Shingles, also known as herpes zoster, is an infectious viral disease caused by the varicella-zoster virus.
A shingles infection is characterised by a painful skin rash with blisters that are usually shaped like a band on one side of the body or face. That distinctive linear shape has been described by the Chinese community as “creeping snake”.
If the shingles-causing varicella-zoster virus sounds familiar, that is because it is the same virus that causes chickenpox. In a person who has previously had chickenpox, the virus stays hidden ‘asleep’ in the body, but can be ‘awakened’ many years later to cause shingles.
Shingles can affect people of all ages, but is most commonly seen in those aged 50 and above. It is also more common in people with a weakened immune system, such as patients on steroids or chemotherapy, transplant patients, and persons with human immunodeficiency virus (HIV), autoimmune diseases such as Type 1 diabetes, as well as chronic lung or kidney disease.
Signs of shingles
The first noticeable signs of shingles may be when you experience weird sensations on your skin. These include an itching, burning, painful or tingling sensation. Some patients develop a fever, headache or feel generally unwell before the characteristic rash with blisters appears, usually within a day or two after the first signs of symptoms.
Typically, the rash and blisters appear in a band across one side of the chest and back, resulting in mild or severe pain. They can also occur on other parts of the body such as the face and limbs. The blisters may develop to become open sores or ulcers within 3 – 4 days, before finally scabbing and healing within 7 – 10 days.
Serious shingles infections are rare, but about 10% of patients develop a condition called post-herpetic neuralgia (PHN). These patients develop persistent pain or discomfort even after the rash has healed. In some cases, this pain can last for months or even years.
In very severe cases, the patient can suffer from sleep disturbances, weight loss, and even depression. Other complications of shingles include bacterial skin infections, eye problems (if the rash is near the eye), or ear problems (if the rash is near the ear). Shingles is also found to increase the risk of cardiovascular disease, including heart attack and stroke.
Shingles is usually treated with antiviral medications prescribed by a general practitioner, especially if the infection is noticed early (when the rash has shown up for less than 3 days), or if the patient has a weakened immune system.
These antiviral medications help to lessen the severity and duration of pain, promote quicker healing of skin lesions, and prevent new skin lesions from forming. They also help decrease viral shedding and reduce the risk of transmission and chances of complications such as PHN.
Analgesics are usually also prescribed to help patients control the pain and discomfort from the skin lesions.
Shingles is infectious, and people who have never had chickenpox or received the chickenpox vaccine can catch the varicella-zoster virus and develop chickenpox. Transmission usually happens through direct contact with the rash or via airborne transmission of bodily fluids. The skin lesions are considered non-infectious after drying up and crusting.
Shingles can be prevented through vaccination, which are readily available at clinics such as Parkway Shenton.
Presently, there are two brands of vaccines: Zostavax and Shingrix.
Shingrix is the newest vaccine option and is recommended for adults aged 50 and older. For adults above 50 years of age, 2 doses of the vaccine will be required, with an interval of 2 – 6 months. For adults aged 19 and older with a weakened immune system, 2 doses of the vaccine will be required, with an interval of 1 – 2 months.
Shingrix is recommended even for people who have had shingles before, or previously received Zostavax or the chickenpox vaccine. Studies show that Zostavax, too, provides strong protection against shingles and PHN.
To find out more about the Shingrix and Zostavax vaccines available for the prevention and protection against shingles, visit our website or get in touch with a general practitioner at a Parkway Shenton medical clinic nearest to you.
Article contributed by Dr Edwin Chng, medical director at Parkway Shenton, The Arcade (level 19)