What is Shingles? 

Shingles, also known as herpes zoster, is a painful skin rash and blisters on the skin that occurs only in people who previously have had chicken pox. Once a person had chickenpox, the virus stays in their body and can be reactivated later in life to cause Shingles. It is possible to have Shingles more than once.

The virus can be re-activated due to a variety of reasons which include the advancement of
age, a weakened body’s resistance, immunosuppressants, illnesses, or stress.

In Singapore, it is estimated that 80 to 85% of adults would have had chicken pox and 20% of these people would then later develop Shingles. It is estimated that Singapore has about 30,000 new cases of Shingles each year.

The incidence of Shingles increases for people 50 years and older. It rises more steeply after 60 years of age.

Symptoms:

1. The first symptom is usually a burning pain or tingling sensation in the skin, or extreme sensitivity in one area of the skin.
2. This is followed with a red rash one to three days later.
3. Groups of blisters on a red base usually follow. These blisters often only show on a particular area on the scalp of the body such as the chest. It can sometimes also affect the face, head, and eye. The blisters usually then scab in seven to ten days. Shingles usually fully clears up within two to four weeks.
4. Other symptoms can include fever, headache, or chills.

Complications:

The most common complication is a long-term pain called post-herpetic neuralgia (PHN).  It is a pain which persists for several weeks or months after the rash on the skin has healed. PHN increases with age and can be incapacitating, requiring multiple painkillers. Other possible complications include scarring, complications with vision (if the rash appears around the eye) and partial weakness/paralysis of the areas served by affected nerves.

Transmission:

A person with Shingles can spread the chicken pox (varicella – zoster) virus to another person through direct contact with the fluid from the Shingles blisters. Transmission can also occur through breathing in virus particles that come from the blisters. The virus cannot spread before
the rash blisters appear or after the rash has crusted.

If someone gets infected, they will develop chickenpox, not Shingles.

Treatment:

There is no cure for Shingles. It simply has to run its course.

However, there are several antiviral medicines available to help reduce symptoms and shorten the duration of Shingles. They are most effective when taken as soon as possible.

The treatment also focuses on pain relief such as painkillers and cool compresses which help in drying the blisters.

Anti-depressants and anti-convulsants are used to treat the nerve pain should the pain become so severe that normal painkillers are not strong enough to relieve.

Consult your doctor for further information.

Prevention with Vaccination

Shingles can be prevented with vaccination. There are two vaccines available:

1. Zostavax

   This live Shingles vaccine contains the weakened varicella-zoster virus. It offers 50 – 60% protection.

2. Shingrix

This recombinant (non-live) vaccine does not contain the live varicella-zoster virus.

Most clinics, including University Health Centre, offer this newer and better vaccine. The Shingrix vaccine offers more than 90% protection.


Sources:

Healthhub, Health Promotion Board (HPB)

https://www.healthhub.sg/a-z/medications/shingles-herpes-zoster-vaccine

https://www.healthhub.sg/a-z/diseases-and-conditions/herpes_zoster

NCID

https://www.ncid.sg/News-Events/News/Pages/What-is-shingles-and-how-is-it-prevented.aspx#:~:text=Dr%20Asok%20Kurup%2C%20an%20infectious,over%20the%20age%20of%2050.