GP Alice Fitzgibbon covers a common condition many people will have heard of – shingles.
Shingles is an infection that causes a painful skin rash on one area of the body. It is caused by a virus called Varicella Zoster Virus (VZV) which also causes chicken pox. Only people who have had chicken pox in the past may develop shingles. This is because the virus stays in the body in an inactivated form. If it reactivates, then shingles occurs. This can happen if someone has a weakened immune system, for example due to certain conditions, medications or chemotherapy. It can also happen during periods of stress.
Shingles is characterised by a blotchy rash that goes on to develop into blisters that may weep then crust over. However, the rash may not be the first symptom to appear. The first signs are often a tingling or painful sensation over an area of skin, a headache or feeling generally unwell for a few days before the rash breaks out. The rash may commonly be on the chest, body or face, but can appear anywhere. It appears on one side of the body only – if there is a widespread rash that appears on both sides of the body then it is unlikely to be shingles. In rare cases, some people may experience pain with no rash appearing.
If you think you have shingles, you should see a medical professional or visit a pharmacy who may be able to supply treatment. Shingles is treated to try avoid complications from the condition such as long term pain (called post herpetic neuralgia). Treatment is most effective if started within three days of the rash appearing, and usually involves antiviral tablets and painkillers to help manage the discomfort. Self-care advice for shingles includes taking paracetamol, wearing loose fitting clothing that doesn’t irritate the area affected and keeping the rash clean and dry to reduce the chance of infection.
Shingles can have serious implications if certain areas of the body are affected. The virus can affect the front of the eye causing ulcers. This is extremely painful and if not treated may lead to visual loss. A painful red eye with a facial rash needs to be seen urgently by an optician or medical professional who can refer for further assessment as often other treatments, such as eye drops, are needed. If shingles affects the facial nerve, it can cause the side of the face to become weak and hearing problems to develop. This is called Ramsay Hunt syndrome and is thankfully rare. Prompt treatment is important to try and improve the symptoms and lead to recovery.
Overall, the recovery time from shingles can take time. The rash itself may take four weeks to heal and pain may be experienced after healing. This usually gets better with time, however in some cases pain may be prolonged and last for months.
As mentioned before, only people who have had chicken pox before develop shingles. Shingles itself cannot be passed to another person. However, as it is the same virus, if you have shingles you could give chicken pox to someone that has never had it, or never had the chicken pox vaccine, before. This is why it is important to cover the rash when you have shingles, and try to avoid certain groups of people who may be more vulnerable to infection such as:
- Anyone who is pregnant who has never had chicken pox
- People with weakened immune systems eg those on chemotherapy
- Babies less than one month old.
The rash is only infectious to others when it is in the blister phase and weeping fluid. When it has dried up and scabbed over it is no longer infectious.
If you have had chicken pox, you may get shingles at some point in your life. There is a vaccine offered on the NHS to help protect people from it. The vaccine boosts the immune system to try and stop the virus reactivating in the body. It is recommended for all adults turning 65, those aged 70 to 79 and those aged 50 and over with a severely weakened immune system. The vaccine reduces your chances of getting shingles and the chance of getting serious problems if you do, so it is worth having.
Shingles is a common condition, but it can be horrible to experience. If you have concerns about having it, it is best to seek medical attention for review and advice.
For further information on Shingles from the NHS click here
