Shingles slideshow: Photos of shingles (herpes zoster)

A magnified, colour-enhanced view of Varicella zoster viruses.

Small blisters form during the initial stage of shingles.

After a person has chickenpox, the virus lies dormant in the nervous system.

Shingles most commonly occurs in people over the age of 60.

Shingles blisters eventually burst and crust over.

Shingles can be spread to individuals who have not had chickenpox.

A dangerous complication of shingles infecting the eye.

Some treatments can reduce the severity and duration of the shingles rash.

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What is shingles?

Shingles (herpes zoster virus) is a painful viral infection of the nerve roots. The virus moves along the nerve fibres and affects cells of the skin, resulting in a skin rash. Caused by the same virus behind childhood chickenpox, the virus is never fully cleared from the body and shingles occurs when the virus reactivates.

What does the shingles rash look like?

Pain, itching, tingling, burning -- these are all symptoms of shingles that may occur before the outbreak of the rash. Starting as small blisters on a red base, with new blisters continuing to form for three to five days, shingles is painful. If you think you have shingles, seek medical advice as soon as possible.

What causes shingles?

After you've had chickenpox, the virus lives in your nervous system, 'sleeping' in the nerve roots. In some people, it remains asleep (dormant) forever. In others, a weakened immune system may cause the virus to 'wake up', reproduce and travel along nerve fibres to the skin's surface. The result: Shingles. When the virus becomes active again, it can only cause shingles, not chickenpox.

Who’s at risk of shingles?

Anyone who has had chickenpox is at risk of developing shingles, although it occurs most commonly in people over the age of 60. Weakened immune systems, emotional stress and cancer can all cause the virus to reactivate. The NHS says about one in five people will get shingles during their lives.

How long does shingles last?

The clusters of blisters that form with shingles fill with fluid, pop, then start to ooze. Eventually the affected areas crust over and heal like the rash shown here. The whole process may take three to four weeks from start to finish. Once all of the blisters are crusted over, the virus can no longer be spread.

Is shingles contagious?

Yes, shingles is contagious. The virus can spread to anyone who hasn't had chickenpox, through direct contact with the open sores of an infected person, as long as that person has new blisters forming and old blisters healing. Instead of developing shingles, the newly infected person develops chickenpox. Once they've had chickenpox, they can't catch it again, though they do now have the potential to develop shingles later in life.

What are the complications from shingles?

Generally, shingles heals well, resulting in few problems. Occasionally blisters can become infected, requiring treatment with antibiotics. The most common complication of shingles is postherpetic neuralgia, where damaged nerves cause persistent pain even after the rash is gone. A complication causing more concern is when shingles affects the forehead and nose, which may spread to the eye and lead to loss of vision.

How is shingles treated?

There is no cure for shingles, but treatment may help you get better sooner and prevent problems. Cool compresses and anti-itching lotions like calamine may provide relief, as will bathing the affected area and cleaning with soap and water. Steroids, antiviral medicines and pain medicines can also help ease recovery. Most people with intact immune systems recover completely from shingles although recurrences are possible.