Signs and symptoms
The initial tingling, sharp, burning pain under the skin can occur anywhere on the body but usually affects the face, upper abdomen or back and almost always occurs on one side of the body only. The pain can be mild or it can be quite severe. In general, the older the person is, the more severe the pain is likely to be. It can be accompanied by other symptoms including:
- A feeling of being generally unwell
- Mild chills and fever
- An upset stomach
- Enlarged lymph nodes.
Only people who have had chickenpox in the past (usually in childhood) can get shingles. The reason why the chickenpox virus reactivates as shingles is not fully understood. It is thought that the following factors influence the development of shingles:
- Emotional stress
- Lowered immunity eg: due to immuno-suppressant medications or chemotherapy
- A recent illness or major surgery
- Injury or sunburn to the skin
As shingles is caused by a virus and cannot be cured with antibiotics, treatment focuses on relieving symptoms. Getting adequate rest is an important factor in the treatment of shingles. Other treatment may include:
- Pain relief medications such as paracetamol
- Cool compresses applied to the affected area
- Lotions and creams may be prescribed for the rash
- Antiviral medications such as aciclovir may be prescribed. These do not destroy the virus but can help to reduce the duration of the symptoms
- Steroids may be prescribed if the rash and pain are severe
- Antibiotics may be required if the skin rash becomes infected
- Acupuncture can also be effective in relieving symptoms in some cases.
The most common complication of shingles is a condition called post-herpetic neuralgia. This condition is characterised by persistent pain at the site of the shingles rash that lasts for more than one month. Anti-seizure and anti-depressant medications are sometimes used to treat the pain caused by post-herpetic neuralgia. Other less common complications of shingles include:
- Bacterial skin infections
- Harm to anunborn foetus if the mother develops shingles in the early months of pregnancy
- Damage to the eye if shingles affecting the eye is left untreated. In rare cases, blindness can occur
- Ramsay Hunt's syndrome caused by facial shingles. This condition can cause ear pain, facial paralysis, loss of taste and hearing.
Prevention / vaccination
Doermann, D. J., Frey, R. J. (2006). Shingles. The Gale Encyclopedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. Farmington Hills, MI: Thomson Gale.
Glanze, W.D., Anderson, K.N. & Anderson, L.E. (Eds.) (2006). Mosby’s medical, nursing and allied health dictionary. (6th ed.) St.Louis, MO: Mosby – Year Book Inc.
Mayo Clinic (2014). Shingles (Web Page). Rochester: Mayo Foundation for Medical Education and Research. http://www.mayoclinic.org/diseases-conditions/shingles/basics/definition/con-20019574 [Accessed: 15/09/16]
Ministry of Health (2012). Shingles (Web Page). Wellington: Ministry of Health. http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/shingles [Date Accessed: 15/09/16]
Reid, J.S., Ah Wong B. Herpes zoster (shingles) at a large New Zealand general practice: incidence over 5 years. N Z Med J. 2014;127(1407):56-60.
Last Reviewed – September 2016