Overview
Shingles (herpes zoster) is caused by reactivation of the varicella-zoster virus, which remains in the body's nerve ganglia for life after a chickenpox infection. Typical signs are burning pain and grouped blisters that usually spread on one side of the body in a band-like pattern along a skin nerve. The trunk is most commonly affected, but the condition can also occur on the face, head or limbs. Timing is crucial: treatment with antiviral medicines is most effective when started within 48 to 72 hours after the first blisters appear. Subject to medical assessment, it can shorten the course of the illness, relieve symptoms and reduce the risk of persistent nerve pain. Because shingles can often be recognised visually, a telemedicine assessment via photo and video is particularly well suited to making use of this time window. At OpenClinic24 you can get a medical video consultation at short notice; if medically indicated, a private prescription can be issued.
Common causes
Shingles is not triggered by a new infection but by reactivation of the varicella-zoster virus already present in the body. After chickenpox – usually in childhood – the virus retreats into nerve ganglia, where it can remain unnoticed for decades. If the immune defence is weakened, the virus can become active again and travel along the affected nerve to the skin. Common contributing factors include older age, particularly from 50 onwards, acute or chronic stress, lack of sleep, severe infections or surgery, as well as illnesses and medicines that suppress the immune system, such as chemotherapy or long-term corticosteroid treatment. Strong UV exposure and physical exhaustion are also discussed as possible triggers. In many cases, however, no clear trigger can be identified. Anyone who has had chickenpox carries the virus – so shingles can, in principle, affect anyone.
When to see a doctor
Seek medical advice within 72 hours of the first blisters appearing if possible, because antiviral therapy is most effective within this time window. An immediate in-person examination is required if the rash appears on the face, especially near the eye, nose or ear: complications such as visual disturbances, hearing loss or facial paralysis can occur. You should also visit a practice or hospital promptly if your immune system is significantly weakened, if you are pregnant, if the rash extends over several body regions or if the skin shows signs of a purulent secondary infection. Call the emergency number 112 in case of high fever with neck stiffness, confusion, impaired consciousness, sudden paralysis or shortness of breath – these signs can indicate a dangerous spread of the infection. For an uncomplicated course on the trunk, a telemedicine assessment via photo and video can be a fast first step.