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Shingles, also known as herpes zoster, is a viral infection caused by reactivation of the varicella-zoster virus in a person who has previously had chickenpox. [1]
After recovering from chickenpox, the varicella-zoster virus responsible for that infection doesn’t go away but instead lies dormant in nerve cells, leaving the potential for it to resurface later in life as Shingles. [2]
Signs and symptoms
Early signs of Shingles infection include pain, itching, or tingling in the area where a rash subsequently appears up to several days later. [3] The rash is generally found on only one side of the body, with the face, chest, back, abdomen and pelvis the most common sites.
The rash develops into painful blisters and can take several weeks to settle and clear. Other symptoms that may be experienced include fever, fatigue, headache, chills and upset stomach. [4] In many cases, the symptoms of Shingles may be mild but in others, it can cause an intense burning, shooting pain that can even be triggered by something as gentle as a sheet touching the rash when you’re in bed. [5]
In addition to the standard common symptoms of an initial Shingles infection, there are several complications that can result. These include the potential for a secondary bacterial infection of the rash site, scarring, severe eye complications, hearing issues, inflammation of the brain, bell’s palsy, trigeminal neuralgia, pneumonia and in rare cases, even death.
The most common complication is a chronic nerve pain called Postherpetic neuralgia (PHN) in which the pain and tingling sensations of Shingles continue for months or even years. PHN occurs in 10-18% of people who have an initial Shingles infection with older people at higher risk of both developing the condition as well as having a more severe case than younger patients. [6]
Shingles and postherpetic neuralgia often have a significant negative impact on an individual’s quality of life. Sufferers of PHN find it impacts on their quality of sleep, participation in general life activities and work, mood, and their relationships with others.
Seeking medical advice
If you or someone you know thinks they are exhibiting signs of a Shingles infection, it is important to seek medical advice promptly.
Blisters on the face or near the eyes are particularly concerning and long-lasting eye damage and blindness can occur, so this requires a particularly urgent referral.
There are anti-viral medications available through prescription that can shorten both the duration and severity of the illness, however these medicines work best when commenced as soon as possible after the appearance of the rash.
Your doctor or pharmacist can also advise you on the most suitable options for pain relief as well as topical gels to soothe the rash and dressings to cover and protect it too. [7]
Whilst it is not possible to contract Shingles by touching an infected patient’s rash, it is possible (although rare) to contract chickenpox (varicella-zoster) if you have never had that virus.
Pregnant women who have not had chickenpox or the vaccine as well as premature or low birth-weight babies and those patients with a poor immune system should avoid contact with someone with Shingles until the rash has crusted over.
Covering the rash, practicing good hand hygiene, and not sharing bathroom towels, etc. will help reduce the risk of spreading the varicella-zoster virus. [8]
So, who is at risk of getting Shingles?
The simple answer is that anyone who has ever had chicken pox can get Shingles, although there are certain factors that contribute to an increased risk in some people.
The virus is being controlled or kept at bay by our immune system so as we age, develop certain medical conditions, or take certain medications that suppress the immune system, the risk of reactivation of the virus increases.
Being female, having diabetes, psychological stress, acute infections, and trauma are other factors that increase the risk of developing Shingles.
Overall, one in three people develop shingles at some stage in their life, being most common in those aged 60 years and older. Up to 50% of people who live to 80 years of age will suffer with a Shingles infection and whilst uncommon, it is possible to get Shingles more than once. [2] [5]
The good news is that there are very safe and effective vaccines available to protect you against Shingles infection and the resultant complications that may occur.
Unless there are contra-indications such as allergy to a component of the vaccine, it is recommended that all people 50 years and older protect themselves from Shingles through vaccination. [2]
Any side-effects from vaccination which may include injection-site pain, redness, swelling, fatigue, and headache subside within 1-3 days and are minimal compared with the symptoms of a potential Shingles infection. [9]
Recent changes to the South Australian Vaccine code mean that appropriately trained immuniser pharmacists are now able to administer certain Shingles vaccines in the pharmacy without need for a prescription.
To find out more, talk with your local National Pharmacies Pharmacist who will be more than happy to consult on what your best options may be.
To learn more or to book an appointment with one of National Pharmacies qualified Pharmacists, click here.
Seniors Card members receive discounts on prescriptions, vitamins, optical, and beauty when they apply for a National Pharmacies membership. Learn more about this offer here.
References
[1] “Australian Immunisation Handbook,” [Online]. Available: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster.
[2] K. HUXHAGEN, “Shingles and its management: An overview,” AJP, 25 01 2022. [Online]. Available: https://ajp.com.au/lessons/shingles-and-its-management-an-overview. [Accessed 13 07 2023].
[3] “Shingles Signs and Symptoms,” [Online]. Available: https://www.cdc.gov/shingles/about/symptoms.html [Accessed 13 July 2023].
[4] “Shingles,” [Online]. Available: https://www.health.gov.au/diseases/shingles [Accessed 13 July 2023].
[5] “National Institute on Aging - Shingles,” [Online]. Available: https://www.nia.nih.gov/health/shingles [Accessed 13 July 2023].
[6] “Complications of Shingles,” [Online]. Available: https://www.cdc.gov/shingles/about/complications.html [Accessed 13 July 2023].
[7] “Prevention and Treatment,” [Online]. Available: https://www.cdc.gov/shingles/about/treatment.html [Accessed 13 July 2023].
[8] “Shingles Transmission,” [Online]. Available: https://www.cdc.gov/shingles/about/transmission.html [Accessed 13 July 2023].
[9] “Shingles (herpes zoster) vaccine,” [Online]. Available: https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service [Accessed 13 July 2023].
The information provided here should not be used in lieu of speaking with a healthcare professional. If you’re experiencing symptoms visit your GP or local National Pharmacies Pharmacist.