Shingles (Herpes Zoster)

What is shingles?

Shingles, also known as herpes zoster, is a condition characterised by a painful skin rash. It is a viral disease caused by the same virus that causes chickenpox. Approximately one in three adults who have previously had chickenpox will develop shingles later in life.

Is shingles contagious?

Direct contact with fluid from shingles blisters is the main way the virus spreads. People who have never had chickenpox or have not been vaccinated against it may become infected with the varicella-zoster virus (VZV) if they come into contact with the fluid from the blisters of someone with shingles.

Although it is possible to inhale viral particles from blisters, this is rare.

What causes shingles?

Shingles can occur when the chickenpox virus is reactivated. After a person recovers from chickenpox, the virus remains dormant in the body and may reactivate later, causing shingles.

Why Do People Get Shingles Years After Chickenpox?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus does not completely leave the body. Instead, it remains inactive in the nerve tissues for years or even decades.

Later in life, the virus can reactivate and travel along the nerves to the skin, causing shingles. Although the exact trigger is not always clear, the risk of reactivation increases with age and may be higher in people with weakened immune systems.

Not everyone who has had chickenpox will develop shingles. However, because the virus remains in the body after the initial infection, anyone who has previously had chickenpox may be at risk.

Understanding the connection between chickenpox and shingles can help people recognise their risk and seek timely medical advice if symptoms develop.

Who is at risk of developing shingles?

Several factors can increase the risk of developing shingles:

• Ageing
• Weakened immune system due to conditions such as HIV/AIDS or cancer treatment
• Long-term use of corticosteroids

What are the signs and symptoms of shingles?

Symptoms may vary from person to person and include:

• Skin sensitivity, tingling, itching, and/or pain in the affected area before the rash appears
• A rash that usually appears after a few days and initially looks like small red spots that develop into blisters
• Blisters typically crust over within 7 to 10 days and resolve within 2 to 4 weeks

Other symptoms of shingles may include:

• Abdominal pain
• Nausea and/or vomiting
• Fever and/or chills
• Headache

Shingles symptoms may resemble other medical conditions. Always consult your doctor for an accurate diagnosis.

How is shingles diagnosed?

Shingles is usually diagnosed based on the signs and symptoms presented. Your doctor will perform a physical examination and review your medical history, particularly whether you have had chickenpox before. A skin scraping may also be taken for laboratory testing.

How is shingles treated?

Treatment aims to relieve symptoms, shorten the duration of the outbreak, and prevent complications. You may not require treatment if the rash is mild.

Antiviral medications (oral tablets) may be prescribed if:

• You have a weakened immune system
• Your rash or pain is moderate to severe
• The rash affects areas other than the chest, abdomen, or back

Antiviral treatment should usually be started within three days of the rash appearing.

Treatment may also include medications to relieve pain, such as painkillers, steroid tablets, or medications for nerve pain.

When Should You See a Doctor for Shingles?

Early treatment can help reduce the severity and duration of shingles symptoms and may lower the risk of complications.

You should seek medical attention if:

• You develop a painful rash or blisters on one side of the body
• The rash affects the face, eyes or ears
• You have a weakened immune system
• You are experiencing severe pain
• The rash is widespread or worsening rapidly
• Symptoms are interfering with daily activities

Prompt diagnosis and treatment are particularly important for older adults and individuals with underlying medical conditions.

How can shingles be prevented?

Vaccines are recommended to prevent shingles and its related complications. Speak to your doctor about the recombinant zoster vaccine.

Some individuals who have received the chickenpox vaccine may still develop shingles years later. However, this is less common than in those who have previously had chickenpox.

Schedule an appointment at Pantai Hospital

Consult your doctor if you experience symptoms of shingles. The dedicated and experienced dermatology specialists at Pantai Hospital are available to provide expert care and support.

Pantai Hospital is accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.