Shingles (Patient information)

Cork Emergency Departments

Shingles is caused by the same virus that causes Chicken Pox. Anyone who has had chicken pox can develop shingles. The virus remains dormant or inactive in certain nerve root cells of the body, and only when it reactivates does shingles occur. About 20% of those people who have had Chicken Pox will get shingles at some stage during their lives. Fortunately most people will only get shingles once. It is not clear what prompts the virus to reactivate or "awaken" in healthy people. A temporary weakness in immunity (the body's ability to fight infection) may allow the virus to multiply and move along nerve fibres towards the skin. Although children can get shingles, it is more common in people over the age of 50. Illness, trauma and stress may also trigger a shingles attack.

What are the Symptoms of Shingles?

The first symptom of shingles is a burning pain, tingling or extreme sensitivity in one area of the skin, usually limited to one side of the body. This may be present for 1-3 days before a red rash appears at that site. There may also be fever or headache. The rash soon turns into groups of blisters that look like Chicken Pox. The blisters generally last for 2-3 weeks. The blisters start out clear then crust over and begin to disappear. The pain may last longer. It is unusual but possible to have pain without blisters or blisters without pain.

Where does Shingles usually Appear on the Body?

Shingles is most common on the trunk and the buttocks. It can also appear on the face, the arms or the legs if nerves in these areas are involved. Care is need if the blisters involve the eye because permanent eye damage can result. Blisters on the tip of the nose signal possible eye involvement. In this instance the involvement of an ophthalmologist (eye specialist) is often required.

What are the complications of Shingles?

• A bacterial infection of the blisters can occur, and can delay healing. If pain and redness increase or reappear you should attend for a review appointment with your doctor
• Post hepatic neuralgia is a constant pain or periods of pain that can continue after the skin has healed. It can last for months or even years and it is more common in older people. The use of medication in the early stages of shingles may help prevent this complication
• Another complication is the spread of shingles all over the body or into internal organs. This can also happen with Chicken Pox. It occurs rarely and in most cases it will be in those with severely weakened immunity

How is Shingles Diagnosed?

The diagnosis is usually based on the way the blisters look and a history of pain before the rash on one side of the body. If there is any doubt, blister fluid containing virus can be sent to the laboratory for special testing.

Is Shingles Contagious?

A person who has never had Chicken Pox can catch it from contact with shingles. You cannot catch shingles from contact with shingles or Chicken Pox. Shingles is much less contagious than Chicken Pox. Persons with shingles can only transmit the virus if blisters are broken. New-borns or those with decreased immunity are at the highest risk of contracting Chicken-Pox from someone who has shingles. Patients with shingles rarely require hospitalisation.

What is the Treatment?

Shingles usually clears on its own in a few weeks, and seldom recurs. Pain-relievers (analgesic medication) are usually required during the acute stages of shingles. If diagnosed early, oral anti-viral drugs can be prescribed. These are routinely prescribed for severe cases of shingles with eye involvement and for patients with decreased immune function. Post hepatic neuralgia can be treated in a number of different ways depending on the severity of the pain.