Dr Rosemary Leonard says: Shingles is caused by the herpes zoster virus, the same virus that causes chickenpox. After you have chicken pox, the virus does not go away completely – some remains in the nerve roots next to the spinal cord.
At some point later on, the virus is reactivated and travels along the nerve to the skin, causing pain and the blistery rash of shingles.
What causes this reactivation is unclear, but it can be triggered by stress, illness or a weakening of the immune system, which can be due to certain medicines and also occurs gradually with increasing age.
Shingles can occur in any of the spinal nerves, including those supplying the face and the eye area, which can be particularly painful.
Although shingles can be an issue at any age, it is much more common in over-50s. Shingles can damage the affected nerve, which then sends confused and heightened messages to the brain, so the area of skin feels painful long after the rash has gone (a condition called post-herpetic neuralgia) – and it sounds as if this is what you have.
The skin may feel burning, aching, numb, or itchy and uncomfortable, and often is very sensitive, so a light touch can trigger pain. The best treatment is with drugs to reduce the abnormal messages travelling up the nerve, such as gabapentin, pregabalin or carbamazepine.
Amitriptyline can also be effective. All these are available on prescription from your GP and it is usual to start with a low dose, which is gradually increased until the pain eases.
Sometimes a combination of different drugs is needed. Post- herpetic neuralgia does usually ease of its own accord with time, so it is unlikely you will need to take medicines long term, but they could certainly make life much easier for you, so please contact your doctor.
If you have a health question for Dr Leonard, email her in confidence at [email protected]. She regrets she cannot enter into personal correspondence or reply to everyone
