Shingles

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.

Symptoms of shingles

The main symptom of shingles is pain, followed by a rash that develops into itchy blisters. These look like chickenpox.

Sometimes shingles causes symptoms that develop a few days before the painful rash. This includes symptoms like:

• a headache
• burning, tingling, numbness or itchiness of the skin in the affected area
• a feeling of being generally unwell
• a high temperature (fever)

Shingles rash

The shingles rash usually appears on one side of your body. It develops on the area of skin related to the affected nerve.

New blisters can appear for up to a week. 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.

Examples of the shingles rash

Shingles pain

Most people with shingles experience a localised band of pain in the affected area.

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.

Getting advice from a GP or pharmacist

Contact your GP practice if:

You haven’t had chickenpox before, you’ve been exposed to someone who has chickenpox or shingles and you:

• are pregnant
• have a weakened immune system (the body’s natural defence system)
• are under 18 years old

If your GP is closed, phone 111.

Speak to a pharmacist if:

• you’re 18 years or over and have symptoms of shingles

If the pharmacist cannot treat you they may recommend you see your GP.

Find your nearest pharmacy

Causes of shingles

When you catch chickenpox the virus stays in your body. It can become active again later on if your immune system is lowered and cause shingles.

Your immune system can be lowered by things like:

• stress
• other illnesses or conditions
• treatments like chemotherapy

It’s possible to have shingles more than once, but it’s very rare to get it more than twice.

Treating shingles

There’s no cure for shingles. But, there are ways to ease your symptoms until the condition improves.

Shingles symptoms usually get better in 2 to 4 weeks.

Speak to your GP or pharmacist as soon as you get symptoms of shingles. Early treatment may help to reduce the severity of the condition and complications.

Treating symptoms at home

Do

• keep the rash as clean and dry as possible
• wear loose-fitting clothing
• use a cool damp cloth to soothe the skin and keep blisters clean
• try calamine lotion to help relieve itching

Don’t

• do not let dressings or plasters stick to the rash
• do not use antibiotic cream – this slows healing

Other treatments for shingles

Your GP or pharmacist may recommend painkillers to ease discomfort caused by shingles. This includes:

• paracetamol
• non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• opioids – used for more severe pain
• antidepressants – used for severe pain
• anticonvulsants – used for severe pain

Some people with shingles may also be prescribed antiviral tablets.

Preventing the spread of shingles

You can’t give shingles to other people. But, other people can catch chickenpox from you if they haven’t had it before.

If you have shingles, you’re contagious until the last blister has dried and scabbed over.

To help prevent the virus being passed on:

Don’t

• do not share towels or flannels
• do not go swimming
• do not play contact sports
• do not go work or school if your rash is weeping (oozing fluid) and can’t be covered

Chickenpox

Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:

• pregnant women who haven’t had chickenpox before
• people with a weak immune system, for example someone with HIV or AIDS
• babies less than 1 month old (unless it’s your own baby)

Complications of shingles

Complications can sometimes occur as a result of shingles. They are more likely if your immune system is low, (the body’s natural defence system), or are elderly.

Shingles is rarely life threatening. Complications, though, can mean that around 1 in every 1,000 cases in adults over the age of 70 is fatal.

Complications can include:

• postherpetic neuralgia
• eye problems
• Ramsay Hunt syndrome
• the rash becoming infected with bacteria
• white patches (a loss of pigment) or scarring in the area of the rash
• inflammation of the lungs (pneumonia), liver (hepatitis), brain (encephalitis), spinal cord (transverse myelitis), or protective membranes that surround the brain and spinal cord (meningitis) – these complications are rare.