SKIN TIPS #9: SHINGLES

Shingles is a good illness to understand, then you can decide:

(i) whether or not to get immunised (ii) what to do if you get it.

• Scalded skin; an early sign of shingles is a patch of tender skin that feels like it's been scalded. e.g. It hurts under warm water like a burn does. If you are thinking "I don't remember burning myself there" that is a clue you might be getting shingles. The pain starts two to three days before the rash. The initial rash isred with small blisters (or vesicles) and gets crusty as its healing. If the skin is sore remember to ask our GP.

• It's IMPOSSIBLE to catch shingles. Shingles comes from you! It is your old chicken pox recycled. That's because, even though we get better from our childhood chicken pox, it doesn't go away. It builds a wee nest on a nerve and hibernates. Later on stress or illness and sunburn turn the chickenpox caterpillar into a shingles butterfly' which flutters down the nerve to annoy the patch of skin the nerve supplies. If it gets a chance, it lays chicken pox eggs on anyone it comes into contact with. The cabbage of the shingles butterfly = people who have never had chicken pox.

• Instructions for getting shingles 1) catch chicken pox in your childhood 2) wait for a few decades (like be super patient, maybe do Sudoku) 3) don't get the shingles vaccination 4) get stressed or sick or sunburnt 4) develop a patch of sore skin 5) ask the GP if it is a shingles butterfly (they will think you are strange because shingles is a virus, it's not really a butterfly) 6) grow a shingles rash 7) see the GP to get medicine in the first 3 days of the rash 8) hide the germs from other people for 2 weeks; Finished! . . . slow motion for ages with a rush and a rash at the end.

• People NEVER catch shingles, we can only make shingles from the old chicken pox left on our nerve. Because most people have had chicken pox when they were kids, shingles is common in adults.

• Urgent treatment helps to stop complications: Once the rash bubbles start on the skin there is a 72 hours window when medicine will work. After that medicine doesn't work.

• Antiviral medicines within 72 hours of developing the rash reduce the risk of permanent nerve injury and chronic pain. Doctors will feel cautious about treating tender skin before a rash appears, that's because there a number of other things that can cause sore skin, so there might be 'cautious weighing up of circumstances.

• Facial shingles can be very serious because, if it affects the eye, it can injure sight, cause an aching eye, that might be a problem for the rest of someone's life.

• Shingles in the eye is an 'eye emergency' and requires prompt specialist attention.

• Shingles immunisation seems like common sense for older folk. Shingles in the elderly people can be a nasty illness that sometimes knocks people off their pins for months. Complications can also affect future independence and well being. Discuss the shingles immunisation with your GP.

• Pain relief for shingles is good idea; your GP might give you aspirin in a special solution to rub on the skin It is jolly good for relieving discomfort. Remember that paracetamol reduces pain and symptoms of all illnesses. It also reduces fever and makes it easier to keep fluids. Doctors will often combine paracetamol with other pain relief because paracetamol helps other pain relief medicine work better; It has an 'additive effect'. Paracetamol is a misunderstood hero. Often underrated and extremely handy, especially for sick infants and toddlers because it makes it easier for them to keep up the fluids. Paracetamol; it's often stronger than we realise.

• Fluids - people tend to drink less when they feel unwell and dehydration is a sign of a more serious illness. Taking regular paracetamol and taking fluids is a good idea. Don't worry so much about food, you'll get hungry again as you get better and there are good liquid supplement foods at Alan and Marinas' (Mapua Pharmacy and Post) for 'juicing up' energy.

• Your Neighbours - as a rule of thumb, especially if you are elderly it's a good idea to let friends, family, general practice administrator or neighbor know if you are unwell, that things aren't right; especially if you live on your own. There's good neighbours all over.

Remember the chicken pox caterpillar is itchy and slightly annoying. If it turns into a shingles butterfly; it 'gets on the nerves'.