Shingles is the term used to describe a particular rash caused by the chickenpox virus. In chickenpox the rash is widespread, but in shingles it is an infection of the nerves that are connected to an area of skin. All our skin is connected to nerves and so any part of the body surface can be affected by shingles. Everyone who has had chickenpox carries the virus that causes shingles, but only about one person in four will develop shingles at some stage in their life.

What causes shingles?
Chickenpox and shingles are caused by herpes zoster. Shingles is caused by the reactivation of the chickenpox virus particles which have been lying dormant, often for many years, in a nerve cell. The reactivated virus spreads along the nerve to the skin.

The virus that causes both chickenpox and shingles is in the same family of viruses as the ones that cause cold sores and genital herpes. The same anti viral medicines are used to treat all of these conditions.

Who is at risk of getting shingles?
Most adults have antibodies to varicella zoster virus (90% in the UK), although not all people will recall having had chickenpox. The risk of getting shingles increases with age and is particularly common in people over 60. Men and women are equally at risk.

Most people who develop shingles have normal immunity and no other serious disease, but in some people it is triggered by another illness.

Is shingles contagious?
Unlike chickenpox, shingles is not very contagious. People who have had chickenpox cannot catch it. The risk to people who have not had chickenpox and who are in close contact with the shingles sufferer is low.

However, it is wise for someone with shingles to avoid close contact with young children and babies until all the crusts have dried. By this time the risk to others will be negligible.

What are the symptoms?
Shingles is usually preceded by a day or two of discomfort or pain in the skin attached to the affected nerve. This pain may be associated with feeling unwell. A flat, patchy red rash is the first sign of shingles.

Small fluid-filled blisters then appear and collapse, leaving small ulcers which later dry and form crusts. The crusts fall off and the rash finally heals after about two or three weeks. Some people also have headaches and a fever for the first few days.

Because shingles is caused by an inflamed nerve, most people will get some discomfort, which occasionally can be quite severe. The pain will often change its character from ‘electric’ or tingling sensations to aches, sharp pain and then an itchy feeling as the rash heals. A few fortunate patients have no pain at all.