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.

Shown is a magnified, colourised view of varicella-zoster viruses.

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, like the boy in the picture, 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 three people in every 1,000 have shingles in the UK every year.

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 fluid from 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 now have the potential to develop shingles later in life.

What are the complications of 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 much 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 with plain or salt 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.

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