Shingles is a viral infection caused by the same virus that causes chickenpox (varicella-zoster virus). Shingles can only develop in a person who has already had chickenpox (varicella). After an episode of chickenpox, the virus does not completely clear, and some particles lie dormant in nerve roots near the spinal cord. They cause no harm, or signs and symptoms, but can re-activate later to cause shingles (herpes zoster).
If the varicella-zoster virus reactivates, it travels along the nerve to the skin to cause shingles. Symptoms are commonly pain and a rash. The pain is localised, and can range from mild to severe. The pain may be a constant dull, burning or gnawing pain, or sharp and stabbing pain that comes and goes. The rash typically appears two to three days after the pain begins.Shingles generally affects only one nerve, on one side of the body.
Shingles can also cause a condition called post-herpetic neuralgia, in which the affected area of skin stays painful after the shingles rash has cleared.
Treatments for shingles include anti-viral medicines, pain-relieving medicines (analgesics) and soothing creams, gels and dressings. Antiviral medicines (e.g. famciclovir, valaciclovir, aciclovir) stop the virus from replicating. Early treatment with antiviral medicines can speed healing, as well as reduce pain and other complications. Antiviral medicines must be prescribed by a doctor, and can only be subsidised on the Pharmaceutical Benefits Scheme for treatment of patients with herpes zoster within 72 hours of the onset of the rash.
Pain-relieving medicines such as non-prescription simple analgesics (e.g. paracetamol, ibuprofen) may help to relieve the pain, and you can buy them from a pharmacy. Stronger analgesics (e.g. opioids and medicines for nerve pain) must be prescribed by a doctor.
Creams, lotions, gels and wound dressings can help to relieve the pain and protect the affected area. Once the rash has healed, capsaicin cream or lignocaine gel may also help to relieve post-herpetic neuralgia.
All people aged 70 years old can receive the shingles vaccine, Zostavax®, on the National Immunisation Program (NIP). There is a five year catch-up program for people aged 71–79 years old until 31 October 2021
If you think you may be developing signs and symptoms of shingles, visit your doctor as soon as possible (within 72 hours of the onset of the rash), and pharmacist to discuss treatment options.