Shingles, also known as herpes zoster, is a very painful condition that can affect adults, especially seniors. It is caused by the same virus that causes chickenpox – the varicella-zoster virus. After recovering from chickenpox, the virus can lie dormant in the body for years before reactivating and causing shingles. Thankfully, shingles treatment in Singapore isn’t difficult to access, and various preventive measures can be taken to reduce the risk of developing this condition.

Vaccination effectively lowers the chances of developing shingles and reduces the severity of symptoms if the disease does occur. In this article, we will dive into what shingles are and how you can prevent and manage them. 

Understanding Shingles

First, let us fully understand what shingles are and the common symptoms you need to be aware of.

What are Shingles?

Shingles, also known as herpes zoster, is a painful skin rash caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After recovering from chickenpox, the virus can remain dormant in nerve cells for years before reactivating and causing shingles.

Common triggers for shingles include weakened immune systems, which can occur due to ageing, certain medical conditions like HIV/AIDS or cancer, or medications that suppress the immune system. As people age, their immune systems naturally weaken, making them more susceptible to shingles. Stress and trauma can also increase the risk of developing shingles by temporarily weakening the immune system.

Symptoms of Shingles

Early symptoms of shingles include:

• Pain, tingling, numbness, or itching in a specific area on one side of the body
• A headache or fever
• Sensitivity to light
• Within a few days, a rash typically appears, consisting of fluid-filled blisters that are often painful and clustered in a band along the affected nerve.
• The rash usually appears on the chest, abdomen, or face, but it can occur anywhere on the body.
• The blisters eventually burst and form crusty scabs as they heal.

One potential complication of shingles is post-herpetic neuralgia (PHN), a condition characterised by persistent nerve pain that can last for months or even years after the shingles rash has healed. PHN is more common in older adults and those with weakened immune systems. The risk of developing PHN increases with age, and it can significantly impact an individual’s quality of life.

Managing Shingles in Singapore: Alleviating Symptoms and Enhancing Comfort

While there is no cure for shingles, this disease typically resolves on its own within a few weeks rarely and recurs. If you have been diagnosed with shingles, it’s important to seek prompt medical attention to manage the symptoms effectively and ensure a comfortable recovery process. Below are some common approaches that healthcare providers may prescribe to manage shingles and alleviate the discomfort:

1. Antiviral Medications

Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, are often prescribed to manage shingles. These drugs work by inhibiting the replication of the varicella-zoster virus, reducing the severity and duration of the shingles outbreak. When taken within the first 72 hours of the rash appearing, antiviral medications can significantly shorten the duration of the illness and alleviate the intensity of the symptoms.

It is crucial to start antiviral treatment as soon as possible after the first signs of shingles appear to reduce the risk of developing complications like post-herpetic neuralgia (PHN). If left untreated, it can cause prolonged and debilitating nerve pain. Prompt treatment also helps to minimise the severity of the rash and blisters, promoting faster healing and recovery. Therefore, seeking medical attention and starting antiviral therapy at the earliest signs of shingles is highly recommended for the best possible outcome.

2. Pain Management

Over-the-counter (OTC) pain relievers, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can help alleviate the discomfort associated with shingles. These medications can reduce pain, inflammation, and fever. However, it’s essential to follow the dosage instructions carefully and consult a healthcare provider if the pain persists or worsens.

For more severe cases of shingles or if OTC medications are not providing adequate relief, prescription pain medications may be recommended. These can include stronger NSAIDs, opioid analgesics, or medications specifically designed to manage neuropathic pain, such as gabapentin or pregabalin. Prescription topical creams or patches containing lidocaine or capsaicin may also be prescribed to alleviate localised pain and discomfort.

3. Post-Herpetic Neuralgia Management

For some individuals, the pain associated with shingles may persist even after the rash has cleared, a condition known as post-herpetic neuralgia (PHN). In such cases, long-term pain management strategies may be necessary to alleviate the lingering discomfort.

Prescription options for managing PHN pain include:

• Anticonvulsants: Medications like gabapentin and pregabalin, originally developed for treating seizures, have been found effective in reducing neuropathic pain associated with PHN.
• Antidepressants: Certain antidepressants, such as amitriptyline and duloxetine, can help alleviate PHN pain by modulating pain signals in the brain.
• Topical analgesics: Creams or patches containing lidocaine or capsaicin can be applied directly to the affected area to provide localised pain relief.
• Opioid analgesics: In cases of severe, persistent PHN pain, opioid medications like oxycodone or morphine may be prescribed, but they should be used with caution due to the risk of dependence and side effects.

