Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox.
Shingles is of real concern for CLL patients because of their compromised immune system, which means that the virus can be more severe and difficult to control.
If you think you may have shingles, we recommend that you contact your health care team immediately, as early treatment is important. Please do not ignore the symptoms.
The first sign of shingles can be:
• A tingling or painful feeling on an area of skin. It can be very sensitive to the touch.
• A headache or feeling generally unwell
• A high temperature
• A rash that appears on one side of the body only, usually a few days later.
• Often shingles appears on chest or stomach areas, but it can appear on your face, eyes, and genitals.
• The varicella zoster virus is the culprit behind both chickenpox and shingles. The first time someone is exposed to the virus, it causes the widespread, itchy sores known as chickenpox. The virus never goes away. Instead, it settles in nerve cells and may reactivate years later, causing shingles.
These are typical pictures of what shingles can look like:
The rash will turn into blisters which can burst.
For some patients, the rash can be more extensive and can become very painful.
The shingles virus remains dormant in the nervous system and when activated can affect the nerves. In severe cases, it can cause damage to that section of the nervous system, which may be long-lasting and, in some cases permanent.
Shingles can also make your eye red and sore, affect your sight or hearing, or make it difficult to move one side of your face.
A person with shingles can pass the varicella-zoster virus to anyone who isn’t immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles.
Chickenpox can be dangerous for some people. Until your shingles blisters scab over, you are contagious and should avoid physical contact with anyone who hasn’t yet had chickenpox or the chickenpox vaccine, especially people with weakened immune systems, pregnant women and new-born children.
It is important that you do not have the standard vaccine for shingles as it is a live vaccine and can cause severe complications.
There is an alternative vaccine, Shingrex, which is now available for all CLL patients over the age of 50.
Shingrix has also been licensed in the UK for the prevention of shingles in adults aged 50 years and older, as well as in adults 18 years of age or older who are at increased risk of shingles. However, these groups will have to pay for the vaccine, as for them it’s not available on prescription.
While there is no cure for shingles, antiviral medications can put the brakes on an attack. Prompt treatment can make a case of shingles shorter and milder. Doctors recommend starting prescription antiviral drugs at the first sign of a shingles rash. Options include acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex). Sometimes doctors can prescribe the treatment prophylactically – which means that you would take them regularly to prevent shingles.