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  • Writer's pictureDr. David Della Morte Canosci


Herpes Zoster, commonly known as shingles, is a painful skin rash caused by the Varicella-Zoster Virus (VZV). This virus also causes chickenpox in children. In this comprehensive guide, we will discuss the causes, symptoms, diagnosis, treatment, and prevention of herpes zoster. We'll also touch on the importance of nutrition in preventing shingles and how the principles of food as medicine are practiced at Palazzo Fiuggi.

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Herpes zoster is a painful condition caused by the reactivation of the Varicella-Zoster Virus (VZV) that initially causes chickenpox in children.

The virus can remain dormant in nerve tissue for many years, and if it reactivates, it can cause herpes zoster or shingles.

The primary manifestation of herpes zoster is a painful skin rash that usually appears on one side of the body, often on the chest or abdomen, but it can occur anywhere, including the face and eyes.

Although not life-threatening, the pain can be severe and last for 2-4 weeks.


Herpes zoster is caused by the reactivation of the Varicella-Zoster Virus in the body.

The first time this virus enters the body, usually in childhood, it causes chickenpox. Although the immune system typically combats the initial infection, the virus remains dormant in nerve cell clusters called ganglia.

After several years, the virus can reactivate and cause herpes zoster.

A sudden decrease in immune defenses, often due to severe stress, certain medications, immune system disorders, excessive sun exposure, or aging, can trigger the reactivation of the virus.

Herpes zoster itself is contagious and can transmit the virus to those who have never contracted the Varicella-Zoster Virus or have not been vaccinated against it.

Transmission occurs through direct contact with open blisters containing the virus. However, those who become infected will develop chickenpox, not herpes zoster.


Characteristic symptoms of herpes zoster include:

  • A red, elongated skin rash covered with fluid-filled, itchy blisters, similar to chickenpox

  • Severe, burning, and stabbing pain

  • Headache

  • Fever

  • Chills

  • Stomach pain

  • Fatigue


In most cases, a medical examination and visual inspection of the skin rash are sufficient for diagnosing herpes zoster. The rash usually has distinct characteristics that a doctor can easily recognize. The doctor may also ask the patient about any past episodes of chickenpox and the presence of any specific symptoms before the appearance of blisters.

In rare cases, if the symptoms are unclear (for example, if there is no rash or if it is more extensive than expected), the doctor may rely on laboratory tests. The most common test is a blood test that looks for IgM antibodies related to the presence of the Varicella-Zoster Virus.

However, in individuals with weakened immune systems, antibody production may be limited, and the test results may be negative even if the virus has reactivated.

Another option is to search for the virus directly in a sample of fluid taken from the blisters.


Herpes zoster affects those who have not been vaccinated against the Varicella-Zoster Virus in childhood. When the virus reactivates as herpes zoster in adults or the elderly, healing usually occurs spontaneously.

However, as the pain can be severe and itchy, pharmacological treatment can help alleviate the pain.

The following medications may be prescribed:

  • Antiviral medications, which help block the proliferation of the virus and shorten the course of the disease

  • Pain relievers and anti-inflammatory medications, although their effects on herpes zoster-related nerve pain may be somewhat mild

  • Anti-inflammatory therapies, usually applied as creams or gels on the affected skin to alleviate itching

To relieve itching and soothe pain, it may also be helpful to wear loose clothing and apply cool compresses to the blisters (or take a bath with cool water). However, it is essential to keep the rash clean and dry to limit the risk of bacterial infections.


While herpes zoster is generally not a dangerous condition, it is essential to seek medical attention if you suspect you have it to prevent potentially severe complications. The typical rash of herpes zoster usually resolves within 2-4 weeks. However, in rare cases, a severe and debilitating complication called postherpetic neuralgia may occur, causing pain to persist for months even without skin lesions.

Herpes zoster generally affects the trunk, but when it involves the face or the eye area (ophthalmic herpes zoster) due to inflammation of the trigeminal nerve, prompt intervention is required to avoid severe vision damage.


Individuals who have experienced herpes zoster may be at risk for further reactivations and episodes of the disease throughout their lives.

Those who contracted chickenpox as children or are prone to recurring herpes zoster can discuss the possibility of receiving the herpes zoster vaccine with their healthcare provider.

The vaccine contains a weakened form of the live virus and strengthens the immune response, inhibiting reactivation.

In Italy, vaccination is free and recommended for individuals over 65 or those at risk. A single dose of the vaccine is administered subcutaneously in the deltoid muscle (upper arm).

The vaccine can reduce postherpetic neuralgia cases by approximately 65% and clinical herpes zoster cases by about 50%.

Since the approval of the National Vaccination Plan in 2017, vaccination against chickenpox has become mandatory for children, preventing the initial encounter with the Varicella-Zoster Virus.


A balanced and nutritious diet plays a crucial role in maintaining a healthy immune system, which is essential for preventing shingles.

Consuming foods rich in antioxidants, vitamins, and minerals can help boost the immune system and reduce the risk of herpes zoster reactivation.

Foods high in vitamin C, vitamin E, and zinc are particularly beneficial in strengthening the immune system.

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At Palazzo Fiuggi, food is considered medicine. The culinary team at Palazzo Fiuggi is dedicated to creating dishes that promote health and well-being while delivering exquisite flavors.

The chefs work closely with nutritionists and doctors to ensure that each meal is tailored to individual needs and preferences while maintaining the highest standards of quality and nutrition.

The principles of food as medicine practiced at Palazzo Fiuggi serve as a pillar for promoting overall health and wellness, including preventing shingles.

By incorporating these principles into daily life, individuals can build a robust immune system, reducing the risk of herpes zoster reactivation.


Herpes zoster is a painful condition caused by the reactivation of the Varicella-Zoster Virus.

While it is generally not life-threatening, the pain and discomfort associated with the condition can be severe.

Early diagnosis and treatment can help alleviate symptoms and prevent complications. Vaccination, a strong immune system, and a balanced diet rich in nutrients can help prevent herpes zoster reactivation.

By embracing the principles of food as medicine, such as those practiced at Palazzo Fiuggi, individuals can maintain a healthy immune system and reduce the risk of developing shingles.


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