What is shingles?

Shingles is a viral infection which is caused by the same virus as chickenpox. After you’ve had chickenpox, the virus remains inactive in your nerve tissue. This means you don’t have the infection, but the virus that causes it is still present. Many years later, this virus can ‘reactivate’, which causes shingles. While there is no cure for shingles, it can be prevented and treated.

In most cases, Shingles appear as a rash which can occur anywhere on your body but most commonly appears around either the left or right side of your torso as a single strip of blisters. It is a contagious condition, meaning you can pass it on to someone else if you have it.

While shingles can be extremely painful, it’s not usually life-threatening, but fast treatment is recommended for most people to avoid any complications. 

Shingles is very preventable with a vaccine, which most people will be offered as they get older. In the UK, you are usually eligible to get the vaccine between the ages of 70 and 79. 

How common is shingles?

Shingles is an extremely common infection that will affect up to 1 in 3 people. Your likelihood of getting shingles also increases as you get older.

What are the symptoms of shingles?

The symptom usually associated with shingles is pain followed by a rash, but there are other symptoms you can get, and you may develop some of these before the rash.

Shingles Rash

The rash you get with shingles usually appears on your stomach or chest, but it can appear anywhere on your body (including your eyes, face, and genitals).

The rash is blotchy then blistering and tends to appear on only 1 side of your body. If you get a rash on both sides of your body, it’s probably not shingles.

What are the early signs of shingles

The first tell-tale signs of having shingles are:

• A painful and/or tingling feeling under areas of your skin
• Feeling generally unwell or having a headache

After these symptoms, you will usually get a rash in a few days (usually within 5 days). The shingles rash is the most obvious symptom of having the infection.

What does shingles look like?

Shingles most commonly appears as a red blotchy rash on the skin. The rash usually forms in clusters on one side of the body. The blotches that make up the rash eventually become blisters that ooze fluid. After this, the blisters start to dry out and scab over. This means shingles may look different depending on how long you’ve had it and what treatment you’ve had. 

What does shingles feel like?

Shingles can feel very painful. It can be a constant, dull and/or burning sensation that ranges from mild pain to severe. You may also experience sharp, stabbing pains from time to time. The area of skin that’s affected by the rash can also become very sensitive and tender while you have the infection. 

How long does shingles last?

Typical cases of shingles tend to last between 3-5 weeks. However, after the rash has gone, you can be left with long-term nerve pain if you develop a condition called postherpetic neuralgia (PHN). The older you are when you get shingles, the more likely you are to develop PHN.

Shingles Complications

The most common complication of having shingles is long-term nerve pain which is called postherpetic neuralgia (PHN). PHN affects between 10 and 18% of people that get shingles and becomes more likely the older you are when you get shingles. It usually occurs in the same area where you had the rash and can take months or even years to go away. The pain caused by PHN can be debilitating, taking a toll on your daily life, which can lead to mental health conditions such as depression and anxiety.

Other complications of shingles include: 

• Blindness (if shingles is affecting your eyes)
• pneumonia
• hearing problems
• brain inflammation (encephalitis)
• death

It is very unlikely to get these complications if you get treatment. The sooner you get treatment for shingles, the less likely you are to have complications.

When should I talk to my doctor about shingles?

If you think you have shingles, you should contact your doctor as soon as you can, especially if you think you may have it near your eye. If left untreated here, it can lead to permanent eye damage and blindness so it’s best to attend your local eye casualty or A&E as soon as possible. With shingles, the sooner you speak to a doctor and get treatment, the lower your chances are of getting any complications.

It’s also important to speak to your doctor as, in some cases, they may want to refer you to a hospital or for specialist advice. This can be because:

• they think you may have a complication of shingles, such as meningitis or encephalitis
• The infection is affecting your eyes, and you need rapid treatment
• They’re not sure about the diagnosis and need further investigation
• You have a persistent case that isn’t responding to treatment
• You’ve had shingles multiple times
• You’re pregnant
• You have a weakened immune system

What causes shingles?

