Shingles or herpes zoster is an infection of a nerve and usually affects the area of skin supplied by that particular nerve. It is caused by the same virus that causes chickenpox. Anyone who has had chickenpox in the past may develop shingles.
Herpes zoster can occur at any age but it is most common in people over the age of 50. A period of stress or illness or weakened immunity can set off an episode. People on steroids or those with HIV/Aids are more prone to it. It usually does not occur more than once in the same person.
The virus usually affects one nerve only. There is pain and a rash on one side of the body. Sometimes two or three nerves near to each other may be affected together.
The pain is a localised band of pain which can range from mild to severe. It is a constant dull, burning, or gnawing pain. There may also be sharp and stabbing pains that come and go. The affected area of skin is usually tender. Rash appears 2 to 3 days after the pain.
The rash usually appears on the skin of the chest or tummy. The upper face (including an eye) is also a common site.
The rashes are red blotches initially but quickly develop into chicken-pox type itchy small blisters. New blisters may develop for up to a week. There may be some inflammation.
The blisters gradually dry up, form scabs, and then fade away. Slight scarring may occur where the blisters have been.
An episode of herpes usually lasts 2-4 weeks. In some cases there is a rash but no pain. Rarely, there is no rash but just a band of pain. There may be a high fever and a feeling of being unwell for a few days.
A person can catch chickenpox from someone with shingles if they have not had chickenpox before but not shingles itself. The rash is contagious until all blisters are dry and therefore should be kept covered.
The most common complication of herpes is post-herpetic neuralgia where the nerve pain persists after the rash has gone. 1 in 5 people with shingles over the age of 60, have pain that lasts more than a month. The older you are, the more likely it will occur.
Sometimes the rash becomes infected and the patient may need to take antibiotics.
Herpes in the eye can cause inflammation and severe cases may cause loss of vision.
Sometimes a weakness of muscles may occur.
Treatment is geared to alleviate pain with pain killers, anti-depressants and drugs to ease nerve pain and prevent complications.
Antiviral medicines such as aciclovir may be prescribed. A short course of steroid tablets may be considered in addition to antiviral medication. This may help to reduce pain and speed healing of the rash.