Shingles: Picture, symptoms, diagnosis, treatment
What causes shingles?
Shingles is caused by the varicella-zoster virus that's also responsible for causing chickenpox.
Shingles usually causes a rash or blisters on the skin.
Only people who've had chickenpox can develop shingles.
The virus 'hides' inactive in nerve cells, but can be triggered later in life to cause shingles.
People in their 70s are now offered a vaccination on the NHS to protect against shingles.
Who gets shingles?
It isn’t yet known why the virus is reactivated in some people but not others.
However, risk factors include:
- Having a weakened immune system
- Being over 50
- Having other illnesses
- Suffering trauma
- Being stressed.
What are the symptoms of shingles?
Symptoms of shingles include:
- Pain or bruised feeling - usually on one side of your face or body - often along with a fever, chills, headache or upset stomach. People will often feel unwell for several days before the rash appears.
- Tingling, itching or prickling skin and an inflamed, red skin rash several days later.
- A group or long strip of small, fluid-filled blisters.
- Deep burning, searing, aching or stabbing pain, which may occur once in a while or last a long time.
- A complication of shingles for at least 1 in 10 people with the condition is post-herpetic neuralgia. This severe nerve pain lasts for more than 3 months after the rash has cleared up.
Doctors don’t know why the shingles virus gets activated. As well as lowered immunity, becoming older increases the risk and suffering from stress may trigger a shingles outbreak.
How is shingles diagnosed?
Shingles is diagnosed based on the symptoms, an examination of any rash or blisters and the person's medical history.
Shingles blisters tend to appear in a band on one side of the body.
A swab from the blister or skin scraping may be sent for laboratory tests.
How is shingles treated?
Shingles cannot be cured, but symptoms of pain and discomfort can be relieved. Other treatments may help with healing the blisters and rash.
Antiviral medications, including aciclovir, famciclovir and valaciclovir, may help reduce the length of time symptoms last and ease discomfort.
These antiviral treatments usually need to begin within 72 hours of the first sign of a shingles outbreak.
Painkillers can also help with pain from shingles.
Mild pain may be helped with over-the-counter paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
However, stronger prescription drugs may be recommended for nerve pain.
Corticosteroids (steroids) may help with inflammation and itching.
Is shingles contagious?
Contact with shingles can cause chickenpox in people who have never had chickenpox before, or who have not been vaccinated against chickenpox.
Is it shingles or something else?
Small blisters that appear only on the lips or around the mouth may be cold sores rather than shingles.
Itchy blisters that appear after gardening or spending time outdoors could be an allergic reaction to plants or trees. Seek medical advice if you are unsure.
Seek medical advice if:
- You suspect an outbreak is beginning. If you take antiviral drugs in the early stages, you may shorten the course of the infection.
- Shingles on your face spreads near your eye, to avoid possible cornea damage.
- The affected area becomes secondarily infected with bacteria (indicated by spreading redness, swelling, a high fever or pus). Antibiotics can help halt the spread of bacterial infection but not the shingles itself.
- Your rash lasts longer than 10 days without improvement.