EDP column by Dr Ketan Dhatariya

“I recently developed some tingling and a rash on the left side of my chest. It was very painful afterwards and my GP told me I had shingles. What is this?"

Shingles is a blistering rash that is caused by the same virus that causes chicken pox – the varicella virus. In fact, you can only get shingles if you have had chicken pox in the past – even if it was decades ago. The chicken pox virus has the capacity to lie dormant within certain areas of the nervous system. Eventually, the virus reactivates itself and spreads along the nerves that it has been residing in causing symptoms. Usually the precipitating factor is a decrease in your body's natural resistance, which may come through other infections, stress, being generally run down.  \being on certain drugs may also increase the likelihood of getting shingles.

These symptoms can start as a tingling and soreness up to a week before the rash appears. The rash starts off as red spots, before turning into blisters. The blisters always affect only one side of the body (left or right) and never cross the midline because the nerves in which they lie do not cross from one side to the other, and so the virus cannot cross the ‘midline’.

There are no specific test for shingles, because the diagnosis is often very straightforward. The treatment is mainly pain relief. This can start as paracetamol or an ibuprofen like drug (as long as it is safe for you to take these medicines). Because the rash can be very irritation, calamine lotion can be helpful as well. In certain circumstances, your doctor may advise  the use of antiviral drugs to help calm the infection down. However, these drugs work best if they are started as soon as the tingling starts. Once the blisters come out, they are not as effective.

If the rash affects you face it is important to see your doctor quickly. Occasionally the rash can involve the eye, in which case you may need to see an eye specialist swiftly.

Usually the blisters heal in a couple of weeks with a few scars, however, occasionally the area that has been affected can be very painful – a condition known as ‘post herpetic neuralgia’. This can last for months and can be very painful indeed. If this happens, there are a number of different medications that your doctor may try to help calm the pain.

For more information about Shingles click these links: