Shingles is a painful rash that tends to affect one side of the body, most commonly on the chest or abdominal area. This most often affects people over the age of 50, but can occur in younger people whose immune system is not at peak performance. Shingles is caused by a reactivation of the chickenpox virus that lies dormant in the nervous system. A drop in immunity can allow this virus to be reactivated, but the virus can only “travel” along the nerve in which it is trapped , which is why the rash of shingles (= reactivated chickenpox) is confined to certain areas and not widespread like the original chickenpox infection.
The condition can start with a few days of pain in a part of the body, sometimes a burning or tingling, itchy feeling. A few days later the red rash appears, followed by clusters of tiny blisters on the red patches. These blisters contain the virus and are infectious. If you have never had chickenpox or been immunised against it, you could become infected from a shingles blister. Persons with shingles should avoid contact with others who have never had chickenpox or been immunised against it, especially if the un-immunised person is pregnant or has an immune deficiency. The shingles blisters dry out after a few days, but they may burst open and become infected with skin bacteria. Normally, by the 7th -10th day, the blisters are scabbed over and the person is no longer infective.
Shingles is seldom a serious condition, but about 10% of persons will have persistent pain for months or even years after the rash has totally disappeared. The pain may be severe enough to need long-term painkillers and may lead to insomnia and depression.
As for all virus conditions, treatment is difficult: within 72 hours of the onset, antivirals (and in some cases certain gels) may be of help to speed up recovery and protect against long-term pain. Pain medication is always useful, and the rash itself must be kept clean and dry. Each case is dealt with individually according to the extent and severity, but in general the sooner treatment is started the better the outcome.
A shingles vaccine is available and is advised for persons over the age of 50 who have had a prior attack of shingles. The vaccine is not suitable for everyone so please ask your doctor for advice on this.