Shingles, also known as 'herpes zoster', is caused by a viral infection of the nerves supplying a particular area of skin.

Symptoms

The first symptoms to appear often include chills, feverishness, feelings of sickness, cramps, diarrhoea and feeling generally unwell. Certain areas of skin then become tender, tingling, itchy, burning or numb. This is usually accompanied by shooting or stabbing pains. Red spots appear which become inflamed until painful fluid-filled blisters develop. The blisters then weep until they eventually dry up and form scabs. Because the virus affects the nerves, the rash usually appears over broad strips of skin supplied by the affected nerve. These strips commonly appear down the ribs on one side of the body, down the neck and along an arm, down a leg or down one side of the face.

Some people continue to experience nerve pain for a long time after the rash has cleared up. This is known as 'post herpetic neuralgia'.

Causes

Shingles is caused by the varicella zoster virus. Initial infection by the virus usually occurs during childhood in the form of chickenpox, which means you can only develop shingles if you have already had chickenpox. The virus can lie dormant in the nerve tissue causing no symptoms at all until one of the following triggers activate the virus causing shingles

  • Age (shingles mainly affects those over 50 years of age)
  • Stress
  • Feeling generally run down
  • Poor diet
  • Infection
  • Tiredness. A weakened immune system caused by illnesses such as Hodgkin's disease and AIDS
  • A weakened immune system caused by cancer treatment or by taking steroids or immunosuppressants

Your doctor will probably be able to diagnose shingles by examining your rash. This diagnosis can be confirmed by sending either a blood sample or a sample of fluid from the blisters to a laboratory for testing.

While You Have Shingles

To prevent the spread of infection, take care not to let the fluid from the blisters come into contact with anyone else.Do not share flannels or towels and remember to change bed linen regularly.Avoid close contact with anyone who has not had chickenpox. Wash your hands before, and after, touching any affected skin or applying cream.

Try not to scratch.

Treatment

Simple pain relief treatments, such as paracetamol, can help to ease the pain associated with shingles. Alternatively, you may wish to take an anti-inflammatory pain reliever such as aspirin or ibuprofen. These medicines can cause irritation of the stomach so if you have ever suffered from stomach or intestinal ulcers or any other stomach problems, check with your doctor or pharmacist first. You should also not take them if you suffer from asthma.Itching can be relieved by applying a cooling lotion such as calamine or crotamiton. Ask your pharmacist for advice. An antiviral medicine containing aciclovir, famciclovir or valaciclovir can help to speed up recovery. They work by slowing down the multiplication of the virus. Antivirals used to treat shingles are available as tablets, cream or eye ointment. They must be used as soon as diagnosis is confirmed (i.e. within 72 hours of the appearance of the rash).If the blisters become infected, your doctor may prescribe a course of antibiotics either in the form of tablets or a cream.If the infection spreads towards your eyes, your doctor will probably refer you to an eye specialist for immediate attention. In such a case, you may be given antiviral eye drops.If you experience long-lasting pain after you have had shingles, your doctor may decide to give you a medicine to help ease the pain. Some of the medicines which can help to ease the pain of shingles include amitriptyline, carbamazepine, sodium valproate, phenytoin and gabapentin.

Long-lasting pain can also be treated with capsaicin cream once the blisters have healed.

When To See A Doctor

Make an appointment to see your doctor if you think you may have shingles.

It is especially important to see a doctor if the infection spreads towards your eyes.