Shingles, also known as herpes zoster, is caused by the varicella zoster virus, which is also responsible for chickenpox. It occurs because of a reactivation of the chickenpox virus, which remains in the nerve cells of the body after an attack of chickenpox. People who contract chickenpox are at risk of developing shingles later in life, since the virus lies dormant in the body. Fortunately, it is rare to have more than one attack of shingles.
Anyone who has had chickenpox can develop shingles. However, people who have never had chickenpox can catch the virus from another person with shingles. A person who has never had chickenpox, but comes into contact with a case of shingles, would develop chickenpox (not shingles).
Symptoms of shingles
Shingles is a skin rash characterised by pain and blistering. Tender, painful skin signals the beginning of an attack. The skin then turns red and breaks out in tiny fluid-filled blisters.
Shingles can affect any part of the body, including the face. Classically, the rash caused by shingles takes the shape of a belt or band around or across the body. The rash forms its characteristic pattern because the virus works down the nerves that branch out from the spinal cord and encircle the body. The chest and stomach are most commonly affected.
The rash can last for a few days or weeks. During that time, a scaly crust might appear. Once the attack is over, the skin usually returns to normal, but there can be some scarring in severe cases.
How shingles is spread
Shingles can be spread when a person comes into contact with fluid contained in the blisters. The virus can be spread by direct contact with the lesions or by touching any dressings, sheets or clothes soiled with discharge from the spots.
Shingles, chickenpox and pregnancy
An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.
Sometimes, the pain doesn’t go away once the shingles rash has cleared. This complication is called post-herpetic neuralgia and is more common when the shingles rash appeared on the face rather than the body. This type of shingles rash tends to affect the skin around the eye and occasionally, the eye itself.
Postherpetic neuralgia can last for months or years. Capsaicin creams can help. Pain-relieving medication or tablets specific for nerve pain may be needed.
Treatment for shingles
Anti-viral medications can help ease the pain and shorten an attack of shingles. The medication works best if administered within three days, and ideally within 24 hours, of the onset of a rash. If you think you have shingles, seek urgent medical attention. Analgesic medication may also ease post-herpetic neuralgia, but consult your doctor first.
Shingles and chickenpox vaccination
Chickenpox and shingles vaccines are both available in Australia. The National Immunisation Program provides free chickenpox vaccine to children aged 18 months of age and as a catch-up dose for adolescents in year 7 of secondary school or age equivalent.
It can also be prescribed by a doctor for older people, but it is not free. People aged 14 years and older require two doses
of the chickenpox vaccine, one to two months apart. People aged 14 years and older must purchase the vaccine privately. The shingles vaccine is also available on prescription for people aged 50 years and over, but it must be paid for by the patient.
Where to get help
- Your doctor
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
- National Immunisation Infoline Tel. 1800 671 811
Things to remember
- Shingles is a skin rash characterised by pain and blistering.
- The virus responsible for shingles can be spread when a person comes into contact with the fluid contained in the blisters, either directly or indirectly.
- Shingles is caused by the same virus responsible for chickenpox.
- Treatment is most effective within three days of the rash appearing.
- A vaccine is available on prescription for people aged 50 years and over.
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