Shingles is an unusual infection because those who develop it will have picked up the chickenpox virus that causes it many years before. After a bout of chickenpox the virus can lie dormant in your nervous system until something reactivates it. If you’ve had chickenpox you’re at risk of shingles.
What triggers shingles isn’t clear but there seems to be a link to a weakening of your immune system. Some researchers believe that the virus senses that your body is weak and tries to jump ship by moving down the nerves to your skin, where it causes blisters. These blisters release the virus, allowing it to move on to someone else. You can only pass it on to someone who hasn’t had chickenpox.
As you get older, your immune system becomes much less efficient, so while there is a one in three chance of developing shingles at some point in your life, it most often occurs after the age of 50. It’s possible to get shingles more than once, but it’s very rare to develop it more than twice.
The first symptom is generally pain in a patch of skin, typically on your trunk or across your face, followed by the appearance of a rash of itchy fluid-filled blisters. This rash usually forms a band around one side of your body.
The shingles rash lasts a week or two but the pain, which is due to nerve damage, can continue for much longer. One in three people over 80 with shingles will develop this complication, known as post-herpetic neuralgia, which can go on for months or even years.
Anti-viral drugs such as acyclovir can reduce the severity of shingles, speed recovery and reduce the risk of complications. But these drugs must be given soon after the rash appears in order to be effective. Other treatments such as painkillers can help with the discomfort and itching.
Fortunately, there is now a vaccine to prevent shingles developing in the first place. It may not completely protect you from shingles, half of people will go on to develop the condition. But if you’re one of them it will be milder and won’t last as long. Plus the risk of post-herpetic neuralgia is significantly reduced if you have the vaccine.
The NHS offers it free specifically to everyone at 70, 78 or 79 years old. Unlike the ’flu jab you’ll only need the vaccination once. If you’re concerned, speak to your GP.
Q. My friend smokes a lot and refuses to quit. How much damage will spending time with her do to my health?
Dr Trisha says: The main risk to your health is passive smoking – inhaling some of the smoke as it drifts into the air around you. Even if you can’t see any smoke, you’ll still be breathing in the 4,000 or more toxic chemicals that it contains.
Research has clearly shown that passive smoking could increase your risk of lung cancer, cardiovascular disease (including heart attacks and stroke), respiratory infections and lung disease. It’s estimated that 12,000 people in the UK die every year from the effects of second-hand cigarette smoke. You may be more vulnerable if you have any form of respiratory disease, from asthma to bronchitis.
Ask your friend not to smoke around you and avoid being with her if she smokes in confined spaces such as in the car. If she’s a real friend she should respect your request.
- Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing firstname.lastname@example.org.