About shingles
Shingles, also known as herpes zoster, is an infection of a nerve and the skin around it. It’s caused by the varicella-zoster virus, which also causes chickenpox.
It’s estimated that around one in every four people will have at least one episode of shingles during their life.
Symptoms of shingles
The main symptom of shingles is pain, followed by a rash that develops into itchy blisters, similar in appearance to chickenpox. New blisters may appear for up to a week, but a few days after appearing they become yellowish in colour, flatten and dry out.
Scabs then form where the blisters were, which may leave some slight scarring.
The pain may be a constant, dull or burning sensation and its intensity can vary from mild to severe. You may have sharp stabbing pains from time to time, and the affected area of skin will usually be tender.
In some cases, shingles may cause some early symptoms that develop a few days before the painful rash first appears. These early symptoms can include:
- a headache
- burning, tingling, numbness or itchiness of the skin in the affected area
- a feeling of being generally unwell
- a high temperature (fever)
An episode of shingles typically lasts around two to four weeks, however in some cases the pain may last for many weeks once the rash has disappeared. Shingles usually affects a specific area on one side of the body and doesn’t cross over the midline of the body (an imaginary line running from between your eyes down past the belly button).
Any part of your body can be affected, including your face and eyes, but the chest and abdomen (tummy) are the most common areas.
Shingles isn’t usually serious, but see your pharmacist as soon as possible if you recognise the symptoms. In most cases your pharmacist should be able to provide treatment, however they may recommend that you need to contact your GP practice for treatment if required.
You should see your GP if you are under 18 years old, pregnant or have a weakened immune system (the body’s natural defence system) and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
Referral to hospital
It’s uncommon for someone with shingles to be referred to hospital, but your GP may consider seeking specialist advice if:
- they suspect a complication of shingles, such as meningitis or encephalitis
- shingles is affecting one of your eyes – there’s a risk you could develop permanent vision problems if the condition isn’t treated quickly
- a diagnosis isn’t certain
- you have an unusually persistent case of shingles that’s not responding to treatment
- you’ve been diagnosed with the condition more than twice
- you’re pregnant
- you have a weakened immune system – particularly in severe cases or cases affecting children
Causes of shingles
Most people have chickenpox in childhood, but after the illness has gone, the varicella-zoster virus remains dormant (inactive) in the nervous system. The immune system keeps the virus in check, but later in life it can be reactivated and cause shingles.
It’s possible to have shingles more than once, but it’s very rare to get it more than twice.
It’s not known exactly why the shingles virus is reactivated at a later stage in life, but most cases are thought to be caused by having lowered immunity (protection against infections and diseases).
This may be the result of:
- old age – as you age, your immunity may decrease, and shingles most commonly occurs in people over 70 years old
- physical and emotional stress – the chemicals released by your body when you’re stressed can prevent your immune system working properly
- HIV and AIDS – people with HIV are much more likely to get shingles than the rest of the population because their immune system is weak
- recently having a bone marrow transplant – the conditioning you require before the transplant weakens your immune system
- recently having an organ transplant – you may need to take medication to suppress your immune system so your body accepts the donated organ
- chemotherapy – chemotherapy medication, often used to treat cancer, can temporarily weaken your immune system
However, young people who appear otherwise healthy can also sometimes develop shingles.
Is shingles contagious?
It’s not possible to catch shingles from someone with the condition or from someone with chickenpox. However, you can catch chickenpox from someone with shingles if you haven’t had chickenpox before.
The blisters that form contain live virus. If a person who has never had chickenpox makes direct contact with an open blister or something with the fluid on it, they can contract the virus and develop chickenpox.
Preventing the spread of the virus
If you have shingles, you’re contagious until the last blister has dried and scabbed over. To help prevent the virus being passed on, avoid sharing towels or flannels, swimming, or playing contact sports. You should also avoid work or school if your rash is weeping (oozing fluid) and can’t be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and haven’t had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it’s your own baby, in which case your baby should have antibodies (proteins that fight infection) to protect them from the virus
Treating shingles
Although there’s no cure for shingles, treatment is available to relieve the symptoms until the condition resolves. Most cases of shingles last around two to four weeks.
Treatment for shingles can include:
- covering the rash with clothing or a non-adherent (non-stick) dressing to reduce the risk of other people becoming infected with chickenpox – as it’s very difficult to pass the virus on to someone else if the rash is covered
- painkilling medication, – such as paracetamol, ibuprofen or codeine
- antiviral medication to stop the virus multiplying – although not everyone will need this
Complications of shingles
Shingles can sometimes lead to complications, such as postherpetic neuralgia. This is where severe nerve pain lasts for several months or more after the rash has gone.
Complications such as this are usually in elderly people who have had the condition and those with a weakened immune system.
The shingles vaccine
It’s not always possible to prevent shingles, but a vaccine called Zostavax can reduce your chances of developing the condition.
If you still develop shingles after having this vaccine, it may be milder and last for a shorter time than usual.
This vaccine’s now routinely offered as a single injection to people aged 70.
Ophthalmic shingles
Some cases of shingles can affect one of the eyes and are known as ophthalmic shingles. This occurs when the virus is reactivated in part of the trigeminal nerve, a nerve that controls sensation and movement in your face.
Symptoms can include:
- a rash over your forehead, nose and around your eye
- conjunctivitis – inflammation of your eye that causes it to become red and watery with a sticky coating on your eyelashes
- a red eye
- problems with your vision
Symptoms of shingles
An episode of shingles typically lasts around two to four weeks. The main symptoms are pain, followed by a rash.
Any part of your body can be affected, including your face and eyes, although the chest and abdomen (tummy) are the most common areas where shingles develops.
Early symptoms
In some cases, shingles may cause some early (prodromal) symptoms that develop a few days before the painful rash first appears. These early symptoms can include:
- a headache
- burning, tingling, numbness or itchiness of the skin in the affected area
- a feeling of being generally unwell
- a high temperature (fever)
Not everyone will experience these prodromal symptoms. A high temperature is particularly uncommon.
Pain
Eventually, most people with shingles experience a localised “band” of pain in the affected area.
The pain can be a constant, dull or burning sensation and its intensity can vary from mild to severe. You may have sharp stabbing pains from time to time, and the affected area of skin will usually be tender.
Pain is less common in young healthy people and is rare in children. It usually starts a few days before the rash appears and can remain for a few days or weeks after the rash has healed.
Rash
The shingles rash usually appears on one side of your body and develops on the area of skin related to the affected nerve.
Initially, the shingles rash appears as red blotches on your skin before developing into itchy blisters similar in appearance to chickenpox.
New blisters may appear for up to a week, but a few days after appearing they become yellowish in colour, flatten and dry out.
Scabs then form where the blisters were, which may leave some slight scarring. It usually takes two to four weeks for the rash to heal completely.
When to seek medical advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system (the body’s natural defence system) and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
Original Article – https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/shingles#causes-of-shingles
