All about Shingles
Shingles: What you need to know
Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. Pharmacists often see patients who are confused, in pain, or unsure about how to manage this condition. While shingles can be distressing, understanding the symptoms, treatment options, and prevention strategies can make a significant difference in recovery and quality of life.
Recognizing the Symptoms of Shingles
One of the first signs of shingles is a tingling or burning sensation in a specific area of the skin, often accompanied by pain. This is followed by the appearance of a rash that typically develops into clusters of fluid-filled blisters. The rash usually appears on one side of the body, often around the torso, face, or eyes. Other symptoms may include:
Fever and chills
Fatigue
Headache
Sensitivity to touch
Itching or irritation in the affected area
The pain associated with shingles can range from mild to severe and is sometimes described as burning, stabbing, or throbbing. It is essential to seek medical advice promptly, especially if the rash develops near the eyes, as it can lead to serious complications affecting vision.
Treatment Options for Shingles
Although shingles cannot be cured, early treatment can help reduce the severity and duration of the illness. Here are some of the treatment strategies:
1. Antiviral Medications
Prescription antiviral drugs such as acyclovir and valacyclovir are the first line of treatment. These medications work best when started within 72 hours of the rash appearing. They help to shorten the duration of symptoms, reduce pain, and lower the risk of complications such as postherpetic neuralgia (PHN).
2. Pain Management
Shingles-related pain can be intense, so managing discomfort is crucial. Depending on the severity a pharmacist might suggest:
Over-the-counter pain relievers: Paracetamol or ibuprofen can help reduce pain and inflammation.
Prescription painkillers: If OTC medications are insufficient, stronger prescription pain relief such as opioids or nerve pain medications like gabapentin or pregabalin may be necessary. Your doctor will know best.
3. Preventing Secondary Infections
It is important to keep the rash clean and dry to prevent bacterial infections. It is recommended to:
Gently washing the area with mild soap and water.
Avoid scratching or picking at the blisters.
Use sterile dressings if necessary to protect the skin.
4. Managing Itching and Discomfort
Itching can be frustrating, so pharmacists will often suggest:
Antihistamines: Over-the-counter antihistamines can help alleviate itching, especially at night.
Cool compresses: Applying a damp, cool cloth to the affected area can soothe irritation.
Preventing Shingles: Vaccination is Key
The best way to prevent shingles is through vaccination. The Shingrix vaccine is highly effective and recommended for adults over 50, as well as younger adults with weakened immune systems. Unlike the older Zostavax vaccine, Shingrix provides stronger and longer-lasting protection. In New Zealand, Shringrix is free once you turn 65.
Some pharmacists can administer the vaccine and patients are encouraged to get vaccinated, especially if they:
- Had chickenpox as a child (which means the virus is dormant in their system).
- Are over 50 years old.
- Have a weakened immune system due to conditions such as diabetes, cancer, or autoimmune diseases.
- Have experienced shingles before, as it can reoccur.
Understanding Postherpetic Neuralgia (PHN)
One of the most concerning complications of shingles is postherpetic neuralgia (PHN), a condition where nerve pain persists long after the rash has healed. This can last for months or even years and is more common in older adults. Treatment for PHN may include:
Nerve pain medications such as gabapentin, pregabalin, or amitriptyline.
Topical treatments like capsaicin cream.
When to Seek Medical Attention
It is crucial to see a healthcare professional if:
The rash is near the eyes or affecting vision.
The pain is severe and unmanageable with OTC medications.
Symptoms persist or worsen despite treatment.
Signs of a bacterial infection, such as increased redness, swelling, or pus, appear.
Final Thoughts
Shingles can be a painful and disruptive condition, but with early intervention, proper pain management, and vaccination, the impact can be minimised. Pharmacists can help patients navigate this condition with confidence, ensuring they have the right medications, self-care strategies, and information to recover as comfortably as possible. If you suspect you have shingles or have questions about treatment and prevention, speak to your pharmacist or healthcare provider for personalized advice.
Stay informed, take care of your health, and don’t hesitate to ask for help when needed.