Herpes zoster, also known as shingles, is caused by a reactivation of the varicella-zoster virus (VZV), the same virus that causes chicken pox. The virus remains dormant in nerve cells and reactivates as a result of stress, causing pain and a rash on the band of the skin supplied by the affected nerve. Those afflicted with shingles should seek medical attention as soon as symptoms appear so that antiviral medication (acyclovir, valacyclovir, and famciclovir) can be prescribed.
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Stress and the Immune System
The central nervous and immune systems are closely interrelated, and physical and psychological stressors can interfere with their functional interaction. The duration and course of the stress response are essential factors that determine the degree of the immune dysfunction and the health-related outcome. Stressor duration may be important because it impacts the release of stress hormones, especially catecholamines (adrenaline and noradrenaline) and cortisol. Over time, the presence of these hormones depress the immune response.
Physiologic Stress and Shingles
Chronic, severe pain is a powerful stressor that my lead to the reactivation of VZV because it is contributes to emotional distress, resulting in depression. In addition, the stress related to trauma or surgery have been shown to cause a reactivation of VZV at the site of injury. In one study, participants suffering from a zoster outbreak were significantly more likely to report trauma at the site of their zoster within a month before their outbreak.
Psychological Stress and Shingles
Psychological stress is defined as a perceived stress that influences an individual's ability to cope with life events. A perceived lack of social support (a spouse, confidant, etc.) also impacts the stress response. Individuals with herpes zoster were significantly more likely to have had negative life events in the 2, 3, or 6 months before the onset of zoster, and to have had significantly more total life events in the 6 months before the outbreak.
Handling Stress to Prevent an Outbreak
Stressed individuals often try and cope by taking up risky health habits that contribute to their stress and immune functions. These include poor eating habits, interruptions in sleeping patterns and less exercise. In addition, they tend to abuse alcohol, cigarettes and other drugs. To better handle stress and prevent a zoster outbreak, these negative habits should be avoided. In addition, social interactions, especially the inclusion of a confidant, can help reduce the chance of developing zoster.
REFERENCES & RESOURCES
- Pyschosomatic Medicine: Effects of a Behavioral Intervention, Tai Chi Chih, on Varicella-Zoster Virus Specific Immunity and Health Functioning in Older Adults
- Immunology: Stress-induced Immune Dysfunction: Implications for Health
- J Neuroimmune Pharm: Stress-Induced Immune Dysregulation: Implications for Wound Healing, Infectious Disease and Cancer
- Centers for Disease Control: Prevention of Herpes Zoster Recommendations of the Advisory Committee on Immunization Practices (ACIP)
- Journal of the American Osteopathic Association: The Burden of Herpes Zoster and Postherpetic Neuralgia in the United States
- Help Guide: Understanding Stress