From understanding symptoms & causes, to treatment & vaccinations, we talk you through all you need to know about shingles
What is shingles?
Shingles is an infection of a nerve and the skin around it, that causes a painful rash. It’s also known as herpes zoster and is caused by the same virus as chickenpox, the varicella-zoster virus.
What are the signs & symptoms of shingles?
Sometimes there are early symptoms that develop a few days before the shingles rash first appears. These early symptoms can include:
• A headache
• Feeling generally unwell
• A high temperature
• Pain, burning, tingling, numbness or itchiness of the skin in the affected area
The main symptoms of shingles are pain in the affected area, followed by a rash that develops a few days later.
The pain may be constant, dull or burning, and can range in intensity from mild to severe. You may also experience sharp stabbing pains at times, and the affected area of skin will usually be tender.
The rash appears on one side of your body only. If you have a rash on both sides of your body, it’s unlikely that you have shingles. The rash can be red, but this can be harder to see on brown or black skin.
The rash normally appears on the chest or stomach. However, it can appear anywhere on your body, including your face, eyes or genitals.
The rash appears as blotches on your skin, and then develops into itchy blisters. These blisters may ooze fluid, and new blisters can continue to appear for up to a week.
After a few days, blisters appear yellowish in colour, flatten, dry out and scab over. These scabs may leave some slight scarring.
An episode of shingles usually lasts around two to four weeks. However, sometimes the pain may continue for several weeks after the rash has gone.
What causes shingles?
If you’ve had chickenpox, the varicella-zoster virus lies dormant in your body, but it can be reactivated and cause shingles later.
We don’t yet know the reason the virus gets reactivated, but it could be linked to:
• Lowered immunity
• Old age: most shingles patients are over 50 years old
• Stress
• Other illnesses and conditions like HIV or Hodgkin’s lymphoma
• Treatments like chemotherapy
Is shingles contagious?
You can’t catch shingles from someone else with the condition, or from someone with chickenpox.
However, if you have shingles and you come into contact with someone who’s never had chickenpox, you could give them chickenpox. This is because the shingles blisters contain the live varicella-zoster virus that causes both shingles and chickenpox.
If you have shingles, you’re contagious until your last blister has scabbed over. It can take between two and four weeks for shingles to get better.
In the UK, chickenpox is very common during childhood. At least nine in 10 adults have already had it and so won’t be at risk from someone with shingles.
However, if you have got shingles, try to avoid:
• Pregnant people who’ve not had chickenpox before
• Those with a weakened immune system (like chemotherapy patients)
• Babies less than one month old (unless you gave birth to them)
These people may be at more risk from the virus.
Treatment for shingles
If you think you might have shingles, speak to your GP or local Boots pharmacist straight away. There’s not a cure for shingles but getting treatment straight away can help to ease your symptoms, reduce the severity of the condition and the risk of complications.
Self-care
If you’re diagnosed with shingles, there are a few dos and don’ts to be aware of.
Do:
• Keep the rash as clean and dry as possible, to reduce the risk of infection
• Wear loose fitting clothing
• Take paracetamol if suitable for you, to relieve the pain
• Use a cool damp cloth to soothe skin and keep blisters clean
• Use dressings that will not stick to your rash if you need to cover the blisters
Don't:
• Let dressings or plasters stick to the rash
• Use antibiotic cream, as this will slow healing
• Share towels, flannels or bedding with anyone else if you have the shingles rash, as this can spread the virus
• Go into work or school if the rash is still oozing fluid (weeping) and cannot be covered, or until the rash has dried out
Antiviral medication
Antiviral medication can also be used to treat shingles. It doesn't kill the virus but can stop it from multiplying and may limit the severity of shingles symptoms.
Antivirals are most effective when taken within 72 hours of your rash appearing. But they can be started up to a week after your rash appears, if you’re at risk of severe shingles or complications.
Antiviral medication may be prescribed if:
• You’re over 50 and have shingles symptoms
• Shingles is affecting your eyes or ears
• You have a weakened immune system
• You have moderate to severe pain
• You have a moderate to severe rash
Shingles & pregnancy
If you’re pregnant and develop shingles, there’s not any danger to you or your unborn baby.
Speak to your GP if you think you have shingles, as you may need antiviral treatment. If this is the case, you may be referred to a specialist.
The shingles vaccine
If you’re between 70 and 79 years old, you're eligible for the NHS shingles vaccination. The vaccine isn’t available on the NHS for anyone aged 80 and over. This is because the evidence indicates it’s less effective in this age group.
The vaccine should help reduce your risk of developing shingles and make the symptoms milder if you do develop it.
The shingles vaccine is not suitable for anyone who:
• Has had a serious allergic reaction to a previous dose of the shingles vaccine
• Has had a serious allergic reaction to any of the ingredients in the shingles vaccine
• Has had a serious allergic reaction to the chickenpox vaccine
If you have a weakened immune system, a GP or practice nurse will assess which shingles vaccine may be suitable for you.
If you’re eligible, speak to your GP or GP practice about having the shingles vaccination.
It’s also possible to have a shingles vaccination privately through the Boots Shingles Vaccination Service. This is suitable for people aged over 50 and is available in selected Boots pharmacies.* Please note, this isn’t an NHS service and charges do apply.
How a pharmacist can help
Under the new NHS Pharmacy First Service*, our pharmacists are now equipped to provide even more support for those suffering with shingles.
No appointment is needed, and we can offer advice and treatment, including prescription medicines where appropriate. It's a convenient option to address minor health concerns without the need for a GP visit.
Under the Pharmacy First scheme, those aged 18 years and over living in England can access advice and care for shingles at our pharmacies. However, pregnant women are among the exclusions, and if our pharmacist deems your symptoms require further attention, they may refer you to another healthcare professional, such as a GP.
It's crucial to seek immediate medical attention at A&E if you are suffering with shingles and:
• Have a severely weakened immune system,
• Have a weakened immune system, and the rash is widespread or severe
• Notice signs of meningitis or encephalitis
• Have muscle weakness
• Notice loss of bladder or bowel control
• Experience facial nerve paralysis
• Have a rash on the tip, side, or root of the nose
• Experience visual symptoms
• Have unexplained red eye
Your health matters to us, and our pharmacy teams are here to provide the best possible care for your shingles symptoms. Visit your local Boots pharmacy today for personalised advice and support with shingles under the Pharmacy First scheme.
Please note, during busier periods, a pharmacist may not be available and waiting times can vary.
*Supply of treatment is subject to a suitability assessment. In most stores in England only. Subject to availability and store opening hours. Charges may apply.
