What is shingles?

Shingles is a viral infection which results in a skin rash and flu-like illness. It is caused by the chickenpox virus. However, it cannot be caught from people with chickenpox and only affects people who have previously had chickenpox. After a chickenpox infection, the virus stays in the body hiding in the nerves to the skin. It is not active and does not cause you any harm. But if your resistance to infection falls the virus can become active again causing shingles.

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What symptoms will I have?

The most obvious symptom is a rash on your skin.This will affect one area of your body, either as a band around half of your trunk, down one leg or arm, or one side of your face. If you have a rash on your forehead your eye may also become infected.
The rash starts as red spots, which rapidly turn into blisters. These then turn into pus-filled spots (pustules) which burst and crust over. As with chickenpox, the crusts drop off within one to two weeks and can leave scars.
A few hours or days before the rash develops, some people notice excessive sensitivity, or a tingling or burning sensation in the area of their body that will be the site of the rash. This may develop into severe pain. You may feel generally unwell, as if you have flu, with fever and aching.
After the rash has gone, many people continue to have pain in the area affected by the rash (post-herpetic neuralgia) and feel depressed. These are just the aftereffects of the virus and will settle with time. They are more common if you are over 60 years old.

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How common is shingles?

Anybody who has had chickenpox can get shingles. One in five people in the UK will get shingles at some time in their lives. People of any age can get shingles but it is more common in the elderly. Each year, two people per 1,000 under the age of 50 get shingles compared to 10 people per 1,000 over the age of 80.
Shingles is more common, and often more severe, if your immune system is not working properly. This might be due to illness or treatment, for example if you are taking steroids, or having chemotherapy for cancer.

What tests will I need?

Your GP will usually make the diagnosis by looking at your rash. Your GP may take a sample of the fluid from one of your blisters or do a blood test. If one of your eyes is involved, your GP will refer you to a specialist.

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What treatments are available?

If you have other health problems, are over 60 years old, have severe pain, or your eye is involved, your doctor may decide to treat you with antiviral tablets. To be most effective these need to be started as soon as possible after the rash develops, ideally within 72 hours. The tablets help both the rash and the pain to settle more quickly and make the sharp after-pains less likely.
Different types of antiviral tablets need to be taken differently. It is important you take them exactly as your doctor recommends, and continue the course until all the tablets in the packet have been taken. Paracetamol, aspirin or other painkillers can help with the other symptoms, such as the pain and fever.
If you continue to suffer from pain, your doctor may prescribe a cream to apply to the area, or give you stronger painkillers.

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Help yourself

• Although people cannot catch shingles from you, they can catch chickenpox if they have not had it before.
• The rash is infectious until the spots dry up, so you should stay off work during that time. This usually takes about seven days.
• Avoid contact with anyone whose immune system may not be protecting them properly, such as people on steroids, people on chemotherapy for cancer or anyone who has leukaemia or who has had a transplant.
• Avoid babies under one month old; their immunity may not yet be strong enough to protect them from chickenpox.
• Do not pick or scratch your spots. Let them heal normally to reduce the risk of scarring.
• If your doctor gives you tablets, take them exactly as recommended and remember to complete the whole course.

This factsheet supported by SmithKline Beecham

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