Shingles

Shingles is a painful skin rash, caused by the varicella zoster virus, the same virus that causes chickenpox.

Summary

After you recover from chickenpox, the virus stays in your body. It moves to the roots of your nerve cells (near the spinal cord) and becomes inactive (dormant). Later, if the virus becomes active again, shingles is the name given to the symptoms it causes. 

You can only get shingles if you’ve had chickenpox in the past (usually as a child). While anyone who has recovered from chickenpox may develop shingles, the risk of shingles increases as you get older.

It is not known what exactly causes the virus to become active again, but the risk of getting shingles is greater in people with a weakened immune system.

Shingles is also known as herpes zoster (a different disease to herpes simplex).

From 1 April 2018, shingles vaccine will be free from general practices for adults at age 65.  Until 31 March 2020, those aged 66 to 80 inclusive will also be eligible for free shingles immunisation.

You can’t catch shingles from someone else. However, if you’ve never had chickenpox, or received the chickenpox vaccine, you can catch chickenpox from close contact with someone who has shingles, because the shingles blisters contain the chickenpox virus.

As the virus is spread through direct contact with fluid from the rash blisters, a person with shingles is infectious when the rash is in the blister phase. Once the rash has developed crusts, the person is no longer infectious. 

Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered. If you have shingles, you should:

  • cover the rash
  • avoid touching or scratching the rash
  • wash your hands regularly to prevent the spread of varicella zoster virus
  • avoid contact with the following high risk groups until the rash has developed crusts:
    • pregnant women who have not had chickenpox or the chickenpox vaccine
    • premature or low birth weight infants; and
    • people with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients and people with HIV infection.

Symptoms

Shingles is a painful rash that develops on one side of the face, body or head. The rash is made up of small blisters that typically scab over after 7–10 days.

Before the rash develops, people often have pain, itching or tingling in the area where the rash will develop. The rash most commonly occurs around the back or upper abdomen but can also occur on one side of the face.

Other symptoms of shingles can include:

  • fever
  • headache
  • chills
  • upset stomach.

The pain or irritation from shingles will usually go away in 3 to 5 weeks. However, if the virus damages a nerve, you may have pain, numbness or tingling for months or even years after the rash is healed. This chronic condition is most likely to occur in people over 50. Antiviral medicine can help prevent this condition.

Call Healthline 0800 611 116 if you are unsure what you should do.

Other complications

If you get shingles on your head or scalp, you may get headaches and weakness on one side of your face (causing that side of your face to look droopy). This usually goes away, but it may take many months – especially if you’ve had a lot of weakness of your face muscles.

Some people also develop painful eye or ear inflammations and infections with shingles.

Treatment

When you should see your doctor

Go to your doctor as soon as you see the rash, as treatment is most effective if it’s started early.

Your doctor may prescribe antiviral medicine, which may help you recover faster and will reduce the chance that the pain will last for a long time.

Your doctor may also give you medicine for pain relief.

See your doctor again if:

  • you get any blisters on your face
  • your fever or pain gets worse
  • your neck gets stiff, you can’t hear properly or you feel less able to think clearly
  • you develop new symptoms such as drooping or weakness to one side of your face
  • the blisters show signs of infection (eg, they become more sore or red) or if you see milky yellow drainage from the blister sites.

Call Healthline 0800 611 116 if you are unsure what you should do.

Self care

  • Take a painkiller such as paracetamol, and any other medicine your doctor prescribes.
  • Put cool, moist washcloths on the rash (wash any used washcloths).
  • Rest in bed during the early stages if you have fever and other symptoms.
  • Wear loose clothing to reduce friction/rubbing of the blisters.

Prevention

The best protection against shingles is immunisation. The shingles vaccine (Zostavax) is free at age 65 years.

Until 31 March 2020, anyone aged from 66 to 80 years is also eligible for a free shingles vaccine.

Talk to your doctor if you are immunosuppressed or immune deficient as the shingles vaccine may not be suitable for you.

Those aged 50 to 64 years who are at increased risk of shingles or are a household contact of an immune compromised individual may also benefit from the vaccination, however a cost will apply for this age group. 

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