TN 38018 (1-901-753-0168).
First, grouped blisters on a red base can comes from both Shingles, also called Herpes Zoster, and from the viral infection of Herpes, or Herpes Simplex. Dermatologists such as myself can often identify which of these viruses is the culprit behind the blisters by inspecting the distribution on the body of the rash and/or blisters. We Dermatologists sometimes take a scraping for a testing called a Tzanck test, which can show features suggestive of both Herpes Simplex and Herpes Zotster, the results of which usually take fifteen minutes or so to become available, after the scraping is done. Sometimes Dermatologists take a swab for a viral culture, which can take several days to a week for results to come back from the laboratory. In severe cases, we sometimes do what’s called a Skin Biopsy, a test that involves a local lidocaine shot and sometimes several stitches, to try to pin down the correct diagnosis.
If the appearance of mouth blisters or genital blisters is characteristic of Herpes Zoster, then this outbreak is generally due to a re-occurrence or recurrence of chickenpox virus, the initial infection of which was an episode of chickenpox in childhood. Sometimes this re-infection can be triggered by emotional stress or stress due to some type of health issue. Sometimes there is no known trigger factor.
As of the early 2000s, there has become available a vaccine that can cut down on risk of Herpes Zoster, or Shingles. This vaccine is called the Shingrix, and the Centers for Disease Control recommends this vaccine for all people above the age of 50, generally given as two doses about eight weeks apart.
Shingles (Herpes Zoster) can have an awkward side-effect, a painful condition that can develop after the acute infection heals that’s called Postherpetic Neuralgia. If this condition develops, Dermatologists sometimes consider doing what’s called an intralesional steroid injection on several occasions about a month apart, into that area of the body, to cut down on burning pain in the area.
In the 1970s and 1980s, improvements in Dermatology research led to several oral prescription tablets that can be used to treat Herpes Zoster, including Acylovir tablets and capsules (Zovirax), Famcyclovir tablets (Famvir), and Valacyclovir tablets (Valtex). Dermatologists also commonly use Acyclovir Cream and Acyclovir Ointment, and Denavir Cream (Pencyclovir Cream).
Most people only develop one episode of Herpes Zoster, but some people can have recurrent Shingles. As well, sometimes Shingles can become more serious and generalized in distribution, a side-effect that is sometimes called Kaposi’s Varicelliform Eruption. Sometimes patients with this condition have to go into the hospital for management.
After 25 years of practicing dermatology, in 2016 I decided to establish a skincare products company - Big River Silk Skincare™ Inc. – of which I am the President - to manufacture and distribute organic skincare products – gentle moisturizers (HypoShea Moisturizer Cream), antiwrinkle cream (GlycoShea Cream), and deep acne cleanser (AmberSoy Soap Gel).
HypoShea Moisturizer Cream is a blend of Refined Shea Butter with some of the purest natural water in the country particular, particularly useful for people prone to chapped lips, for people with lip blisters and lips sores. HypoShea notable for being dye free moisturizer, a fragrance free moisturizer that’s also propylene glycol free, sulfate free, parabens free, and formaldehyde free, having been used by my patients in Tennessee and Arkansas for years, now also available nationally: https://www.Bigriversilkskincare.com (1-901-753-0168).
So if you or a family member or a family member or partner are seeking possible Herpes Evaluation or Herpes Treatment, or Herpes Simplex Treatment, consider getting a checkup from a Board-certified Dermatologist. My own Memphis Dermatology practice since 1993 has been with Rheumatology and Dermatology Associates, as a Cordova Dermatologist, in Tennessee (www.Rheumderm.com or www.Bigriversilkskincare.com) (1-901-753-0168). Or you can find a Dermatologist in your own neighborhood by going to the American Academy of Dermatology web site, AAD.org, then plugging your zip code into the “Find a Dermatologist” tab.
George Woodbury Jr. M.D. (03/31/2023)
Memphis Dermatologist George Woodbury M.D. on Herpes Zoster Treatment, Shingles Treatment, from skin testing to medication therapy, including Acylcovir Tablets and Capsules, Famcyclovir Tablets, and Valacyclovir Tablets. www.Rheumderm.com 1-901-753-0168 (03/31/2023)