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Shingles

Key Points

  • Shingles is caused by the varicella zoster virus. It’s the same virus that causes chickenpox.
  • After you have had chickenpox, the virus remains dormant in your body. It can be reactivated at any point in your life, causing shingles.
  • Shingles results in painful blisters. They develop on your skin in infected nerve fibres, usually forming a rash in a band or strip.
  • The pain of shingles can remain, even after the rash is gone. This is called post-herpetic neuralgia.
  • Shingles can affect anyone, but is more common in people over 50.

FAQs

    Is there a shingles vaccine?

    Yes, there is a vaccine for the varicella zoster virus. The vaccination is available in the UK for adults aged 70 years old.

    The vaccine can reduce the risk of shingles by half. It can also reduce the pain of shingles in people who still get shingles after being vaccinated.
     

     

    See all FAQs

Shingles causes a painful, blistering rash that usually appears on one side of the body. It’s caused by the same virus that causes chickenpox.

About shingles

The varicella zoster virus that causes chickenpox can also cause shingles. After you have had chickenpox, the virus stays in your body, lying dormant or hidden in your nerve cells. At any time later in life, the virus can be reactivated, causing shingles (also known as herpes zoster).

When the virus is reactivated, it travels down nerve fibres to your skin. Painful blisters then develop on your skin, usually in a strip on one side of your body over where the infected nerve fibres run.

Shingles can affect anyone who has previously had chickenpox, but you’re more likely to get it when you’re an adult, especially if you’re over 50.

Animation – how shingles develops

Symptoms of shingles

Two or three days before you develop shingles, you may have a fever and generally feel unwell. It’s likely that you will feel a tingling or burning sensation in the affected area. This is usually on one side of the body and it can be very painful. You will then develop a rash in this area, consisting of red spots. This will usually appear in a band or strip following the affected nerves on your body.

A person with shingles rash in a band across the right side of the lower chest.

Shingles

Your spots will then turn into small, fluid-filled blisters. These blisters usually last between seven and 10 days before drying up and turning into scabs. Your scabs will heal and drop off within two to four weeks.

Example of a group of small shingles blisters filled with a cloudy fluid on the skin

Shingles

Symptoms are usually more severe in adults than in children.

Complications of shingles

The pain caused by shingles is often severe and can sometimes stay after your rash has gone. This is called post-herpetic neuralgia (PHN). Neuralgia is a sharp, shocking pain that follows the path of a nerve and is caused by irritation or damage to your nerve. It occurs in shingles because the virus affects your nerves.

PHN is more common as you get older, and more likely if your initial rash was severe and painful. Up to half of people who are older than 50 and get shingles will have some form of PHN. It usually goes within six months, but for some people, the pain can last for years. Your GP will be able to offer you some medicine to help manage your pain. The type of medicine will depend on the severity of your pain. Always read the patient information leaflet that comes with your medicine.

Occasionally, shingles can affect other parts of your body. If you develop shingles near your eye (ophthalmic zoster), you should see your GP as soon as possible. You might need to see an ophthalmologist (a doctor who specialises in eye health, including eye surgery). This is because your eye can be damaged by shingles if you don’t get the right treatment soon enough.

Sometimes, shingles blisters can become infected. Your GP may prescribe you antibiotics if this happens. Try to keep your rash clean and dry to prevent bacterial infections, and try not to scratch your blisters.

Causes of shingles

It’s not usually possible to say what causes the varicella zoster virus to reactivate but you’re more likely to get it if you: 

  • are over 50
  • are under stress
  • have an illness that weakens your immune system
  • are receiving chemotherapy or radiotherapy for cancer
  • are taking treatments that suppress your immune system (for example, medicines taken after an organ transplant)

You can’t catch shingles from somebody who has shingles, nor can you catch shingles from someone with chickenpox. However, you can catch chickenpox from someone with shingles if you haven’t had it before.

If you have shingles, you’re infectious until your lesions have dried and crusted over. Unlike chickenpox, shingles can only be passed on by direct skin contact with the affected area. Therefore, cover the area if possible.

Try to stay away from pregnant women, especially if they can’t remember having chickenpox before or they haven’t had the chickenpox vaccine. Also, stay away from babies younger than one and people with a weakened immune system.

Diagnosis of shingles

See your GP as soon as possible if you think you have shingles. He or she will ask you to describe the location of the pain. Pain in a band on one side of your body and the appearance of the rash will suggest shingles.

Treatment of shingles

Your GP will be able to prescribe you the best treatment depending on the severity of your shingles.

Shingles will resolve on its own within a few weeks without treatment, but dermatologists strongly recommend some form of treatment. Dermatologists are doctors who specialise in identifying and treating skin conditions. Without treatment, you may get pain, numbness, itching and tingling that can last for months or even years.

Self-help

Keep your shingles rash clean and dry. This will reduce the risk of your blisters becoming infected. Don’t use antibiotic creams or adhesive dressings, as this can cause irritation and slow down the healing process.

You can soothe your rash with ice cubes wrapped in a flannel or a tea towel. Don’t apply ice directly to your skin as it can damage it. You can also apply a soothing lotion (such as Eurax cream) to the rash. Some people may find that aloe vera gel provides some relief but there is no firm evidence that it gives any benefit.

Medicines

There are medicines available to help you control your symptoms and make the rash clear up more quickly.

Paracetamol and other over-the-counter painkillers will often help relieve the pain of shingles. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. If your pain is severe, your GP may prescribe you more powerful medicines. Ask your pharmacist or GP for advice if you’re unsure about how to manage your pain.

Antiviral medicines can make your symptoms milder and not last as long. They also help to reduce complications and prevent long-term nerve pain. You should start treatment with antivirals, which are prescribed by your GP, within three days of the onset of the rash and you will usually continue for seven to 10 days.

An injection containing an anaesthetic (a medicine used to completely block pain from a specific area) or a corticosteroid is sometimes given for intense pain. Post-herpetic symptoms can sometimes be helped with a local anaesthetic patch or capsaicin creams.

Prevention of shingles

A shingles vaccine has been developed, and was originally available for use in the USA.

From September 2013, a routine shingles vaccination programme began in the UK. The Zostavax vaccination is routinely offered to adults aged 70. A catch-up booster is also available if you’re 79 years old on 1 September 2013 (born 2 September 1933 to 1 September 1934) for the 2013 to 2014 year.

The vaccine aims to help boost immunity and reduce the occurrence and severity of shingles in adults aged 70 to 79 years old. For more information, see our FAQ, Is there a shingles vaccine?

There is also a different vaccine that can help prevent chickenpox. This will protect you from catching the varicella zoster virus in the first place. However, it’s only recommended for certain people, such as healthcare workers and for those in regular contact with someone who has a weak immune system.

If you have shingles, don’t go to work and stay away from schools and nurseries. This is in case you come into contact with people who haven’t had chickenpox before. Wait until your blisters have dried and crusted over, or make sure your rash is covered.

 

Reviewed by Alice Rossiter, Bupa Health Information Team, November 2013.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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