Shingles treatment needs to start as soon as possible 

“Most of us get chickenpox as children and that virus remains in our bodies, only to re-emerge as shingles when our immunity is reduced,” Stack says. The chances of this increase with age.

“Shingles is most common in the over-50s,” says Stack. “That’s because of age-related weakening of our immune system. Those who have weakened immunity or are immune compromised for any reason are also at higher risk of developing shingles.”

The first sign of shingles is usually itchiness.

“It’s itchiness that runs along a single nerve,” says Stack. “It can be any nerve in the body but most commonly, it’s the one that runs around the lower abdomen from the spine to the bellybutton. The second most common nerve is just under the breast and the third most common is the top of the skull and down into the eye. Wherever it is, the nerve becomes irritated, which manifests as itchiness or pins and needles followed by pain. And it’s always on one side of the body.”

This itchiness is usually followed by a blotchy rash, which turns into fluid-filled blisters.

“These can be very painful,” says Stack.

Recovery speed depends on patient recognition of the warning signs and early medical intervention.

Biopharma company GSK, which produces a shingles vaccine, conducts an annual survey measuring how much Irish people know about the condition.

“We have found that general awareness is good,” says Eaven Daly, GSK country medical director. “About three-quarters of people have heard of shingles and are aware it can be serious. But they are unsure when it comes to the details. They don’t know what shingles involves or what they can do to manage or prevent it.”

Olive Creavy, 68, from Raheny in Dublin, is someone who is well informed about shingles as she has had it twice. “I was in my 30s the first time and I remember the itchiness on my lower tummy. My mother had shingles quite badly, so I recognised the symptoms and went to the doctor. I felt better in a matter of weeks and had no after-effects.”

Six years ago, Creavy had shingles again: “This time, it was higher up my tummy, but I knew what it was straight away and rushed to the doctor. The rash and the blisters were sore but again the pain passed within weeks.”

Creavy knows that everyone isn’t as lucky: “I’ve heard it’s important to get treated quickly. Leaving it is asking for trouble.”

Stack confirms this: “Shingles can be serious in some circumstances, which is why treatment should always start as soon as possible. For example, if shingles occurs on the nerve that supplies the eye, that can lead to worsened vision or even blindness in that eye.”

He outlines other complications, including blister infection, scarring of the skin, and two rare forms of shingles that cause pneumonia and encephalitis.

There is also the possibility of developing post-herpetic neuralgia.

“This is a form of nerve pain that persists after the rash heals,” says Stack. “It can last for weeks, months or even years and occurs in some 10% of cases.”

The risk of developing long-term after-effects is reduced by seeking treatment early.

“There are oral antiviral treatments available that reduce the severity of symptoms and their duration,” says Stack. “The sooner they are started, the better. The pain can also be treated with paracetamol, anti-inflammatories, codeine and morphine if necessary.”

Stack is keen to reassure people that most cases resolve quickly and with minimal intervention, with most recovering in three to four weeks.

He also wants to dispel the uncertainty regarding whether shingles is contagious: “It is and it isn’t. Someone with shingles cannot give another person shingles. But they can give them chickenpox if that person hasn’t had chickenpox already. That’s why people with shingles need to be careful around children.”

With talk of adding the chickenpox vaccine to the childhood vaccination programme, Stack believes that chickenpox and shingles could become much rarer than they are today.

“A successful vaccination programme should make it far less likely that children get chickenpox and go on to develop shingles in later life,” he says.

The shingles vaccine might also play a part in this, but its current cost makes it prohibitive for many.

“It’s very effective and recommended for older people,” says Stack. “But it’s not covered by the vaccination programme and costs roughly €500.”

While we wait for our vaccination programmes to be updated, it’s probably best to heed Creavy’s words.

“There’s nothing you can really do to prevent yourself from getting shingles beyond minding yourself as the virus is in your body already,” she says. “But if you show any signs of it, go to the doctor immediately. They’ll help you to recover.”