Shingles

What is shingles?

Shingles is a painful rash caused by an infection of a nerve underneath the skin with the varicella-zoster virus. This is the same virus that causes chickenpox but it is not the same illness.

Most people have chickenpox at some stage (usually as a child). The virus remains dormant in the nerve roots next to the spinal cord. Sometimes a period of stress or illness can trigger the virus and it begins to multiply. Shingles results from a reactivation of the virus.1

The following is a summary about the disease. For further details speak to your local pharmacist or GP.

How is shingles spread?

Shingles cannot be passed from one person to another.

Someone with an activated shingles infection can spread chickenpox to another person who has never had chickenpox.2 Only people who have never had chickenpox are at risk of catching chickenpox from the shingles infection.

The shingles rash is contagious and spread via direct contact with the blisters. Covering up the rash can help to minimise spread of the infection.

Pregnant women and those who are immunocompromised are advised to minimised direct contact with shingles infection.1

Who is at risk of shingles?

About 1 in 4 people have shingles. Those who are considered at a higher risk include:

  • Adults aged 50 and over
  • Pregnant women
  • People with an weakened immune system1

What are the signs and symptoms of shingles?

The first signs include:

  • Tingling feeling on the skin
  • Itchiness
  • Stabbing pain

 

After several days a rash can appear:

  • It begins as a band or patch of raised dots on the side of the trunk or face or other areas of the body
  • It develops into small fluid filled blisters
  • Within a few days they begin to dry out and crust

When the rash is present, symptoms can range to mild itching to intense pain. The rash and pain usually disappears within 3-5 weeks.

What are the complications of shingles?

Occasional complications of shingles include:

  • Postherpetic neuralgia – the nerve pain of shingles persists after the rash has gone
  • Skin infection – the rash becomes infected with bacteria and the surrounding skin then becomes red and tender
  • Eye problem – in severe cases it can lead to inflammation of the whole of the eye which may cause loss of vision.
  • Weakness – if the nerve affected is a motor nerve it may result in a weakness of the muscles that are supplied by the nerve1

What is the treatment for shingles?

Loose-fitting cotton clothes are best to reduce irritating the affected area of skin.

 

Pain may be eased by cooling the affected area with ice cubes (wrapped in a plastic bag), wet dressings, or a cool bath. A non-adherent dressing that covers the rash when it is blistered and raw may help to reduce pain caused by contact with clothing.

  • Simple creams (emollients) may help if the rash is itchy.
  • Calamine lotion can help to cool the skin and reduce mild itchiness
  • Painkillers – such as paracetamol or ibuprofen
  • Stronger painkillers – GPs may prescribe these for nerve pain and in severe cases
  • Antiviral medicines – stops the virus from multiplying and limiting the severity of the symptoms. These are only used in a certain groups of people1.

What advice is there for travellers?

It is possible to travel with a shingles infection but best to check with the airline and receive a fit to fly letter from a doctor confirming that the rash is not contagious.

When to consider vaccination?

A shingles vaccine is available on the NHS for people who are aged 70 and 78. It helps reduce the risk of getting shingles. It is still possible to get shingles after being vaccinated but the symptoms are much milder.3

Vaccination

A live, attenuated (weakened) shingles vaccination is available in the UK. The vaccine is effective for at least 5 years post vaccination.4

References

This information is taken from trusted third party websites, NaTHNaC (Travel Health Pro) and EMIS (Patient info) and use of all information has been licenced under the Open Government Licence http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

Although the materials are being used/replicated under the provisions of the Open Government Licence this in no way represents endorsement of Traveljab.co.uk by NaTHNaC, Emis, Public Health England, the NHS or the Department of Health and Social Care.

References:

  1. Patient.info: Shingles – Herpes Zoster
  2. APIC (Association for professionals in infection control and epidemiology): Infection prevention and you
  3. NHS: Shingles
  4. The Green Book: Chapter 28a – Shingles