Treatment is usually started within five days of the start of the first outbreak and while new blisters or sores are still forming. If the patient is unable to close their eyelids they will require advice on eye care (including eye protection) such as artificial tear drops and ointments and taping the eyelids shut at night. See your GP immediately if an area of skin suddenly turns red, hot and tender. The main symptom is a painful rash which develops into itchy blisters that contain particles of the virus. These need to be started as soon as the outbreak begins. 3. Having a skin condition such as eczema or a fungal infection of the foot or toenails (athlete’s foot) can cause small breaks and cracks to develop in the surface of the skin.
Most people will have chickenpox as a child, but after the illness has gone, the virus remains dormant (inactive) in the nervous system. If you have an outbreak of herpes in pregnancy it is still possible to have treatment. Dec 2008; 25(6):458-64. If the surface of your skin is damaged, this creates an entry point for bacteria, allowing them to attack the skin and tissue underneath. This vaccine is now routinely offered to older people on the NHS. Ice should not be put directly onto the skin. There is also a catch up program for those who have reached the age of 78 or 79 since the program started in 2013.
Your immune system may be weakened if you have a condition such as HIV and AIDS. If you wish to have the shingles vaccine and you are not eligible for the NHS vaccination programme, you will usually need to visit a private clinic. Apply a local anaesthetic ointment such as lidocaine. The blisters that form contain live virus and if a person who has never had chickenpox makes contact with an open blister, they can contract the virus and develop chickenpox. Lymphoedema is a condition that causes fluid to build up under your skin. You may have sharp stabbing pains from time to time and the affected area of skin will usually be tender. Gently bathe the area using cotton wool and a warm salt water solution (1tsp to 1pt water).
It usually starts a few days before the rash appears and can remain for a few days or weeks after the rash has healed. An estimated 20-30% of people with a previous history of cellulitis will be admitted to hospital again with another cellulitis infection. It then develops into itchy blisters similar in appearance to chickenpox. Drink extra fluids; such as water or soft drinks. Shingles is not usually serious, but see your GP as soon as possible if you recognise the symptoms. This is usually doxycycline or ciprofloxacin in combination with flucloxacillin or erythromycin. You should also see your GP if you are pregnant or have a weakened immune system (the body’s natural defence system) and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
Outbreaks will last a different length of time in each person and will depend on your general state of health and whether this is the first or a recurrent outbreak of genital herpes. physical and emotional stress – the chemicals released by your body when you are stressed can prevent your immune system from working properly. This should make you feel more comfortable and help to reduce the swelling. recently having a bone marrow transplant – the conditioning you receive before the transplant will weaken your immune system. recently having an organ transplant you may need to take medication to suppress your immune system so your body accepts the donated organ. chemotherapy – chemotherapy medication, often used to treat cancer, can temporarily weaken your immune system. This type of antibiotic can kill a range of different strains of bacteria.
However, it is possible for someone who has never had chickenpox to catch chickenpox from someone with shingles, as the shingles blisters contains the live virus. You may also be referred to a specialist if you have an unusually persistent case of suspected shingles that is not responding to treatment, or if you have been diagnosed with the condition more than twice. However it’s still important to see your GP as soon as possible if you recognise the symptoms of shingles. In some cases, the antibiotics that are used to treat cellulitis may also help to remove the abscess. keep the rash as clean and dry as possible – this will reduce the risk of your rash becoming infected with bacteria. wear loose-fitting clothing – this may help you to feel more comfortable. do not use topical (rub-on) antibiotics or plasters (adhesive dressings) as this can slow down the healing process.
Keep the wound covered with a plaster or dressing. If you have any weeping blisters, you can use a cool compress (a cloth or a flannel cooled with tap water) several times a day to help soothe the skin and keep blisters clean. It’s important to only use the compress for around 20 minutes at a time and stop using them once the blisters stop oozing. Don’t share any cloths, towels or flannels if you have the shingles rash. As well as painkilling medication, some people with shingles may also be prescribed a course of antiviral tablets lasting 7 to 10 days. Commonly prescribed antiviral medicines include aciclovir, valaciclovir and famciclovir. Antiviral medicines are most effective when they are taken within 72 hours (three days) of your rash appearing.
