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Shingles

Herpes zoster, commonly referred to as shingles, is a painful blistering rash caused by the varicella-zoster virus— the same virus that causes chickenpox.
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What is shingles?

Herpes zoster, commonly referred to as shingles, is a painful blistering rash caused by the varicella-zoster virus— the same virus that causes chickenpox.
Shingles are not life-threatening but can be very painful. It has been shown that vaccination may help reduce an individual’s risk of developing shingles while early diagnosis and treatment can help reduce both the severity and duration of your shingles infection, significantly lowering your chance of having a complication.

What causes shingles?

Shingles is caused by the varicella-zoster virus, which also causes chickenpox. In the aftermath of a chickenpox infection, the virus can remain dormant in certain parts of your nerves associated with the neck region, spinal cord, or the head. Over time, the virus can become active again, multiplying in numbers before spreading to the surrounding skin area and causing painful blistering rashes on your body.

What are the symptoms of shingles?

Common symptoms of shingles include:

  • Pain: major symptom of shingles is pain in the affected area. However, not all patients will experience pain.
  • Itching/burning sensation: some individuals experience itching or a burning sensation instead of pain at the affected skin areas.
  • Cluster of red spots: these red spots will quickly transform into blisters which will either burst or get filled with blood or pus. Eventually, these blisters dry out and become crusty before falling off.
  • Mild headache: coupled with fever may also accompany your symptoms.

It is important to be treated early because shingles tend to appear near or on the nerves of your body. If shingles occur on your face, running along the nerve root over your face and eyes, it can result in eye complications such as blindness, scarring, and glaucoma.

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Who is at risk of shingles in Singapore?

Shingles can only affect you if you’ve had chickenpox before, but there are also several factors that increase your risk of shingles:

  • Those experiencing physical or emotional distress
  • Those using certain medications that suppress the immune system, such as steroid medications, radiotherapy, chemotherapy, and medications to prevent infections.
  • Those with advanced age, particularly those aged 60 and above.
  • Having a compromised immune system or suffering from certain medical conditions such as human immunodeficiency virus (HIV)/AIDS, blood and bone cancers, and lymphoma.

What are the possible complications or risks of shingles?

There are a few potential shingles complications, such as:

  • Brain inflammation
  • Loss of hearing
  • Facial muscle paralysis
  • Skin bacterial infection
  • Post-herpetic neuralgia
  • Blindness

Those who are older than 60 years are highly encouraged to get vaccinated against shingles because it’s the ultimate way to prevent the potential occurrence of post-herpetic neuralgia.

How are shingles diagnosed?

The diagnosis of shingles occurs in the following ways:

  • Visually: by identifying them based on the distribution of the rashes on your body.
  • Fluid samples: a sample of the blister’s fluid is extracted and sent to the laboratory for a diagnosis.

What are the treatment options for shingles in Singapore?

The treatment for shingles are as follows:

  • Oral antiviral drugs: highly effective at reducing both the severity and duration of symptoms. It also prevents the potential occurrence of a condition referred to as post-herpetic neuralgia. These medications must be consumed within 3 days of onset.
  • Symptomatic relief medications: Topical creams as well as anti-inflammatories are the other treatment options for shingles. Topical creams help alleviate pain and prevent the development of post-herpetic neuralgia while anti-inflammatories help relieve pain.

FAQ

Are shingles curable?

Shingles are not curable. However, there are various effective treatment options that not only help manage the associated symptoms, but also prevent the development of a condition known as post-herpetic neuralgia.

Are shingles contagious?
Yes, shingles is contagious as the virus that causes it is highly infectious. If you have shingles, the virus can spread and result in chickenpox in an individual who has never encountered the virus or is not vaccinated against it. Therefore, it is highly recommended that if you are in the blister phase, stay away from everyone who has never had chickenpox, people who are pregnant or those with low immunity. Shingles patients are contagious until their rashes have completely dried and crusted over.
Does the shingles vaccine offer 100% protection against singles?
No. Just like any other type of vaccine, being vaccinated against shingles doesn’t offer 100% protection. However, getting the vaccine significantly reduces your risk of developing shingles. If you do develop shingles, you will most likely have mild symptoms and a reduced chance of complications like post-herpetic neuralgia.
Can you get chickenpox more than once?

While it’s generally very rare to catch chickenpox more than once during your lifetime, it’s possible if you have a highly compromised immune system.

REFERENCES

Treatment of herpes zoster and postherpetic neuralgia – PMC (nih.gov)

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