If you’ve had chickenpox, there’s a one-in-five chance that you’ll develop this painful condition says Dr Melanie Wynne-Jones

Shingles

Virus particles can lie dormant in our nerve cells © Alamy

If you’ve had chickenpox, there’s a one-in-five chance that you’ll develop this painful condition

Over 90% of us have had chickenpox, usually as children. But although the rash and fever quickly disappear, dormant virus particles can ‘hide’ deep in our nerve cells, reappearing as shingles, often decades later.

Shingles is most common in older adults, perhaps because our immunity wears off (although children can get shingles too).

It’s also more common in people whose resistance has been lowered by immune-system disorders or medication.

You can’t ‘catch’ shingles, but the blister fluid contains active virus, so there’s
a small risk of passing chickenpox on to people with lowered immunity, including pregnant women who’ve never had it.

The symptoms

The virus hides in nerve- cell ‘junction boxes’, located on either side of our spines and heads, so when it spreads out along that nerve, you’ll get a one-sided patch on your face, back, tummy, arm or leg.

You may notice a puzzling burning pain (neuralgia) beforehand, and/or feel unwell with muscle aches, headache and fever.

The blisters appear over several days, starting as fluid-filled red lumps which burst, scab over and may develop bacterial infection (redness and weeping).

They take several weeks to heal completely, and may leave mild scarring.

Some of the possible complications

Pain varies from mild irritation and itching to very severe and distressing, but usually improves as the blisters heal.

But if nerve damage is severe, you may be left with persisting throbbing, stabbing or other types of pain, numbness, pins and needles or odd sensations. This is called post-herpetic neuralgia (PHN), and usually settles with time, but can be very debilitating.

Shingles can also affect the eye, leading to redness, pain, ulcers, raised eyeball pressure (glaucoma) and optic-nerve inflammation, and it can affect the ear, producing dizziness, vertigo, hearing loss and facial weakness.

You’ll need to see an appropriate specialist quickly to prevent long-term sight or hearing loss.

Getting immunised

The shingles vaccine is available on the NHS for older people and those whose immune system isn’t working properly, including those who have already had shingles, as
the condition can recur.

But the age restrictions change every autumn. This year, you will be entitled to a jab if you were aged 71 or 72 years on 1 September – or if you are 78 or 79 years of age and haven’t already been immunised.

The vaccine isn’t offered to people aged 80 years or above as it’s thought to become less effective with age.

If you’re over 50, but not eligible for an NHS jab, you could pay (£100 or £200) for a private one.

The jab isn’t 100% effective, although shingles should be milder, clear up more quickly and leave you with less PHN. But it may lead to a sore arm or, very rarely, an allergic reaction.

The UK is also considering chickenpox immunisation for children, which could eventually reduce shingles rates.

6 ways to cope with shingles

1 Antiviral tablets (prescribed by your GP) often help if started within 72 hours of
the rash appearing.

2 Paracetamol may help (check with your pharmacist about other illnesses/medicines) but your GP can also prescribe stronger painkillers if necessary.

3 Avoid rubbing – wear loose clothing, and wash by splashing and patting dry.

4 A cool, wet compress (for up to 20 minutes) can soothe weeping blisters. Don’t share flannels or towels.

5 Cover an exposed rash with a non-adhesive dressing to prevent infecting others.

6 PHN can be blocked with antidepressant or anticonvulsant drugs, capsaicin cream, lidocaine patches or other help from your GP.