Our grateful thanks to the patient support charity, the Shingles Support Society for their input to our radio report, which you can hear again via the audio player at the bottom of this page, and for the use of the information below. To access the Shingles Support Society website click here.
What is shingles? It (herpes varicella-zoster) is a reappearance of chickenpox. This often happens many years after the original chickenpox infection.
What are the signs and symptoms of shingles? Most often people get shingles on the left or right side of the torso, on a patch of skin served by nerves from a single ganglion (nerve ‘junction box’). This often follows the line of a rib. Sometimes, it will instead appear somewhere else on the face/head or the body.
Red patches are usually the first sign of the rash appearing, and there may also be itching, tingling or burning under the skin.
Pain around the affected area, usually on one side of the torso, sometimes elsewhere on the body. This will usually be in one dermatome, which is the area of skin served by one nerve junction. You can see the dermatomes: each is a stripe in the diagram of the body, above.
Some people may feel very tired or may develop a slight temperature.
Fluid filled blisters that burst and weep and turn into sores. They may not come up all at once, but form and slowly heal over a period of 2 to 5 weeks. The skin then crusts over and heals, apart from a little sensitivity or ‘nerve ache’ which soon disappears. This may signal the end of the shingles for many people but some people develop post herpetic neuralgia (PHN -see below)
How do people get shingles? When you recover from a chickenpox infection, the virus retreats to a neural ganglion (junction box) in the nerves beside the spine. It remains there in a dormant state for the rest of your life. One day, something ‘triggers’ the virus to reactivate (perhaps when you are run down or unwell, but no one really knows why) and it comes out as shingles.
Who will get shingles? Anyone who has had chickenpox can develop shingles – and most people have chickenpox in childhood: it is one of the common childhood illnesses and is usually trivial. (Chickenpox in adults can be more severe and if they are seen by the doctor within 24 hours of the onset of the rash, they will be given antiviral pills.)
Shingles is more likely to occur in older people.
People who have not had chickenpox cannot get shingles. (Some people with shingles believe that they have never had chickenpox. This simply means that their original bout of chickenpox was mild and not diagnosed – or they have forgotten because it was a long time ago.)
Is shingles common? Yes. About 194,000 people (this is the number for the England and Wales) get shingles every year. About half of these will develop post herpetic neuralgia (PHN).
Can you catch shingles? (Is shingles contagious or infectious?) People do not catch shingles – it happens to people who have previously been infected with chickenpox.
Shingles is infectious for people who have not had chickenpox – but they have to touch the rash to catch the virus. They will then develop chickenpox. People who have had chickenpox already will not be at risk.
When people who have had chickenpox encounter the disease again, it increases their immunity and means they are less likely to develop shingles.
Can shingles be treated? For the early shingles rash, your doctor may prescribe a course of anti viral treatment. These do not work for everybody, but if treatment is started within 72 hours, it may reduce the severity of the episode. This is why it is important to visit the doctor as soon as you become aware of the first symptoms of shingles so that treatment can be started immediately.
What can I do to help my shingles? Keep the sores clean, but do not use scented soaps or bath oils and do not rub too hard as this will delay healing. You can sooth the rash with ice cubes wrapped or a pack of frozen peas wrapped in a towel (so as to avoid frost-bite) or a soothing lotion (such as calamine) applied to the rash. Some people have found aloe vera gel gives relief.
Wear loose fitting, comfortable clothes preferably in a natural fibre such as cotton.
You may find vitamins help, especially those related to skin and nerve healing like vitamins A, E and B-complex. Most vitamins depend on a good supply of other vitamins to function efficiently, so make sure your diet contains plenty of fresh fruit, vegetables and cereals. Remember – the skin will heal, so try not to worry.
A vaccine to prevent shingles. There is a vaccine to prevent shingles - currently Shingrix in the UK - offered on the NHS to 70-79 year-olds, people 50+ with certain health conditions, and 60-64 year-olds are gradually being added to the programme.
Data shows the vaccine is 90% effective at preventing shingles in people aged 70 and over. 85–97% effective in people aged 50 to 69 It doesn’t guarantee you’ll never get shingles, but: If you do get it after being vaccinated, it’s likely to be much milder. You’re far less likely to develop serious complications like post-herpetic neuralgia (PHN)
Post-herpetic neuralgia (PHN). PHN is the name given to the shingles pain when it has been going on for a month or more after the shingles sores have healed.
Post herpetic neuralgia can be felt as itching, irritation, stabbing, burning, tingling, supersensitivity, numbness or soreness but to simplify our text we will always call it “pain”. If this happens, it will be in the area where you had the shingles – not elsewhere on your body.
When does PHN happen? Post herpetic neuralgia may begin as the symptoms of shingles subside and can last a few weeks, months or occasionally years. It can appear several weeks or even months after the shingles has gone.
Why does PHN happen? PHN happens when the chickenpox virus damages a sensory nerve during the shingles outbreak. The damaged nerve sends abnormal messages or even stops sending them so there is numbness. Sometimes there can be changes in nerves in the spinal cord – this is why cutting the affected nerve does not stop the pain of PHN.
As you get older, your chance of developing PHN increases.
Listen to this weeks radio report
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