Shingles is always caused by the varicella-zoster virus. After catching chicken pox, this virus remains in your system inactive. Later in life, it can reactivate, causing shingles. 

How does shingles start?

Shingles usually starts with a burning, tingling, or painful sensation on one side of the body or head. A rash will appear within 1 to 5 days of this. After this, the rash will turn into fluid filled blisters.

What increases your risk of shingles?

Your likelihood of developing shingles increases with age, meaning you become more at risk of getting it as you get older. Your risk is also increased by having conditions like:

• Rheumatoid arthritis 
• Asthma and chronic obstructive pulmonary disease 
• Chronic kidney disease 
• Depression
• Diabetes
• Systemic lupus erythematosus
• Wegener's granulomatosis 
• Malignancies

Being immunocompromised

Studies have shown that people who are immunocompromised are also more likely to develop shingles. In this study, the average rate of shingles in the immunocompromised group being tested was 7.8/1000, and for those over 80 years and older 12.6/10000. This was compared to the people who were not immunocompromised having an average rate of 6.2/1000. This shows clearly you’re more likely to develop shingles if you're older or immunocompromised. 

Physical & emotional stress

When you’re stressed, your body releases chemicals that can prevent your immune system from working as effectively. This can make it easier to become infected with shingles.

HIV and AIDS

People with HIV are more likely to get shingles because their immune system is weaker.

Bone marrow transplant

Before a bone marrow transplant, the conditioning you require weakens your immune system, making you more likely to get shingles.

Organ transplant

After an organ transplant, you need to take medication that can suppress your immune system to help your body accept the donated organ. While your immune system is suppressed you’re more likely to develop shingles.

Chemotherapy

Chemotherapy medication may temporarily weaken your immune system making it easier to catch shingles.

How is shingles diagnosed?

A doctor can usually diagnose shingles by looking at the rash on your skin. At Superdrug, our doctors can diagnose shingles online. All you need to do is upload photos of your skin, and our doctors can identify your skin condition.

If you see a GP or dermatologist, they may take a scraping of the fluid from a blister to send to a lab for analysis if there is any doubt. This fluid contains the virus that causes shingles, so if they spot this virus when examining your sample, they can be certain that you do have shingles.

How do I know if I have shingles?

You can usually spot shingles by the rash, which will be painful and only on 1 side of your body. You may also notice other symptoms before hand such as a tingling, itchy feeling beneath the skin or a feeling of general unwellness. If you do think you have shingles, you should speak to a doctor for a diagnosis, so you can start treatment as soon as possible.

Hives vs Shingles

While a shingles rash can appear anywhere on your body, it usually only appears on one side with blisters. Hives often appears all over the body, not just on one side. Hives also tend to be a lot more itchy rather than painful, whereas shingles is often painful.

Shingles vs chickenpox

While chicken pox and shingles both come from the same virus, they are different conditions. For a start, you can’t get shingles if you have never had chicken pox. Shingles is what happens when the virus that causes chicken pox reactivates later in life. The symptoms of these conditions also slightly differ with chicken pox causing a lot more itching and usually a more widespread rash and the shingles rash only affecting one side of the body.

How is shingles treated

There is currently no cure for shingles, but it is very treatable until you recover from the condition. Depending on the severity of the condition, it is either treated at home or in hospital if necessary. It’s usually recommended to start treatment if you have shingles as quickly as possible to avoid any complications. Once you’ve recovered from shingles, you can get it again, but this is extremely unlikely.

Treating shingles

How you treat shingles depends on the case, and while there is no cure for the disease, it usually clears up within 2-5 weeks with appropriate care. 

Shingles is usually treated with a combination of self care and prescription antiviral medication, but you may also be prescribed pain killers if you need them.

