A painful rash

by | February 28, 2017

Seniors are particularly prone to having shingles and a vaccine is recommended to reduce your risk.


Shingles are red patches and blisters that appear in a band on one side of the body.

Shingles, also known as herpes zoster, is not a life-threatening condition but is a painful blistering rash caused by the varicella-zoster virus that causes chickenpox.

Following a chickenpox infection, the virus may become dormant living in the nerves linked to your spinal cord. The virus then becomes active again when there is a temporary decrease in the body’s resistance, and then multiples and moves along the nerve fibres to the skin supplied by them to become shingles.

Most attacks of shingles occur for no apparent reason, but an attack is most likely:

  • If you are a senior.
  • If you are under stress.
  • If you have an illness that weakens the immune system such as cancer (e.g leukaemia and lymphoma) or AIDS.
  • If you are have been given treatments that suppress the immune system including irradiation for cancer, chemotherapy and drugs taken to prevent organ rejection.


What are the symptoms of shingles?

The first symptom is often a burning pain or tingling sensation, or extreme sensitivity in one area of the skin. This may be present for one to three days before a red rash occurs. Groups of blisters on a red base usually follow. The blisters last for two to three weeks, during which time pus may appear and then crust over and begin to disappear. The pain may last longer. The blisters usually appear on only one side of the body.

Other symptoms also include fever with chills and headaches, and upset stomach or abdominal pain.


How severe is the pain?

The pain can be severe enough for you to request for painkillers. Post-herpetic neuralgia, a persistent painful complication of shingles, can occur especially in older individuals. Ingestion of antiviral drugs during a bout of shingles may reduce the risk of getting post-herpetic neuralgia in individuals above 50 years of age.


Where do shingles appear on the body?

Most commonly, blisters will appear on one side of body, the buttocks and genitalia, or the face in the distribution of the nerve(s) supplying the area. If the blisters involve the eye region, permanent eye damage can result and your doctor will refer you immediately to an eye specialist.


What are the complications of shingles?

  • Post-herpetic neuralgia – a condition in which either constant or episodic pain persists for a long time after the skin has healed.
  • Infection of the blisters by bacteria – this can lead to delayed healing of the skin. Antibiotics are needed in these instances.
  • Rarely, high fever and spread of the disease all over the body in very ill persons.
  • Inflammation of the brain (encephalitis).
  • Temporary or permanent blindness.
  • Loss of facial movement (paralysis).
  • Chronic nerve pain which can last more than three months, according to a study done by the National Skin Centre (NSC) last year.


How do I know I have shingles?

This is by the appearance of the blisters and pain on one side of the body. To be certain, your doctor may do a special test called Tzanck smear in which scrapings from the blister are put on a slide and examined under the microscope for “giant cells”.


If herpes zoster affects the region around the eye, the eye itself may also be affected.

Is shingles contagious?

Shingles is much less contagious than chickenpox. People with shingles can spread the virus if blisters are broken and a susceptible person (someone who has never had chickenpox or who is already ill) is close by. The main people at risk are babies or those who are already ill, e.g. from cancers or AIDS.


Is there much scarring?

Scarring occurs in those who have more severe infections, elderly people, those whose blisters become infected, those who use toxic home-remedies, those who treat their rashes by burning or scalding them, or those who use chemicals to treat themselves.


How is shingles treated?

Shingles usually resolves spontaneously in a few weeks and seldom recurs. Treatment consists of painkillers, as well as cool compresses to help in drying the blisters. Anti-viral medications, e.g. acyclovir, valacyclovir or famciclovir, are usually given for severe cases of shingles, those with eye involvement or those who are very ill. If taken within the first few days of the attack, acyclovir can shorten the duration of the attack.

Post-herpetic neuralgia can be treated with topical painkillers such as lignocaine gel or capsaicin, or simple analgesics such as paracetamol. In severe, persistent post-herpetic neuralgia, tricyclic antidepressants can be used to relieve the pain. See your doctor early for shingles.


Are there any prevention measures?

These include having a shingles vaccine called Zostavax, which costs about S$240 in public hospitals to S$400 in private clinics, which can reduce the risk of getting the disease and is recommended to those over 50. The vaccine is also available at polyclinics and selected Guardian outlets.


(** Most of the above information has been taken from the National Skin Centre’s website, with the Centre’s knowledge.)

(** PHOTO CREDITS: National Skin Centre)




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