Shingles Dr Rob Hicks Everyone who has had chickenpox is at risk of developing shingles, which is caused by the same virus.

In this article

What causes it? What are the symptoms?

Who's affected? What's the treatment?

Advice and support

Shingles is a reactivation of the virus infection that causes chickenpox. After a person has had chickenpox the virus remains in their body, lying dormant or hidden in part of the nervous system.

For some reason, often many years later, the virus travels back down one of the nerves to the skin, where it causes a rash in the area of skin supplied by that nerve.

It's not clear what triggers reactivation of the chickenpox virus but it may be linked to changes in the immune system. Ensuring your immune system is not weakened may help to prevent this occurring.

You may experience fever, headache and enlarged lymph nodes

The first sign of shingles is usually excessively sensitive, tingling or burning skin where the shingles rash subsequently appears. The area is often painful. At the same time, you may experience fever, headache and enlarged lymph nodes.

After a few days, the characteristic shingles rash appears as a band or patch of red spots on the side of the trunk or face. It usually appears on one side only. The rash develops into fluid-filled blisters that then collapse, forming small ulcers. These dry out and form crusts.

A common complication of shingles is pain in the area of the rash that persists after the rash has disappeared, called post-herpetic neuralgia. People with intractable post-herpetic pain often become depressed. Post-herpetic neuralgia is more likely to occur the older you are.

Around one in four people will develop shingles in their lifetime, with men and women affected equally. It's most common in older people, although it can also occur in younger people and those with a weakened immune system.

You can catch chickenpox from someone with shingles if you've never had the infection

The skin blisters that form in shingles are full of the chickenpox virus, which means a person with shingles is infectious. You can't catch shingles from someone with shingles (or someone with chickenpox), but you can catch chickenpox from someone with shingles if you've never had the infection and therefore aren't immune.

Most adults - about 95 per cent - have been exposed to chickenpox and are immune, even though many aren't aware of it (they may have had only a mild dose of chickenpox when they were young). However, a small number of adults aren't immune and will be at risk. Also, when the immune system is suppressed (for example, when someone is being treated for cancer), a person can catch chickenpox for a second time.

The shingles virus can be treated with antiviral medication. Painkillers can relieve the pain, while calamine lotion should help to reduce the itching.

Shingles that affects the eyes requires antiviral therapy and urgent referral to an ophthalmologist.

If someone with a weakened immune system is exposed to shingles they are usually referred to hospital for possible intravenous antiviral therapy, as they're at very high risk of complications from chickenpox. They may be offered an injection of immunoglobulin or antiviral antibodies.

This doesn't prevent the disease, but may reduce the length and severity of the infection, and the risk of complications. The sooner immunoglobulin is given, the more effective it is likely to be. It must be given within 96 hours to have a significant effect.

The treatment of post-herpetic neuralgia can involve painkillers, capsaicin cream and, if necessary, specific antidepressants.

Shingles Support Society

Helpline: 0845 123 2305
Email: info@herpes.org.uk
Website: www.herpes.org.uk/shingles

This article was last medically reviewed by Dr Rob Hicks in July 2006.