The pain is incessant and intense; a band of tiny blisters gnawing at your skin and fluid oozing out of the infection site.

Shingles - a viral infection caused by the same virus that causes chickenpox, varicella-zoster - leaves many with a haunting memory and reminder of just how painful, more than itchy, the rash is.

And 90% of adults are at risk of contracting it, experts warn.

“Patients describe the pain of shingles in different ways, often as severe and excruciating. Typically, it is described as a burning sensation”, Dr Jody Pearl, a neurologist in private practice in Joburg said.

“Once the pain starts, the impact on your life can be devastating, ”Dr Allison Glass, a specialist virologist at Lancet laboratories.

According to the experts, after you’ve had this infection, the virus remains in the body, lying dormant in the root of the sensory nerves that supply the skin. From there, and at any time, the virus can be re-activated and travel back down the nerve to the skin, causing the rash and, in some cases, the severe pain that is characteristic of shingles.

The first symptoms of shingles usually include tiredness and headache, followed by abnormal sensations such as itching or tingling in one area of the skin. A few days later, a chickenpox-like rash develops, starting with red patches that go on to form clusters of small blisters. The shingles rash is characteristic, limited to the area of the skin that is supplied by the specific nerve either on the right or left side of the body, front and back, but not crossing the midline. Pain levels can vary in intensity .

“Depending on the nerves involved and the severity of the illness, other complications can also occur”, said Glass. “The worst of these include paralysis, stroke or blindness.”

Shingles pain can be very difficult to treat.

Dr Milton Raff is the director of the Christian Barnard Memorial Hospital Pain Clinic in Cape Town and specialises in treating chronic pain. “We only have a few specialised medications. If these prove to be ineffective, then the pain can be incapacitating.”

Commonly used medicines to treat shingles, including chronic pain of shingles, include antivirals and medicines for neuropathic pain.

There is good news, though. Recently, a shingles-specific vaccine has been developed. It can prevent the development of shingles in up to 7 out of 10 people.

In South Africa, children can be vaccinated against chickenpox as part of their routine vaccination schedule. “Now that the new vaccine is available, it is just as important for adults over 50 to be vaccinated against shingles”, Raff said.

(Adapted from a press release)