1. Bolton, Laura L. PhD

Article Content

To the Editor:


I would like to compliment the authors of "Treatment of Herpes Simplex Virus Protection: Rationale for Occlusion," which was published in the July 2007 issue of Advances in Skin & Wound Care. I commend them on this thoughtful review, presenting a rationale for use of occlusive dressings on orofacial Herpes simplex virus lesions. I would also like to ask if they think this rationale might also apply to varicella-zoster virus lesions (also called herpes zoster or shingles)? The 2 conditions share many parallels in patient discomfort and healing progression.


The only literature I have been able find on the topic of dressing shingles' lesions with occlusive dressings were 3 case studies combining appropriate systemic antiviral therapy with primary hydrocolloid1,2 or absorbent silicone3 dressings. Authors reported improved patient comfort, autolysis of necrotic tissue (in 1 case1 with an initial 3-day application of an amorphous hydrogel), reduced patient-reported itching and pain, and protection of the lesions from damage and secondary infection resulting from patient scratching.


For perspective, healing time ranged from 2 to 3 weeks after initial presentation in patients dressed with hydrocolloid dressings to 5 months for the patient dressed with the absorbent silicone dressing; however, variables other than dressing, such as time from lesion onset or patient condition, are likely to have accounted for these variations in reported healing time.


Laura L. Bolton, PhD




1. Lee SK. Healing shingles with moist occlusive dressings. Ostomy Wound Manage 2002; 48(3):24-7. [Context Link]


2. Bolton RL, Uthappa M. Healing shingles with moist dressings. (Letter to editor) Ostomy Wound Manage 2002;48(8):4. [Context Link]


3. Serena TE. Use of an atraumatic dressing in the treatment of a painful wound resulting from herpes zoster. Ostomy Wound Manage 2006;52(12):14-6. [Context Link]