All about shingles
It’s not a walk along a pebbled beach, and it’s certainly less enjoyable. Shingles affects one in five people in their lifetime and can cause long-term pain. Fortunately, most people will recover completely if they see their doctor early for treatment.
Shingles – what is it?
Shingles is an infection caused by a virus called varicella-zoster or herpes zoster – the same virus that causes chickenpox (but not the same as the herpes virus that causes cold sores). Confusingly though, you don’t exactly ‘catch’ shingles in the way you catch other viral infections like colds. Instead, you may get shingles if you’ve had chickenpox in the past. The virus lives in on in your nerve roots, next to your spinal cord, after you’ve recovered from chickenpox. After years of causing no symptoms, it can become active again and start multiplying, causing the typical shingles rash.
Although you can’t ‘catch’ shingles, you can catch chickenpox from someone who has shingles (but you need to touch the blisters to catch it).
What causes it?
There is often no trigger for shingles. It can happen after stress, or because you’ve been ill for another reason. Medicines like cancer chemotherapy and steroid tablets also increase your risk by weakening your immune system.
What are the symptoms?
Shingles just affects the skin served by one (or occasionally two or three) nerve roots of the spine. It only affects a band of skin over one half of the body – usually the chest or tummy, although the face around the eye is also commonly involved. The first symptom is usually a band of pain over this area of skin, which can be a dull ache or sharp, stabbing or burning. It’s followed two or three days later by a red rash which blisters for up to a week then scabs over and fades over the next few weeks.
The pain usually lasts for two to four weeks. Most people recover completely after this and it’s uncommon to get shingles more than once in a lifetime. However, if you’re over 50 (and especially over 60) or your immune system is weak, you’re more likely to get longer term nerve pain, called neuralgia. Fortunately, you can reduce your symptoms by getting treatment early.
If shingles affects the skin round your eye, it’s important to get regular follow up from your doctor to ensure the infection doesn’t spread into your eye.
What’s the treatment?
Some people don’t need treatment, as symptoms will usually settle on their own. However, some people are at higher risk of developing complications, and this can be reduced by taking anti-viral tablets for about a week. Do see your GP as soon as you get symptoms – the earlier treatment is started, the more effective it is.
You’re in a higher risk group if:
- You’re over 50
- You have a medical condition or are taking tablets that may weaken your immune system
- You have shingles anywhere other than your tummy or chest wall
- You have severe pain
How can I help myself?
- Simple measures that will help include:
- Keeping cool
- Wearing loose-fitting clothes
- Cold compresses
- Painkillers like paracetamol (if these aren’t strong enough, talk to your GP)
Neuralgia – what is it?
Neuralgia is the medical name for any nerve pain. You can get continued nerve pain after the rash of shingles has faded; people with diabetes can get neuralgia (especially in their feet); and trigeminal neuralgia is a nerve pain affecting part of the face and scalp around the ear.
All neuralgia is treated by medicine to try and make the nerves less sensitive. The most effective medicines were all developed to treat other conditions of the nervous system. One of the most widely used is amitriptyline, first used to treat depression. Two drugs used for epilepsy – gabapentin and pregabalin – can also be very effective.