What is Shingles
Shingles (herpes zoster) is caused by the same virus as chickenpox, the varicella zoster virus. The virus remains dormant in the nerve cells of the body after contracting chickenpox and is consequently reactivated. Those that have had chickenpox are at risk of developing shingles, although more than one attack is rare.
Half of all shingles cases occur in those aged 60 or over; other groups more susceptible include those undergoing cancer treatments, organ transplant patients and people suffering from stress.
While shingles itself isn’t contagious, those that haven’t been exposed to the varicella zoster virus can contract chickenpox if in contact with a person who has shingles.
Shingles can be spread by a person coming into contact with the fluid from the blisters that form on the skin. The virus can be spread by direct contact or by contact with dressings, bed linen or clothing that contain discharge from the sores. Keeping the blisters covered can prevent others from contracting the virus.
Shingles can affect any part of the body, most commonly the abdomen and chest, and is characterised by a painful, blistering rash. An attack can begin with sensitive, painful skin, which then turns red, before breaking out in tiny blisters filled with clear fluid. Other early symptoms, while not as common, can include tiredness, aching limbs, headaches and nausea as well as a high fever.
The rash caused by shingles tends to take the form of a single band across the body, due to the virus working through the nerves branching out from the spinal cord and surrounding the body. The blisters develop over a week to 10 days, during which time, a crusty scab may form. Once the shingles is over, the skin usually returns to normal although scarring can occur in severe cases. Shingles symptoms commonly last between two and four weeks.
When the pain of shingles refuses to go away long after the rash has disappeared – three months or more – the condition is defined as postherpetic neuralgia. This tends to occur more often when the shingles rash appears on the face and can be prolonged for months or even years.
An estimated one in five patients with shingles will go on to develop post-herpetic neuralgia. The risk increases with age, affecting about 40% over the age of 60; risks also increase in those that experience pain in the early stages of shingles and severe pain throughout an episode.
Nerve damage caused by shingles causes the nerve to become faulty, sending unrestrained pain signals to the brain, which is subsequently felt as a throbbing, burning or stabbing sensation. The pain is variable and can range from mild discomfort to severe.
Living with postherpetic neuralgia is challenging as it can interfere with daily activities such as dressing and baths and can lead to further issues including fatigue, insomnia and depression.