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Shingles

Also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a person has had chickenpox, the virus remains dormant in the nerve tissues near the spinal cord and brain.

When the virus reactivates, it travels along the nerves to the skin, causing a painful rash typically occurring on one side of the body.

FAQ

While shingles is a self-limiting condition that resolves on its own, it’s essential to seek medical attention if a rash appears 2 – 3 days after an initial period of pain or burning sensation in the affected area.

Shingles is diagnosed if the patient follow typical progression of shingles clinical features:
☐ First signs of shingles are an abnormal skin sensation and pain in the affected area which can be described as burning, stabbing, throbbing, itching, tingling and can be intermittent or constant.
☐ The rash usually appears within 2-3 days after the onset of pain, and a fever and or a headache may develop.
☐ Shingles rash appears as a group of red spots on a pink-red background which quickly turn into small fluid-filled blisters.
☐ Some of the blisters burst, others fill with blood or pus. The area then slowly dries, crusts and scabs form.
☐ Shingles rash usually covers a well-defined area of skin on one side of the body only (right or left) and will not cross to the other side of the body, in a dermatomal distribution.
☐ Refer to NHS.UK website for images of Shingles

Here is the inclusion criteria
☐ Adults 18 years and over
☐ Diagnosed with shingles within 7 days of rash onset

Here is the exclusion criteria
☐ Under 18 years of age
☐ Pregnancy or suspected pregnancy 
☐ Recurrent sinusitis ((4 or more annual episodes Of sinusitis)
☐ Symptom duration of less than 10 days

Shingles rash can take several weeks to heal, but the pain can continue for months or even years.

While shingles is usually a self-limiting condition, it's essential to seek medical attention if you develop shingles, especially if you are at increased risk of complications or have severe symptoms

How common is shingles

Shingles is relatively common, particularly among older adults or individuals with weakened immune systems. It is estimated that about one in three people will develop shingles in their lifetime.

Symptoms of shingles

The symptoms of shingles usually begin with localised pain, itching, or tingling, followed by the appearance of a red rash that progresses to fluid-filled blisters. The rash typically forms a band or stripe pattern on one side of the body, most commonly on the torso or face. Other symptoms may include fever, headache, fatigue, and sensitivity to light.

Causes of shingles

Shingles is caused by the reactivation of the varicella-zoster virus, which remains dormant in the nerve tissues after a person has had chickenpox. The exact triggers for reactivation are not fully understood but may include factors such as aging, stress, illness, or a weakened immune system.

Treatment for shingles

Treatment for shingles aims to relieve pain, shorten the duration of the outbreak, and prevent complications. Antiviral medications, such as acyclovir, valacyclovir, or famciclovir, are commonly prescribed to reduce the severity and duration of symptoms. Pain relievers, such as paracetamol or codeine, may also be recommended to alleviate discomfort. In some cases, corticosteroids or topical creams may be used to reduce inflammation and itching.

Preventing shingles

The best way to prevent shingles is by getting vaccinated. The shingles vaccine, also known as the herpes zoster vaccine, is recommended for adults aged 50 and older, regardless of whether they have had chickenpox or shingles before. The vaccine can significantly reduce the risk of developing shingles and may also help reduce the severity of symptoms if the infection does occur.

When to seek medical attention

While shingles is usually a self-limiting condition that resolves on its own within a few weeks, it’s essential to seek medical attention if you develop shingles, especially if you are at increased risk of complications or have severe symptoms. Complications of shingles may include postherpetic neuralgia (persistent pain after the rash has healed), bacterial skin infections, or eye complications if the rash affects the eyes.

Conclusion

Shingles is a viral infection caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. While it can cause discomfort and inconvenience, especially in older adults, prompt treatment and preventive measures such as vaccination can help reduce the risk of developing shingles and its complications. With proper care and management, individuals can minimise the impact of shingles on their health and well-being.

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