Shingles

What is shingles?

Shingles is a condition caused by the varicella-zoster virus — the same virus that causes chickenpox. After a person has chickenpox, usually in childhood, the virus does not fully leave the body but lies dormant in the nerves. Years or decades later, it can reactivate, travelling along a nerve to the skin and causing the painful rash known as shingles. Its medical name is herpes zoster.

Because it follows the path of a nerve, the shingles rash typically appears as a band or strip on one side of the body or face, often around the torso. It is usually preceded by pain, tingling or burning in the area. Shingles is more common in older adults and in people with weakened immune systems, as the immune system's control over the dormant virus can wane. While usually not dangerous, it can be very painful and occasionally leads to complications, so early recognition and treatment matter.

Symptoms

Shingles often begins with sensations in the affected area before the rash appears, which can make it harder to recognise at first. Typical symptoms, usually affecting one side of the body, include:

• •An early tingling, burning or painful feeling in an area of skin
• •A rash appearing a few days later, as red blotches then blisters
• •Blisters that scab over after a week or so
• •Pain, which can range from mild to severe
• •The rash and pain following a band on one side of the body or face
• •Sometimes a general feeling of being unwell, headache or fever

Treatment

Shingles is treated with the aim of easing symptoms, speeding recovery and reducing the risk of complications. Antiviral medicines, when started early (ideally within three days of the rash appearing), can reduce the severity and duration of an episode, which is why seeing a doctor promptly is helpful. They are particularly important for older adults, those with weakened immunity, and those with shingles affecting the face or eyes.

Pain relief is also a key part of treatment, as shingles can be very painful. Simple painkillers help milder pain, while stronger or specific medicines may be needed for more severe nerve pain, prescribed by a doctor. Keeping the rash clean and dry, wearing loose clothing, and using a cool compress can ease discomfort. Most cases of shingles clear up within two to four weeks, though the pain sometimes lingers longer.

Complications and the vaccine

While many people recover from shingles without lasting problems, complications can occur, particularly in older adults. The most common is postherpetic neuralgia, where nerve pain in the affected area persists for months or longer after the rash has healed. Shingles affecting the eye is another important complication, as it can threaten vision and needs prompt medical attention. Less commonly, other complications can arise, especially in those with weakened immunity.

A vaccine is available that significantly reduces the risk of getting shingles and of developing complications like postherpetic neuralgia. It is offered to older adults and certain at-risk groups, as this is when shingles and its complications are most likely and most severe. If you are in an eligible age group or have a condition that increases your risk, it is worth asking your doctor about the shingles vaccine.

Knowing the warning signs for complications helps you seek help when needed. Shingles near or in the eye, severe or spreading rash, symptoms in someone with a weakened immune system, or pain that persists well after the rash heals all warrant medical attention. For most people, though, shingles is a self-limiting if unpleasant illness, and prompt treatment improves the outlook.

Is shingles contagious?

Shingles itself cannot be passed from person to person — you cannot catch shingles from someone who has it. However, the varicella-zoster virus that causes it can be spread from the shingles rash to someone who has never had chickenpox (or the chickenpox vaccine), and they would develop chickenpox, not shingles. This spread happens through contact with the fluid from the blisters.

This means that while the rash is blistering and weeping, a person with shingles should take care around those who have not had chickenpox, particularly pregnant women, newborn babies, and people with weakened immune systems, for whom chickenpox can be more serious. Covering the rash, not sharing towels, avoiding scratching, and washing hands all reduce the risk of spreading the virus.

Once the blisters have dried and scabbed over, shingles is no longer contagious. Understanding this helps people with shingles take sensible precautions without unnecessary worry — normal contact is generally fine once the rash is covered or has crusted over, and the main precaution is avoiding direct contact between the weeping rash and those at risk who have not had chickenpox.