Shingles generally resolves without any major problems but there are potential complications in elderly adults. The Pain Management Centre at the Singapore General Hospital explains.
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If you've had chicken pox in the past, you can still get it again but in a slightly different form. This condition is a painful skin rash called shingles (also known as herpes zoster) and it's caused by the same varicella-zoster virus responsible for chicken pox. However, shingles is less contagious than chicken pox.
When shingles heal… is that it?
A major complication of shingles is
post-herpetic neuralgia (PHN).
"PHN occurs when the virus stays in the body and causes pain even after the shingles have healed. Those above 55 years old are 20 per cent more likely to develop PHN because of decreased immunity," explains
Dr Tan Kian Hian, Senior Consultant and Director of the Pain Management Centre,
Singapore General Hospital (SGH), a member of the SingHealth group.
Such pain can be constant or episodic, and it can worsen at night. "Patients can have trouble falling asleep because of the pain, so night medications for PHN have to be stronger," he says.
In severe cases, the pain can disturb the patient's emotional and psychological wellbeing. A shingles attack typically lasts three to five weeks.
Chicken pox vaccine can help
The ultimate goal is to help PHN patients improve their quality of life. "At the Pain Management Centre, we take a very holistic approach. Besides medication, intervention and surgery, we also have psychiatrists to provide psychological and emotional counselling," says Dr Tan.
Also, those who are above 60 can consider taking the chicken pox vaccine to reduce the incidence of shingles. As the vaccine can work as a booster, this is effective even if you have had chicken pox before.
"It is even better if you have young grandchildren who have already been vaccinated. Just being around them can work as a booster for you," says Dr Tan.
Old wives' tales about shingles
Myth: If the shingles blisters stretch around your chest, you will die.
Fact: The Chinese describes the ring of shingles as a "creeping snake". And it is said that if this "snake" grows around your chest or abdomen, it will cause death. This is not true. Dr Tan explains, "There is no scientific evidence behind this claim."
Myth: To deal with shingles, one has to kill the "creeping snake" by burning incense on affected areas.
Fact: Such traditional remedies do not help to alleviate the pain or eliminate the virus from the body. "Patients have approached me with burn marks on their shingles," says Dr Tan. "This actually may cause infections, not to mention excruciating pain. It would have been better for them to seek proper treatment."