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Shingles

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Shingles can be a painful and worrisome condition. It is a non-life threatening condition that is characterized by a one-sided, sore, red blistering rash in a band distribution where a nerve travels on the surface of the body (also called a dermatome). It can emerge on the face but more commonly on one side of the chest or abdomen and back. About 20-30% of the population suffer shingles in their lifetime and it commonly affects those over the age of 50, or those with poor immune systems. It can be extremely itchy and cause discomfort, which is sometimes sharp and protracted, as well as malaise for 1-2 weeks. It is caused by a ‘reactivation’ of the chicken pox virus (herpes zoster) in much the same way as the cold sore virus does on the lips.

When we have the actual chickenpox infection, or are immunized against it, usually in childhood, the virus is stored in nerves in a dormant state. However, when some people are run down this virus is permitted to replicate, and this re-emergence of the virus as shingles is confined to the path of that specific nerve, as opposed to blowing up into full-blown chickenpox across the whole body. Consequently, the vast majority of cases of shingles are not caught from others with active chickenpox or shingles, instead find it coming from virus that had already been stored and present in that person for many years. Despite this, once someone has a shingles blistering rash they are contagious to people whom have never had chickenpox in the past; the most at risk groups of whom are pregnant women (since it affects foetal development) and those immuno-compromised such as the very old or undergoing cancer treatment, with whom contact should be avoided for the duration of the rash.

While there is no cure for shingles and it settles spontaneously, doctors can prescribe an antiviral medication that can dampen symptoms if taken within 72 hours of onset of symptoms. The mainstay of treatment is good pain relief measures, especially if the nerve pain becomes more intense and outlasts the rash, a complication called post-herpatic neuralgia.

Zostavax is a vaccination available privately or free under medicare for over 75 year olds which reduces the chance of developing shingles. It is made up of high dose inactive particles of herpes zoster so can not be given to people with low immunity or had no previous chicken pox or shingles.

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