Is it SHINGLES?

How to spot and treat this common virus

Despite its distinctive clustered, blistering rash, research shows many of us won’t recognise the key symptoms of shingles. Yet one in four of us could develop the infection in our lifetime. So, what actually is it?

Shingles is caused by the same virus responsible for chickenpox, varicellazoster. Chances are, you may have caught chickenpox as a child. With its itchy rash and flu-like symptoms, it generally only lasts a week or two. But the virus can lay dormant in your body for years, before reactivating and spreading along nerve pathways to an area of skin.

If you notice a rash that could be shingles, don’t delay in seeking medical advice. Fast treatment can speed up recovery and help prevent complications, including ongoing nerve pain.

TV presenter Eamonn Holmes has revealed his experience of shingles after he woke up one morning with shooting pains and a rash on his face. “It was like some hideous movie where you feel your face and you go, ‘What’s that?’” he told

The i newspaper. “I remember going to the bathroom mirror and jumping back in horror.”

Symptoms

Before a rash appears, there can be other symptoms. These include pain, tingling or tender skin in the affected area, or a headache. You may also have a fever, feel very tired or generally unwell. After this, a red rash usually appears that turns into blisters, which can burst and weep.

Where exactly shingles strikes depends on which nerve fibres are affected. It’s most common on the chest or abdomen, but can affect any area, including the face, eyes and genitals. And generally it affects a band of skin on either the left or right side of the body or face – it doesn’t cross from one side to the other.

The blisters continue to emerge for about a week, then gradually scab over and disappear over the course of two to five weeks. Not everyone suffers pain, but when they do, it can be intense.“the pain of shingles can be burning, stabbing, tingling or itching. For some people, it is a patch of numbness. In other words, any ‘wrong message’ that nerves are capable of sending,” explains Marian Nicholson, director of the Shingles Support Society.

Once the rash has healed, the area may be sensitive or ache for a while, but that’s usually the end of it. But shingles can sometimes lead to long-term problems.

The most common is postherpetic neuralgia (PHN) – pain that continues for months or even years after the rash has cleared up, or pain that goes and then returns. It’s caused by damaged nerve cells sending confused messages to the brain.

Sometimes the rash can become infected with bacteria, requiring antibiotics, or leave white patches or scarring on the skin. Shingles can also cause vision problems, affecting your sight. And in rare cases, depending on the nerves affected, it can cause inflammation of the brain, lungs or liver, meningitis, hearing loss, or paralysis on one side of the face.

Contagion

In the UK, most children have had chickenpox by the age of ten. But not everyone catches it young, and plenty of people won’t remember whether they’ve had it or not. Eamonn had to ask his mum. It’s worth noting that you can only get shingles if you’ve already had chickenpox. And if you haven’t had chickenpox and you are exposed to someone with shingles, you will develop chickenpox first – regardless of your age. The virus is spread by skin-to-skin contact or contact with fluid from an open blister. And you’ll be contagious until the last blister has dried up

One in four of us could develop the infection in our lifetime

and crusted over.

Chickenpox tends to be more serious in adults than children and, for particular groups, it can be particularly dangerous. So, if you have shingles, you should avoid pregnant women, people with weakened immune systems (as a result of chemo, for example) and babies under one month old. Unless it’s your own baby – if you’re the birth mum, your own immune system should have given them some protection.

Who gets shingles?

Shingles is most common in adults over 50, but anyone can get it. Exactly why the varicellazoster virus can reawaken and cause shingles isn’t clear, but the risk is higher if your immune system is weakened in some way.

This can happen naturally with ageing, and the chances of both developing shingles and suffering serious complications rise sharply as you get older. For this reason, a shingles vaccine is available on the NHS for people in their 70s – and Marian urges anyone eligible to have it. Emotional or physical stresses lower your body’s defences and can also trigger a f lare-up. As can illnesses and treatments that dampen immunity, such as leukaemia and long-term use of steroids.

For Elizabeth, now 42, a severe outbreak of shingles seems to have been triggered by a period of intense stress. She’d already suffered two milder attacks, in her 20s and early 30s.

“I was 37. My marriage had just ended and, shortly after moving, there was a burglary while I was asleep in the house,” she explains. “A few days later, I noticed itching above my eye and pain that side of my forehead, which I put down to a stress headache. A couple of days later, I stood in front of the mirror and noticed the telltale lesions. I knew immediately what it was.”

Unfortunately, this time the pain and tiredness didn’t end when her rash cleared up, and a few weeks later, she was diagnosed with PHN.

“The best way to describe the nerve pain is like hitting your funny bone,” she says. “But instead of the pain wearing off quickly, it was there all the time above my eye. Some days were worse than others. Out of nowhere, a bolt of pain would hit me and all I could do was curl into a ball and wait until it passed. It became very isolating, and with the fatigue and constant pain, I became very depressed.”

Only now, with support from specialists and an NHS pain clinic, is the PHN easing. “I’m still aware of the pain in the background, but it’s less intrusive,” she says. “Five years on, I feel as though I’m finally getting my life back.”

Treatments

If you have any inkling you might have shingles, you should see a doctor as soon as possible. Early on, you might be offered a course of antiviral tablets, such as aciclovir. They don’t work for everyone, but could shorten the course of the illness and make the symptoms less severe. They might also reduce the risk of long-term problems.

“The antiviral treatment must be started within 72 hours,” explains Marian.

“So, if you have any aggravating area of pain that has no cause you’re aware of, see your GP, so the treatment can be started immediately.”

The NHS also advises taking paracetamol to ease pain, keeping the rash clean and dry to avoid infection, wearing loose-fitting clothing, and using a cool compress on the rash twice a day, such as a wet cloth or frozen peas wrapped in a towel.

If shingles is treated early, the risk of PHN is reduced. But if you’re unlucky enough to develop the pain, contact your doctor to discuss which medicines or therapy to try.

Prevention is better than cure so, if you’re eligible, it’s a great idea to get vaccinated – to boost your immunity and reduce your risk of contracting shingles.

• For more information, visit Shinglessupport.org.uk

Stress lowers your defences and can trigger a flare-up