The shingles rash
Shingles is an infectious disease that is typically characterised by a band of blistering, painful, rashes that appears in one area on the body and lasts for 2-4 weeks.1
Shingles is also known as herpes zoster and locally, as snake disease (生蛇) or kayap ular.
What causes shingles?
Shingles most commonly occurs in individuals 50 years and older and almost all older adults are at risk of shingles.1,2* It is caused by the same virus that causes chickenpox (i.e. the varicella-zoster virus). For most individuals who recover from chickenpox, the virus lies inactive within certain nerve cells (known as the dorsal root ganglia) without causing any problems. However, in 1 in 3 individuals, the virus reactivates causing shingles.1,2
What are the symptoms of shingles?
The typical symptom of shingles is a painful rash.1 It usually starts with a pain that is often described as aching, burning, stabbing or tingling at the affected site.1 Other symptoms that can occur are headaches, sensitivity to light, upset stomach, and fever.1
Shingles usually appears as a band on one side and site of the body, rarely crossing over to the other side1. This unique distribution of the rash occurs because it follows the area supplied by the affected nerve cells. The most common site for the rash to appear is the torso. However, shingles can also affect the face, neck and the eyes.1
The skin over the affected area forms fluid-filled blisters that eventually crust over and clear. The whole process can last between 2-4 weeks.1 The pain of shingles is usually experienced through the early to late stage but can also become chronic, as shown in the “Timeline for shingles symptoms.”1,2,6
Pain is an important symptom of shingles as it has been described as the "the worst pain ever experienced," and is well known to be difficult to treat.6
Is shingles contagious? How does shingles spread?
Shingles itself cannot be spread from one person to another. However, the virus that causes shingles is contagious.11 If you have shingles, you can pass the virus to another person, if the person comes into contact with open blisters and has never had chickenpox or has not been vaccinated (i.e., parents or grandparents of small infants should be wary).
Complications from the shingles rash
After treatment, most individuals recover from shingles with no complications. However, some patients experience complications from shingles that can last for months to years after the rash clears.6
The impact of shingles on quality of life
The symptoms and complications of shingles can impact an individual’s daily life such as impeding work productivity, movement, sleep and enjoyment of general activities. In older patients, the pain itself can lead to anxiety, mood disturbances and depression.6,9,14,15 It can also impact carers or family due to days of work lost from taking care of the patient.
There are also direct costs (e.g., medications, doctor consultations and hospitalisation) and indirect costs (e.g., medical leave, loss of productivity) to consider when looking at the overall impact of shingles.14,15
For these reasons, early shingles treatment1,16,17 and prevention is recommended.18
Read real patient accounts about their experience with shingles here.
*>90% of adults ≥50 years of age in Singapore have been exposed to the chickenpox virus.5
- Harpaz R et al. MMWR Recomm Rep 2008;57:1-30; quiz CE2-4.
- Centers for Disease Control and Prevention. Herpes Zoster (Shingles). Available at: https://www.cdc.gov/shingles/hcp/clinical-overview.html. Accessed May 2022.
- Kawai K, et al. BMJ Open. 2014;4:e004833.
- National Population and Talent Division, Strategy Group, Prime Minister’s Office, Singapore Department of Statistics. Population in brief 2020. Available at: https://www.strategygroup.gov.sg/files/media-centre/publications/population-in-brief-2020.pdf. Accessed May 2022.
- Fatha N, et al. Int J Infect Dis. 2014;22:73-77.
- Chen L-K, et al. BMC Infect Dis. 2017; 17:213. doi: 10.1186/s12879-017-2198-y.
- Northern Territory Government (Australia). Shingles. Available at: https://nt.gov.au/wellbeing/health-conditions-treatments/viral/shingles. Accessed May 2022.
- National Institutes of Health (US), National Institute on Aging. Shingles. Available at: https://www.nia.nih.gov/health/shingles. Accessed May 2022.
- Goh C-L, Khoo L. Int J Dermatol. 1997; 36:667-672.
- Batram M, et al. Dermatol Ther (Heidelb). 2021 Jun;11(3):1009-1026.
- Healthline.com. Is shingles contagious. Available at: https://www.healthline.com/health/shingles-contagious#takeaway. Accessed June 2022.
- Johnson RW, Dworkin RH. BMJ. 2003;326:748-750.
- Opstelten W et al. BMJ (Clinical research ed) 2005;331:147-51.
- Chen Q, et al. Dermatologica Sin. 2015;33(4):201-205.
- Drolet M, et al. CMAJ. 2010;182(16):1731-1736.
- Johnson RW, et al. BMC Medicine. 2010;8:37. doi: 10.1186/1741-7015-8-37.
- John A, Canaday DH. Infect Dis Clin North Am. 2017;31(4):811-826.
- Society of Infectious Disease, Singapore; College of Family Physicians, Singapore. Handbook on adult vaccination in Singapore 2020.
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