Shingles: A Useful Guide

Shingles is a relatively common infection. In fact, around one in four people will experience shingles at least once in their life. The infection is caused by the varicella-zoster virus, the same virus which causes chickenpox.

Although chickenpox is common in children, shingles is especially common in old age, particularly in those over the age of 70. This is because your immunity can often decrease as you get older. Fortunately, there is a free vaccination available on the NHS to those aged between 70 and 78 years old. We will discuss this vaccination in detail later in this article.

In today’s post, we will also look at the causes, symptoms and treatments available for shingles, as well as the complications it can cause.

What is Shingles?

Shingles is an infection which causes a painful rash on the skin. It’s caused by the same virus as chickenpox. After someone has recovered from chickenpox, the virus remains inactive in their system. This virus often lies in nerve tissue near the brain and spinal cord. If the virus ‘reactivates’, the person will develop shingles.

Shingles commonly leads to a painful red rash on the skin, usually just on one side of the body.

Causes of Shingles

As we already know, the same virus is responsible for both chickenpox and shingles. Experts aren’t certain why the virus sometimes reactivates years later. However, people with weakened immune systems seem to be more likely to get shingles.

Your immune system can get weaker for a number of reasons, such as:

• Chemotherapy.
• Physical and emotional stress.
• HIV and AIDS.
• Being over the age of 50.
• Taking steroids and certain other medications for a long time.

Despite being more common in older people, young people who are otherwise healthy can also develop symptoms.

It is not possible to catch shingles from someone who has shingles or chickenpox. However, it is possible to catch chickenpox from somebody with shingles, if you haven’t had chickenpox before.

If you have shingles, it’s important to avoid passing on the virus. You should keep the rash clean and cover it with a dressing. Avoid touching the rash or any blisters, washing your hands if you do touch it. It’s also important to avoid pregnant women, people with weak immune systems such as those undergoing chemotherapy, and anyone else who has never had chickenpox.

Symptoms of Shingles

The main symptom of shingles is the distinctive red rash. This rash is often painful and will usually form blisters after a while. This blisters will usually be itchy and ooze fluid, so you should cover them with a dressing. New blisters may continue to appear for up to a week, before drying out and forming scabs.

The area around the rash will also be quite tender, and you may experience sharp stabbing pains every now and then. Alongside these main signs, you might also experience some early symptoms, such as:

• A high temperature.
• A headache.
• A general feeling of being unwell.
• Burning, tingling, numbness or itchiness of the skin in the affected area.

Once the blisters are gone, the scabs may remain for a while, sometimes leaving scarring or loss of skin pigment. You may continue to feel some pain even after the rash has gone down.

Shingles usually affects the chest and abdomen, although any part of the body can be affected. Commonly, the virus will only affect a specific area on one side of your body and won’t cross the ‘mid-line’ – an imaginary line running from between your eyes down past the belly button.

Diagnosis

Shingles is rarely serious. However, if you start to notice any symptoms, you should call 111 for advice. They might recommend that you see a doctor if they think you could benefit from medicine to speed up your recovery.

In most cases, shingles goes away by itself with no lasting effects. However, it can be more serious if:

• Your doctor suspects any complications such as meningitis.
• The condition is affecting your eyes, as this could cause permanent vision problems.
• You have an unusually persistent case of shingles which hasn’t been responding to any treatment.
• You have been diagnosed with shingles twice.
• You’re pregnant.
• You have a weakened immune system.

If any of the above apply to you, you might need further medical treatment for shingles. You should contact your GP if you haven’t done so already.

Treatment for Shingles

Currently there is no treatment for the virus which causes shingles. However, there are treatments which can relieve the symptoms until they go away by themselves.

The earlier the diagnosis, the sooner treatment can begin. Early treatment can help to reduce the severity of your condition and reduce the risk of any complications. There are also several ways you can treat shingles yourself. These include:

• Keeping your rash as clean and dry as possible to reduce infection.
• Wearing loose-fitting clothes to avoid irritation.
• Not using any rub-on antibiotics or adhesive dressings such as plasters as this can slow down the healing process.
• Using a dressing that won’t stick to your rash – Non-adherent.

The NHS suggests using Calamine Lotion as this has a cool, soothing effect on the skin and can relieve the itchy feeling. If your blisters are weeping, you can use a cloth or flannel which has been cooled with tap water. You can do this several times throughout the day, but only do so for around 20 minutes at a time.

Your doctor may give you a course of antiviral tablets which last seven days, which help to prevent the virus from multiplying. These tablets can also reduce the severity of your symptoms, speed up the healing process, and prevent any further complications. These tablets are most effective when taken within 72 hours of the rash first appearing.

Painkillers can help relieve the pain and discomfort of shingles. The NHS recommends paracetamol.

Complications of Shingles

As we have mentioned, shingles can lead to a few complications. While these are quite rare, they are more likely if you have a weakened immune system or are an older person. Here are a few of the known complications:

• Posterpetic Neuralgia – This is the most common complication of shingles, affecting as many as one in five people over the age of 50. This can cause severe nerve pain and intense itching even after the rash and other symptoms have gone. This can last between three or six months, years or in some cases, for life.
• Eye Problems – If one of your eyes is affected, further problems may develop. These include glaucoma, inflammation of the eye and optic nerve, and ulceration and permanent scarring of the surface of your eye.
• Ramsay Hunt Syndrome – This can occur if shingles affects certain nerves in your head. Symptoms include earache, hearing loss, dizziness, vertigo, a rash around the ear and a loss of taste. Early treatment can lead to recovery if started within 72 hours of the symptoms occurring.
• Inflammation of your lungs (pneumonia), liver (hepatitis), brain (encephalitis), spinal cord (transverse myelitis) or protective membranes that surround your brain and spinal cord (meningitis). Fortunately these complications are quite rare.

Shingles is rarely life-threatening, but complications like the above mean that around one in every 1,000 cases in adults over the age of 70 is fatal.

Shingles Vaccination

The best way of preventing shingles is by getting a vaccination. The vaccine, known as Zostavax, is given as a single injection into your upper arm and you’ll only need to have it once. Unlike the flu vaccine, you can get the shingles vaccine at any time of the year.

You are eligible for this vaccination if you’re aged 70 or 78-years-old. However, there is some leeway as the NHS explain:

In addition, anyone who was eligible for immunisation in the previous three years of the programme but missed out on their shingles vaccination remains eligible until their 80th birthday.

The vaccine itself contains a weakened chickenpox virus. Very occasionally, people have developed a chickenpox-type illness following the vaccination. Research suggests the shingles vaccine will protect you for at least five years, probably longer.

Once you’re eligible for the vaccination, your doctor will offer you the vaccine when you attend the surgery for general reasons or for your annual flu vaccination.

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Editor’s Note: This article was updated on 30th October 2020 to reflect current information. Originally published February 2018.