Shingles: what is it, how do you recognize it, and what can you do about it?

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 chicken pox. After a previous infection, this virus can remain dormant in the nervous system for years and re-emerge later in life, often when your immune system weakens.

How does shingles occur?

Anyone who has ever had chickenpox carries the virus with them. It remains inactive in nerve nodes in your back or face. Under certain circumstances, such as old age, illness or stress, the virus can become active again. This leads to a painful rash and nerve pain.

The symptoms of shingles

The first signs of shingles can be vague. It often begins with:

• Burning or stabbing pain on one side of your body
• Tingling, itching or numbness in a restricted area
• Mild fever, fatigue or general unwellness

After one to three days, small reddish-pink blisters appear in a band-like pattern, usually on the trunk, chest or face. These blisters dry up within a week, but the pain can last for weeks to months.

Who is at risk for shingles?

Anyone who has had chickenpox can later develop shingles. The chance increases in the following situations:

• Age over 50
• Weakened immune system due to illness or medication
• Chronic stress or a serious physical condition
• Use of immunosuppressive drugs

Postherpetic neuralgia

A common complication of shingles is postherpetic neuralgia (PHN). This is persistent nerve pain in the area where the rash was. PHN can persist for months and is especially common in the elderly.

Other possible complications

• Eye inflammation when shingles occurs on the face
• Bacterial infection of the vesicles
• Rare spread of virus in people with severely compromised immune systems

Treatment of shingles

Treatment is aimed at inhibiting the virus and relieving symptoms.

Medical options

• Antivirals such as aciclovir or valaciclovir - start within 72 hours
• Painkillers or anti-inflammatories for severe symptoms
• Specific medication for nerve pain, if PHN develops

Self-care tips

• Keep skin clean and dry to prevent infection
• Wear loose-fitting clothing to reduce irritation
• Try not to scratch blisters to avoid scarring

Preventing shingles: vaccination

There is a vaccine (Shingrix®) against shingles. The vaccine is recommended for:

• People 60 years and older
• People at increased risk due to a weakened immune system

Vaccination reduces the risk of shingles as well as long-term nerve pain after infection.

When should you contact a doctor?

• If you think you have shingles
• If you have a rash or pain around your eye
• In case of severe pain or if symptoms persist

Summary

Shingles is a painful viral infection that mainly affects the elderly and people with reduced immunity. Early recognition and treatment reduce the risk of complications. Vaccination can be a valuable way to protect yourself.