Shingle is a condition caused by a viral infection that leads to a severe rash in patients with persistent symptoms that can be both debilitating and life-threatening. This can have detrimental effects on the quality of life for some individuals, affecting their physical, emotional and social well-being. This highlights the importance of being aware of its symptoms, as well as understanding the management options to help improve outcomes and prevent complications.

What is shingles?  

Shingles is a viral infection that can occur after an episode of Varicella, more commonly known as chickenpox. Usually, after this episode, the varicella-zoster virus stays dormant in the body, which means it can live in the body for years without having any effect. However, in some individuals, this virus gets reactivated in the form of shingles, causing widespread inflammation and pain from affected nerves.

This condition usually manifests in its early stages as a painful rash or blistering that can cause mild to severe discomfort for an individual. Symptoms such as a headache and fever can also occur, worsening this condition. Though shingles can occur at any age, factors such as increasing age and a weaker immune system can increase your chances of re-activating this virus and developing shingles.

The physical impact of shingles

Shingles can have a great physical toll on the body, as its symptoms consisting of blisters and rash can be painful for patients and prevent them from engaging in day-to-day activities. The burning and tingling sensation accompanied by this infection can further disrupt lives by, for example, affecting their sleeping patterns due to pain, which can ultimately increase their fatigue and affect productivity. 

In some cases, patients can develop Postherpetic neuralgia (PHN).¹ This is when nerve fibres get damaged, causing continuous nerve pain in the affected area, which feels like a burning or throbbing sensation. This can impact their quality of life, as these pains, due to damaged neurons, are continuous and are often long-term, lasting from weeks to months, with medication aimed at only relieving the pain temporarily rather than being able to remove it entirely.

Shingles patients can also experience symptoms such as:¹

• Headache
• A high temperature (Fever)
• Numbness or tingling of the skin 
• Generally feeling unwell or lethargic

However, if these symptoms go unnoticed or are not checked and evaluated by your GP, shingles can worsen, presenting complications such as:¹ 

• Vision loss from nerve damage
• Muscle weakness
• Scarring in the affected area 
• Infected rashes requiring antibiotic interventions
• In rare cases, Ramsay Hunt syndrome, where the facial nerves are affected leading to weakness on one side of the face

The emotional and physiological impact

Though shingles primarily affect the physical body, it can have profound effects on the mental and social health of individuals. With rashes and blisters causing acute pain and discomfort, shingles can lead to significant emotional stress and anxiety, with the fear of potential complications and further episodes of pain making daily tasks and interactions emotionally challenging. 

With patients experiencing symptoms like PHN, this emotional impact is exacerbated, as patients can feel a sense of hopelessness or depression, further affecting their quality of life. This can even result in patients withdrawing from their social circles, putting a strain on personal relationships and social interactions.

Interestingly, the stress caused by the pain and discomfort of shingles can affect how we perceive pain, with studies showing that stress can either dull pain or amplify it.² This highlights the importance of reducing stress if you are diagnosed with shingles, as activities such as meditation, sleep and exercise are all methods that can reduce your stress levels and consequently reduce your body's response or sensitivity to pain. 

The social and daily life impact

As we know, Shingles can have a great impact on a person’s daily activities and social interactions. The pain caused by this can make even the simplest of tasks, like getting dressed, bathing or walking, unbearable. This can mean that the person may have to be dependent on others, which can affect personal relationships, leading to frustration and helplessness. This dependency also limits the patient's own independence, which can leave them feeling less confident and have lower self-esteem, which can negatively impact their social lives.

Furthermore, though shingles cannot be spread to others, this infection still originates from the initial chickenpox viral infection. This means shingles patients can spread chickenpox to people at risk who have not had chickenpox before or have not had the chickenpox vaccine. This also includes anyone with a weakened immune system as well as young babies and vulnerable groups. As shingles patients may need to isolate themselves to prevent spreading the original chickenpox virus, patients express loneliness and depression, as this social isolation can weaken their mental state. It can also impact their daily life, as work and productivity may be limited and individuals might struggle to stick to their usual work schedule due to symptoms, leading to poor performance and financial stress.

Treatment and management of shingles

Importantly, early treatment and management can help prevent shingles from presenting with devastating symptoms that often negatively impact a person's quality of life, as well as potential implications. With mild rashes, treatment isn't required, though shingles cases might have their GP offer antiviral medication to be taken within 3 days from your first symptoms.¹ This helps speed up the recovery process, especially for individuals at risk for complications with a weakened immune system, or in patients who present mild to severe rashes. The GP might also offer painkillers to help reduce the pain of these rashes/blisters and manage the nerve pain caused by shingles.

For cases of shingles, where symptoms like PHN persist, long-term management strategies are needed in combinations, like medication, physical therapy and psychological support. The chronic pain caused by shingles can have severe impacts on the mental health and well-being of an individual, so emphasis on emotional support is key to restoring one’s quality of life. This can range from stress management techniques to help reduce pain perception, and maintaining a balanced diet to speed up recovery.

Alternatively, shingles patients can approach treatment with home management techniques such as:¹

• Keeping the area of the rash clean and protected
• Applying a cold compress to the area
• Wearing loose clothing to prevent contact and irritation
• Taking over-the-counter painkillers to manage symptoms

Prevention and vaccination

Whilst there is no definitive cure for shingles, vaccines are available to the public to help reduce and prevent the occurrence and severity of shingles cases, reducing its impact. This includes the Shingrix and Zostavax vaccine:³

• Zostavax Vaccine: This original vaccination has a weakened version of the shingles virus.
• Shingrix Vaccine: This is a recombinant vaccine meaning it has no parts from the actual shingles virus. This makes it better suited for individuals with a severely weakened immune system. This vaccine has also been shown to be more effective in studies when compared to the Zostavax vaccine.^4,5,6

These vaccinations help reduce the risk of developing shingles later on in life and also minimise potential complications, especially PNH and nerve pain which impact on quality of life. By taking this preventative approach, individuals can protect themselves from an outbreak, ensuring their physical and mental well-being.

Conclusion

Shingle is a condition that can occur from the reactivation of another viral infection, chickenpox. This can have severe consequences on an individual's physical, emotional and social well-being. The physiological distress caused by shingles shows how it can impact the quality of life, making early detection, management and treatment important in recovery. This can help reduce the risk of complications and severity of symptoms, limiting how chronic this condition can potentially be. By understanding its risk factors, impact and severity, individuals can be proactive in taking precautions through vaccinations when recommended and seeking appropriate treatment if symptoms are seen. However, approaching treatment and management choices should be guided and advised by your GP, who can offer the best options available to diminish the impact of shingles. This ensures that patients can regain control of their physical and emotional well-being and reduce the long-term effects on their quality of life.