How is shingles diagnosed?

Understanding Shingles

Shingles, also known as herpes zoster, is a viral infection that results in a painful rash. It is caused by the varicella-zoster virus, the same virus responsible for chickenpox. Even after recovering from chickenpox, the virus remains dormant in the body and can reactivate years later, causing shingles. Early diagnosis and treatment are crucial to managing the symptoms and preventing complications.

Recognising the Symptoms

Shingles typically begins with pain, itching, or tingling in a specific area, usually on one side of the body. Within a few days, a red rash appears, developing into small blisters filled with fluid. The rash commonly occurs on the torso, but it can also affect the face, neck, or eyes. Other symptoms may include fever, headache, and general feelings of being unwell. Recognising these symptoms early is essential for timely diagnosis and treatment.

The Diagnostic Process

Diagnosing shingles in the UK usually involves a clinical evaluation by a healthcare professional, often a General Practitioner (GP). The GP will inquire about the patient’s symptoms and medical history and will examine the rash. The characteristic appearance of the rash and the pattern of pain often suffice for diagnosis. However, the GP might consider additional tests if the diagnosis is unclear or if complications are suspected.

Laboratory Tests

In some cases, laboratory tests are administered to confirm the diagnosis. The most common test is a polymerase chain reaction (PCR) test, which detects viral DNA in a sample taken from the rash's blisters. A less common alternative is examining a sample under a microscope for signs of the virus. Blood tests can also be performed to detect the body's immune response to the virus, although these are less definitive than direct testing of the rash.

Complications and Further Assessment

In certain situations, a more thorough assessment may be necessary. For instance, shingles can sometimes affect the eye (ophthalmic shingles), leading to complications that require an examination by an eye specialist. Additionally, especially in older adults or individuals with weakened immune systems, shingles can lead to complications like postherpetic neuralgia, a condition characterised by prolonged pain even after the rash has healed.

Next Steps After Diagnosis

Once diagnosed, timely medical treatment is crucial. The primary treatment for shingles is antiviral medication, which can help reduce the severity and duration of the symptoms. Pain management is also an important aspect of treatment, often involving over-the-counter painkillers or prescribed medications for more severe pain. It is advised that patients diagnosed with shingles should follow their healthcare provider's recommendations closely and attend any follow-up appointments to monitor their condition.