Many of us think of chickenpox as a childhood illness — a harmless rite of passage that fades into memory once the itchy blisters heal. However, what most people don’t realize is that the virus behind chickenpox, the varicella-zoster virus (VZV), never really leaves the body. Instead, it lies dormant in the nervous system for years, only to reawaken later in life as a painful and potentially debilitating condition known as shingles.1

Shingles, or kulebra as it’s locally known, is a viral infection that can cause severe discomfort. It’s the same virus that caused your chickenpox but reawakens when your immune system is weakened.

In a radio interview, family medicine and geriatrics expert Dr. Cheridine Oro-Josef, likened the pain of shingles to “a dormant volcano suddenly coming to life.” She emphasized that the most challenging symptom isn’t the rash itself, but rather the nerve pain known as postherpetic neuralgia or long-term nerve pain. Her patients often described this pain as “barbed wires” piercing the skin, which can linger for months or even years after the rash has healed.

“When it develops there, it can be extremely painful because it affects the nerves. Our sensations come from our nerves, so if they are inflamed or affected, the pain can be really intense,” Dr. Oro-Josef said.

Shingles primarily affects older adults, particularly those over 50, as well as individuals with weakened immune systems due to conditions such as asthma, coronary heart disease, chronic obstructive pulmonary disease, depression or rheumatoid arthritis. In fact, about 24 percent of adults aged 50 to 59 — around two million Filipinos — are at risk of developing shingles.

Spotting the signs

Shingles often starts with signs that are easy to miss. You might feel itching, tingling or a burning sensation on one side of your body. This early feeling can seem like a minor skin irritation but is actually a warning of more noticeable symptoms to come.

As shingles progresses, a painful rash usually appears. It begins with a few red spots or small blisters that quickly turn into clusters of fluid-filled blisters, which then crust over. In addition to the rash, shingles can cause sharp, shooting pain that can last for more than 10 days. You might also experience fever, headaches, sensitivity to light and fatigue.

Dr. Oro-Josef noted that since the VZV can spread through direct contact with fluid from shingles blisters or through airborne particles if the blisters burst, individuals with shingles should isolate themselves. This helps prevent spreading the virus, especially to those who haven’t had chickenpox or been vaccinated.

“If you’ve already been vaccinated against chickenpox and had the disease, you likely have some protection against shingles. However, if you haven’t had chickenpox and are exposed to someone with shingles, you could contract chickenpox instead,” Dr. Oro-Josef explained.

Staying ahead of shingles

While shingles is a viral infection, there are effective ways to reduce the risk. Dr. Oro-Josef emphasizes that preventing shingles isn’t just about hoping for the best; it requires a proactive strategy.

She also highlighted the importance of consulting a healthcare professional before using any ointments or topical treatments on skin rashes. “Sometimes, patients use different ointments, which can alter the appearance of the rash. This makes it harder for doctors to diagnose shingles since the rash might look different. If you have a painful rash or blisters, see your doctor right away.”

Maintaining a strong immune system is key. This involves managing stress, eating a balanced diet, staying active and vaccination according to Dr. Oro-Josef. Shingles treatment can be expensive, making prevention crucial.