However, they may be started up to a week after your rash appears if you are at risk of severe shingles or developing complications. If you are pregnant and have shingles, it is likely that your GP will discuss your case with a specialist to decide whether the benefits of antiviral medication significantly outweigh any possible risks. Shingles will not harm your unborn baby. The most commonly used painkiller is paracetamol, which is available over-the-counter (OTC) without a prescription. Always read the manufacturer’s instructions to make sure that the medicine is suitable for you and that you are taking the correct dose. For more severe pain in adults, your GP may prescribe a weak opioid, such as codeine. This is a stronger type of painkiller which is likely to be prescribed alongside paracetamol.
If you have shingles, you will usually be prescribed a much lower dose of tricyclic antidepressants than if you were being treated for depression. This will usually be as a tablet to take at night. Your dose may be increased until your pain settles down. It may take several weeks before you start to feel the antidepressants working, although this is not always the case. As with antidepressants, you may have to take an anticonvulsant for several weeks before you notice it working. If your pain does not improve, your dose may be gradually increased until your symptoms are effectively managed. A number of complications can sometimes occur as a result of shingles.
They are more likely to occur if you have a weakened immune system (the body’s natural defence system) or if you are elderly. Postherpetic neuralgia is the most common complication of shingles. It’s not clear exactly how many people are affected, but some estimates suggest that as many as one in five people over 50 could develop postherpetic neuralgia as the result of shingles. Postherpetic neuralgia sometimes resolves after around three to six months, although it can last for years and some cases can be permanent. It may be treated with a number of different painkilling medicines. Ramsay Hunt syndrome is a complication that can occur if shingles affects certain nerves in your head. In America, Ramsay Hunt syndrome is estimated to affect 5 in 100,000 people every year and it may affect a similar number of people in the UK.
The earlier treatment is started, the better the outcome. Around three-quarters of people who are given antiviral medication within 72 hours (three days) of the start of their symptoms usually make a complete recovery. If treatment is delayed, only about half of those treated will recover completely. The Shingles vaccination which was introduced on the 1 September 2013 is now offered routinely as part of the NHS vaccination programme for those aged 70, 78 and 79. Eligibility for this vaccine is based on a person’s age on that date (see below). Vaccination will reduce your chances of developing shingles by more than a third. And, if you do go on to have shingles it will probably be a milder and shorter illness.
Each year the vaccination program runs from the 1st of April until the 31st of March. To be eligible for a vaccination in any one year, you must have had your 70th birthday by the 1st of September in that year. Once elligible, you can have the vaccine anytime before your 80th birthday. Any person who has met the eligibility criteria since the programme started on 1 September 2013 and who has not yet received the vaccination may receive it up to the day before their 80th birthday. Your GP will invite you for the vaccination. You can have it at any time of year, including at the same time as your flu jab in the autumn. If you think you may have missed your invitation, contact your GP surgery.
Yes, it can be. Not only can shingles be very painful and uncomfortable, some people are left with long-lasting pain called postherpetic neuralgia (PHN) for years after the initial rash has healed. Very occasionally, shingles can be fatal. It’s estimated that around one in five people who have had chickenpox (usually in childhood) go on to develop shingles. That means that tens of thousands of people in England and Wales will get shingles each year. It’s quite common to experience redness and discomfort at the vaccination site as well as headaches, but these side effects shouldn’t last more than a few days. See your GP if you have persistent side effects, or if you develop a rash after having the shingles vaccination.
People under the age of 70 will get the shingles vaccine during the year following their 70th birthday. It’s not available on the NHS to younger people, because shingles is more common in the over-70s. It won’t guarantee that you won’t get shingles, but it will reduce your chances. And, if you do get shingles, the vaccine will likely make the symptoms milder and the illness shorter. You’ll also be less likely to get shingles complications such as postherpetic neuralgia. People who have a weakened immune system, for example due to current cancer treatment, should not have the vaccine. Also anyone who has had a severe reaction to anything used in the vaccine shouldn’t have it.
Your GP or practice nurse will check this.