What is shingles?

Shingles is caused by the re-activation of the varicella zoster herpes virus, which is also the virus that causes chickenpox. Once you have had chickenpox the virus remains dormant in your body within a single sensory nerve. It can become active again at any time but particularly when your immunity is low. Your immunity or ability to fight infection may be lowered by several things including old age, stress, illness, injury, chemotherapy, HIV/AIDS or after organ transplantation.

Symptoms

The first symptom is often sensitivity, tingling, itching or pain in a band on one side of the body. Any part of the body can be affected although most commonly the trunk, face and even eyes. The rash then appears on the area of skin supplied by the affected nerve. You may also experience a headache, fever and feel generally unwell.

Initially the rash looks red and blotchy and then it will blister looking similar to chickenpox. New blisters may continue to appear for up to a week and gradually the lesions will scab over. It usually takes 2-4 weeks for the rash to resolve. Some people may get some pain continuing in the area once the rash has resolved and this is called postherpetic neuralgia and is caused by damage to the nerve fibres in question.

So, is shingles contagious?

Many people think that shingles is contagious, however, if you have had chickenpox you cannot catch shingles from someone else who has shingles. If you have never had chickenpox or have not received the chickenpox vaccine you can catch chickenpox from someone with shingles. Covering the rash with clothing or some sort of dressing, and maintaining strict personal hygiene will decrease the risk of spreading infection to others. If you have shingles you are contagious until the lesions are all scabbed over, which is usually 10-14 days.

If you have shingles you should avoid contact with anyone who hasn’t had chickenpox, especially pregnant women, people with a weak immune system and very young babies as they are at risk of catching chickenpox.

Treatment

Keep the rash clean and dry. Calamine lotion may be soothing. Pain relief may be needed. Antiviral medications (aciclovir tablets/creams) are sometimes prescribed but should ideally be started within 24-72 hours after the onset of the rash. A vaccination is now available to prevent shingles.