Shingles

Written by Dr Isabelle Benard 

Shingles is the common name given to a painful rash, which is a reactivation of the chickenpox virus (varicella zoster virus) in the body. It is very common and it is thought that one in three adults over the age of 50 will develop shingles in their lifetime.

What causes shingles?

If you get chickenpox as a child, the virus never entirely leaves your body and it lies dormant for years (inactive, but still alive), usually in a nerve bundle near the spinal cord.

As you age, the antibodies directed against the virus start to grow weaker, meaning that the virus has a stronger chance of reactivating. This may also occur if your immune system is a bit weak, which can happen when you're tired or stressed.

How does shingles affect the body?

When the chickenpox virus is reactivated, it will develop along the nerve where it was hiding. It will generally only affect one side of your body, and only on a narrow band of skin, but it often causes a painful rash.

The nerve becomes very irritable and inflamed, which may cause tingling, pain and a burning feeling in the area affected.

What are the symptoms of shingles?

The area affected by shingles will feel sore and tender. It may start with some redness, but quickly become clusters of small blisters (very similar to cold sores), in the distribution of the nerve: this could be on your chest, abdomen, back or your arms or legs. Frequently, shingles may affect part of your face, forehead or cheeks, and can be extremely painful.

Is shingles contagious?

While you cannot pass shingles on, the small blisters that develop contain the chickenpox virus can be passed on to people who have never had chickenpox or could be at risk (young babies, people with weak immune systems or who are receiving chemotherapy, and pregnant women who have not had chickenpox before). 

If you suspect you have shingles it is important to avoid contact with vulnerable people until your rash has resolved fully.

How can you treat shingles?

Treatment for shingles depends on how acute your symptoms are, and how vulnerable you are. If you have a mild rash, you can usually treat any rash outbreak at home, and avoid seeing the doctor. 

When should you see a doctor if you have shingles?

If you have shingles along with any of the following, we would advise seeing a doctor as soon as possible:

• A weakened immune system
• A painful rash
• A rash that appears on areas of your body aside from your chest, abdomen, and back

Treatment is most effective in the early days of an infection, when a rash starts to appear. You may be offered oral antiviral medications for a week, to halt the progress of the virus, and some topical treatments to apply to the rash, which can significantly reduce any pain and itching/burning.

Can you treat mild shingles symptoms yourself?

Yes. You can try the following at home, which can help to ease any discomfort:

• Keep your rash clean and dry, to avoid risk of infection
• Take paracetamol to reduce pain
• Wear loose-fitting clothes
• Apply a cool compress to your rash at regular intervals and apply some calamine lotion to the rash to dry the blisters.  Always clean your hands with soap and water after touching the rash.
   

How long does shingles last?

Your rash should dry up and crust over within a couple of weeks, but it may take up to four weeks for your shingles rash to heal completely. 

What is post-herpetic neuralgia?

Some people may have persistent pains after shingles (post herpetic neuralgia), which may affect their sleep and quality of life. This type of shingles rash does not respond well to usual painkillers, and you should see your doctor for advice on how to alleviate the pain. 

Is shingles in or around the eye dangerous?

Shingles in and around your eye can cause long term issues if it is not treated.  

You should contact your doctor immediately you experience symptoms such as:

• Redness and tearing in your eye
• Burning or throbbing in your eye
• Swelling in your eye
• Blurred vision

To avoid the risk of vision loss and permanent scarring or your cornea, call your doctor if you experience any type of shingles rash on your eyelids, forehead, or on your nose. You will also need to see an eye specialist urgently. 

Can shingles be prevented?

In order to try and prevent shingles and its complications, there are two vaccines available to stimulate your immune system. You can get these vaccines from age 50 and up. 

The newer vaccine Shingrix is more effective than an earlier vaccine called Zostavax. Shingrix is known to be 75% effective at preventing shingles from occurring. It is given in 2 separate injections, 2 months apart.

Visit our London clinic for the shingles vaccination

Please make an appointment online or call 020 7244 4200 to find out more about protecting yourself from shingles.