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What is shingles (Herpes Zoster)?
Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus. This is the same virus that causes chickenpox. Anyone who has had chickenpox may develop shingles later in life as the virus remains in your nervous system long after you have recovered.
The virus can be reactivated at a later date, causing shingles. It’s not known exactly what causes this reactivation, but it may be linked to having a lowered immunity (your body’s ability to protect you from infection and disease). Common causes of changes to your immune system are:
- old age
- physical and emotional stress
- taking medication that affects your immune system, such as chemotherapy medication
- recently having had an organ or bone marrow transplant
- having a condition that affects your immune system, such as HIV or AIDS
Although shingles can occur at any age, it is most common in people over 70. One in four adults are estimated to experience shingles at some point in their lives, and it is possible to get shingles more than once. Although the virus belongs to the herpes family, it is not the same as the viruses that cause genital herpes or cold sores.
Last reviewed: 16-04-2020 by Dr Simran Deo
What does shingles look like?
The main symptom of shingles is pain followed by the development of a rash. An outbreak of shingles usually lasts 2-4 weeks. The rash can appear on any part of your body, including your face and eyes, but is most common on your chest, stomach, or back. Some people experience early symptoms before the rash appears. These can include a headache, generally feeling unwell, a burning, tingling, itching or numbness of an area of skin, or a high temperature.
Most people with shingles feel burning, tingling or pain at the affected area a few days before the rash appears. The pain may feel constant, dull or burning, and can be mild or severe. You may also experience sharp stabbing pains. The pain can remain for a few days or weeks after the rash has cleared up.
The rash is initially red and blotchy, but like chickenpox, it can develop into itchy blisters. New blisters can appear for a week, but they should dry out and flatten, and look yellow as they start to scab over. Scabs may leave slight scarring, and usually take 2-4 weeks to heal completely, however the tingling or stabbing pains may remain for long after the outbreak has gone.
Is herpes zoster (Shingles) contagious?
You can’t catch shingles from someone who has shingles but if you haven’t had chickenpox there is a low risk of catching the chickenpox virus from them.
Chickenpox is usually transmitted when you come into direct contact with the open sores of someone suffering from shingles, as the fluid in the blisters contain the virus.
Because getting chickenpox as a child is so common in the UK, 9 out of 10 adults will have already been infected with the virus, and will therefore not be at risk of catching it again.
However, patients with shingles should avoid contact with high-risk groups, such as pregnant women and newborn babies.
What is the treatment for shingles?
There is no cure for shingles. However, if you think you have shingles you should see your GP as soon as possible. They will be able to confirm the diagnosis based on your symptoms. Although shingles is not usually serious, early treatment can help relieve the severity of your symptoms and the risk of developing complications. To help relieve the symptoms of your rash you can:
- Keep blisters as clean and dry as possible.
- Wear loose-fitting clothing to prevent rubbing and irritation of the skin.
- Make sure blisters are covered with clothing or non-stick dressings. This should prevent you from transmitting the virus to other people.
- Don’t cover the rash with plasters or use antibiotic creams as this can slow the healing process.
- Apply calamine lotion to help cool the skin and relieve itching.
- Apply a cool compress (a flannel soaked in cold tap water) to weeping blisters, for no more than 20 minutes at a time, several times a day, to help soothe and clean them. Make sure you don’t share your flannel, to prevent transmission.
Your GP may also recommend taking a painkiller, such as paracetamol or ibuprofen, and they may prescribe a stronger painkiller if the pain is severe. Your GP may also prescribe a course of antiviral medication, which won’t kill the virus, but instead stops it from multiplying.
There is a vaccine for shingles, which can be offered to eligible people over 49. The vaccine is available via Superdrug Health Clinics.
Pregnancy and shingles
Complications that can affect the unborn baby vary, depending on how many weeks pregnant you are at the time of contracting the infection.
However, you should see your GP if you think you have been exposed to someone with shingles and you haven’t had chickenpox before.
Complications of shingles
Although uncommon, shingles can cause complications, particularly if you are at risk of having a lowered immunity. Some of the most common complications are:
Post-herpetic neuralgia – Some people continue to experience severe nerve pain long after the rash has cleared up. This is caused by damage by the virus to your nerve fibers. Typically, one in five people with shingles will develop post-herpetic neuralgia. The pain usually goes away within a year, but in some cases it can be permanent. It can often be treated with specific painkillers.
Ophthalmic shingles – Shingles in or around your eye can be painful and can lead to further infections, including conjunctivitis (inflammation of the eye with a sticky discharge) and sores. Other problems such as scarring of the eye’s surface or glaucoma (a buildup of pressure in the eye) can also develop. Quick treatment is required to help prevent permanent vision problems.
Skin infections – Open sores on your rash can get bacterial infections. Developing a high temperature could be an indication of this, so see your GP if you get a fever.