Self care

After developing a shingles rash, you will be advised on how to treat it at home. This will include:

• Keeping the rash clean and dry: This reduces the risk of the rash becoming infected with more bacteria
• Wearing loose fitting clothing: This can help you feel much more comfortable with the rash
• Avoiding plasters and topical antibiotics: using these can slow the healing progress
• Covering the blisters to avoid spreading the infection: It’s important to cover your blisters if in public to protect other people from the disease.
• You may also want to apply Calamine lotion as it has a soothing, cooling effect on the skin, which can help stop the itching.

Antiviral medication

Some people may be prescribed a course of antiviral antibiotics, which will usually last between 7 and 10 days. The most common antiviral medications used to treat shingles are:

• Acyclovir (Zovirax)
• Famciclovir
• Valacyclovir (Valtrex)

While these antivirals aren’t a cure for shingles, they can help stop the virus from multiplying, which can:

• Reduce how severe your case of shingles is
• Shorten how long shingles lasts
• Lower the likelihood of getting complications

Antiviral medications get working straight away and are best started within 72 hours of developing a shingles rash, so you should make sure you speak to a doctor for treatment as soon as possible.

Recent studies on the effectiveness of antiviral medications, including Valacyclovir, showed that participants reported less pain from shingles after taking medication. However, researchers did not find any differences among the medications compared in terms of fewer lesions, crusting over, or adverse events.

Natural treatments

There’s limited evidence that any home remedies are effective at treating shingles however some people have tried ways to treat shingles naturally, such as:

Dietary changes

A shingles diet consists of foods high in vitamins A, B-12, C, and E, and the amino acid lysine. These include:

• orange and yellow fruits
• leafy green vegetables
• red meat
• eggs
• chicken
• wild-caught fish
• dairy
• whole
• grains
• legumes
• beans
• tomatoes
• spinach

Foods to avoid include:

• food and juices with high amounts of sugar
• arginine-rich foods (including chocolate, gelatin, and nuts)
• refined carbohydrates
• foods high in saturated Fat

Soothing lotions and creams

While lotions and creams won’t speed up the healing process, they can be used to help itching, reduce scarring, and reduce pain. 

Baking soda and cornstarch paste

Some people use a paste made from baking soda or cornstarch, which is applied to the rash for 10-15 minutes several times a day to reduce itching and pain.

Herbal remedies

Some people feel that supplements and herbal medicines help your body fight the virus as well as treat insomnia and anxiety, which are often caused by the virus. These include:

• melatonin
• St.John’s Wort
• oregano oil
• Echinacea
• lemon balm
• green
• tea
• essential fatty acids

Before trying a herbal or natural remedy, you should always speak to your doctor first to make sure it’s safe and suitable as part of your treatment plan.

How to prevent shingles

The best way to prevent shingles is by making sure you get the vaccine when you’re eligible to get it. It’s a vaccine that usually only requires a single dose, and has been shown to be effective at preventing the disease or making the disease more mild if you do get it.

There are 2 shingles vaccines used in the UK:

• Zostavax, a live vaccine given as 1 dose
• Shingrix, a non-live vaccine given as 2 doses, 2 months apart

Most people will be given the Zostavax vaccine. The Shingrix vaccine is usually only recommended if Zostavax is not right for you.

These vaccines are considered safe and effective, protecting from shingles for up to 5 years.

Dietary changes

While changing your diet won’t guarantee you don’t get shingles, you can help to make sure your immune system is functioning as well as it can be by eating a balanced, healthy diet.

Lifestyle changes

You can also prevent shingles by trying to reduce stress and by getting plenty of rest. Stress can weaken your immune system which makes shingles more likely, so the generally healthier you are (both mentally and physically), the less likely you are to get shingles.

Sources

Shingles: What are the risk factors? NICE [accessed 17 August 2022]

Shingles NHS Inform [accessed 17 August 2022]

Shingles NHS [accessed 17 August 2022]

5 Things You Need to Know About Shingles National Institute of ageing [accessed 17 August 2022]

Painful Rashes Stockton Dermatology [accessed 17 August 2022]

4 Ways Shingles Is More Than Just Adult Chickenpox PennMedicine [accessed 17 August 2022]