Additionally, non-pharmacological approaches like physical therapy, transcutaneous electrical nerve stimulation (TENS), and complementary therapies like acupuncture or massage may be recommended to manage PHN pain and improve overall quality of life.

Preventing Shingles in Singapore

The best way to ensure you don’t develop shingles or experience the complications associated with the condition is to get vaccinated against the varicella-zoster virus (VZV). The shingles vaccine, known as Shingrix, is recommended for adults aged 50 and above, even if they have had shingles before.

Shingles Vaccination

There are two vaccines available for shingles prevention in Singapore:

1. Zostervax: This is a live, attenuated vaccine that protects shingles and post-herpetic neuralgia. It is recommended for adults aged 50 and above and is approximately 51% effective in preventing shingles.
2. Shingrix: This is a non-live, recombinant vaccine that is more than 90% effective in preventing shingles and post-herpetic neuralgia. It is recommended for adults aged 50 and above and provides superior protection compared to Zostervax.

It is highly advisable, especially for seniors, to consider getting vaccinated with Shingrix. The vaccine is safe, well-tolerated, and offers excellent protection against the debilitating effects of shingles and its complications.

Who Should Get Vaccinated?

The shingles vaccine is recommended for all adults aged 50 and above, regardless of whether they have had shingles or chickenpox in the past. This age group is at a higher risk of developing shingles and its complications due to a weakening immune system as we grow older.

Additionally, individuals with weakened immune systems due to certain medical conditions or treatments are also strongly advised to get vaccinated against shingles. These include:

• People undergoing cancer treatment (chemotherapy or radiation therapy)
• Those with HIV/AIDS or other immune system disorders
• Organ transplant recipients on immunosuppressive medications
• Individuals with autoimmune diseases like rheumatoid arthritis or lupus

Vaccination can help reduce the risk of shingles and its deliberating effects, especially for individuals with weakened immunity. Protecting yourself and those around you through vaccination can help maintain your health and well-being.

Where to Get Vaccinated in Singapore

In Singapore, the shingles vaccine is widely available at various healthcare facilities, including public polyclinics, private general practitioner (GP) clinics, and certain hospitals. Here are some options for getting vaccinated against shingles:

• Public Polyclinics: The Shingrix vaccine is offered at all polyclinics under the National Healthcare Group Polyclinics (NHGP) and SingHealth Polyclinics (SHP). Appointments can be made through the respective polyclinic websites or by calling their hotlines.
• Private GP Clinics: Many private GP clinics, such as Atlas Associates Clinic, offer the Shingrix vaccine. Atlas Associates Clinic is conveniently located at the heart of Singapore, making us an accessible option for those seeking vaccination.
• Hospitals: Several hospitals in Singapore, including Mount Elizabeth Hospital, Raffles Hospital, and Gleneagles Hospital, provide shingles vaccination services through their specialist clinics or outpatient departments.

It is advisable to check with the specific healthcare provider regarding vaccine availability, pricing, and appointment scheduling before visiting. Some clinics may also offer vaccination packages or discounts for certain age groups or medical conditions.

Precautions and Care for Shingles

Precautions Post Infection

After a shingles infection, it is crucial to take proper care of the rash and follow precautionary measures to prevent the spread of the virus. Some precautions include: 

• Cleanliness is key to promoting healing and preventing secondary infections. Gently wash the rash with mild soap and warm water, and apply cool, wet compresses to alleviate pain and discomfort.
• Avoid direct contact with individuals who have weakened immune systems, such as infants, pregnant women, and those undergoing cancer treatment or taking immunosuppressive medications. The virus can be transmitted through contact with the fluid from the shingles blisters, potentially causing chickenpox in susceptible individuals. Therefore, it is crucial to keep the rash covered with loose, breathable clothing or bandages until the blisters have completely dried and crusted over.

The Bottom Line

Shingles can be a painful and disruptive condition, especially for older adults or those with weakened immune systems. Prevention through vaccination is one of the most effective ways to lower the risk of this disease. While early shingles treatment in Singapore can help minimise symptoms and prevent complications like post-herpetic neuralgia, by taking proactive steps to protect yourself, you can reduce the impact of shingles and maintain a better quality of life.

If you’re considering vaccination or need guidance on managing shingles, consult Atlas Associates Clinic for comprehensive prevention and treatment options. Schedule an appointment today with us to learn how we can help keep you protected against shingles.