Shingles is a rash of blisters on the skin accompanied by a severe stinging pain, caused by a virus – the Varicella zoster virus – which is also responsible for chicken pox. Anyone who develops shingles will have had chicken pox in the past, sometimes without realising it, as one can have what is known as a ‘subclinical’ attack, in which no spots appear.
Antibodies to the virus develop in the bloodstream at the first infection and prevent further attacks of chicken pox. However, the virus is able to settle and lie dormant in a noninfectious state, in the ‘junction boxes’ of nerves supplying a part of the skin or – less commonly – muscles. Often it will cause no further trouble, but if it does, the result will be shingles.
All manner of events can trigger an attack. If you’re emotionally or physically exhausted, or suffering from illness or injury – indeed, if your body’s defences are not at their best for whatever reason, the virus can become active. The older you get, the more likely you are to develop shingles – of those who reach their eighties at least one in two will have suffered.
The first symptom is usually pain over the area of skin supplied by the nerves harbouring the virus. The most common place is around the side of the body, along a line following a rib. It can occur on both sides of the chest, but it is an old wives’ tale that if it meets in the middle the outcome is fatal – that just isn’t true.
To have the best chance of success any treatment should be given early on, preferably at the painful stage which can be when, or just before, the blisters appear.
Your doctor will sometimes prescribe a course of tablets which may help to lessen and shorten the attack. Antiviral applications to the affected area of skin can help and anaesthetic ointments or over-the-counter ointments containing calamine can also be soothing.
The surrounding skin should be kept clean to prevent other germs infecting the blisters, as this could interfere with healing and lead to scarring. Antibiotics may be needed if infection does occur.