Shingles

Created: 09.01.2025

Updated 09.01.2025

Approved by: Consultant Dermatologist, Dr James Denny

What is Shingles?

Think of Shingles as a relapse of chickenpox. It is not contagious to those who have had chickenpox in the past. However, it can lead to chickenpox if you have not had this before. For children, this is not a big problem, but chickenpox in adults can be quite serious. Adults who have not had chickenpox should therefore not come into contact with people who have shingles.

Shingles (Herpes Zoster) is caused by the varicella-zoster virus, the same virus that causes chickenpox. About a third of all people get shingles and most are over 60 when it happens.

What are the symptoms?

You may initially notice headaches and sensitivity to light. This is normally followed by a painful rash, often on one side of the face, neck, chest or arm. It can cause blisters on the skin. Within a week, crusts will form before it begins to heal. For some, the discomfort persists long after other symptoms have subsided.

What are the treatments?

Treatment for shingles focuses on relieving symptoms, speeding up healing, and preventing complications. Antiviral medications such as aciclovir and valaciclovir are the mainstay of treatment and are most effective when started within 72 hours of the rash appearing. These medications help reduce the severity and duration of the outbreak and decrease the risk of long-term complications, like postherpetic neuralgia (persistent nerve pain).

For pain relief, over-the-counter medications like paracetamol or ibuprofen can help manage discomfort. For more severe pain, prescription pain relievers, corticosteroids, or nerve pain medications like gabapentin or pregabalin may be necessary. Topical treatments such as lidocaine patches or calamine lotion can soothe the rash and reduce irritation.

Good self-care is also important during recovery. Keeping the rash clean and dry can help prevent bacterial infections, while wearing loose, comfortable clothing can minimize irritation. To reduce the risk of spreading the virus to others, individuals should avoid close contact with people who are at high risk (e.g., pregnant women, infants, or immunocompromised individuals) until the blisters crust over.

In some cases, complications like postherpetic neuralgia may require additional treatments, including nerve blocks or antidepressant medications. Vaccination with the shingles vaccine, Shingrix, is recommended for adults over 50 or those with weakened immune systems to prevent shingles and its complications in the future.