If you had chickenpox as a child — and most Irish adults over 50 did — the virus that caused it never truly left your body. It lies dormant in your nerve cells, sometimes for decades, before reactivating as shingles (herpes zoster). The result is a painful, blistering rash that can knock you sideways for weeks, and in some cases, leave lasting nerve pain that persists for months or even years.
The good news? Shingles is preventable, treatable, and far better understood today than it was a generation ago. Here is what every adult over 50 in Ireland should know.
TL;DR
- Shingles is caused by the reactivation of the chickenpox virus and affects roughly one in three adults over their lifetime, with risk rising sharply after 50.
- Early treatment with antiviral medication (within 72 hours of the rash appearing) significantly reduces severity and the risk of long-term nerve pain.
- The Shingrix vaccine is highly effective (over 90%) and is now available through the HSE’s National Immunisation Programme for eligible age groups.
- Postherpetic neuralgia (PHN) — persistent pain after the rash heals — is the most common complication and disproportionately affects older adults.
- Your GP is your first port of call for diagnosis, treatment, and vaccination — do not wait for the rash to worsen before seeking help.
What Exactly Is Shingles?
Shingles occurs when the varicella-zoster virus — the same virus responsible for chickenpox — reactivates after lying dormant in your nervous system. Unlike chickenpox, which spreads across the whole body, shingles typically affects a single strip or band of skin on one side of the body, following the path of a specific nerve. The torso is the most common site, but it can also appear on the face, neck, or around the eye.
Around one in three people will develop shingles at some point in their lives. While it can occur at any age, the risk increases significantly after 50, as the immune system naturally weakens with age. Research from the Irish Longitudinal Study on Ageing (TILDA) consistently highlights immune function decline as one of the key health changes in the over-50s population in Ireland.
Recognising the Symptoms
Shingles often begins with a tingling, burning, or itching sensation on one side of the body — sometimes several days before any rash appears. This early phase can be confusing, as many people mistake it for a muscle strain or skin irritation.
Within a few days, a red rash develops, which quickly forms fluid-filled blisters. Other symptoms may include:
- A sharp, stabbing, or burning pain in the affected area
- Sensitivity to touch — even clothing brushing against the skin can be painful
- Fatigue and general malaise
- Headache or mild fever
The blisters typically crust over within 7 to 10 days and clear within two to four weeks. However, the pain can linger far longer — and it is this lingering pain that causes the most trouble.
The Complication to Watch For: Postherpetic Neuralgia
Postherpetic neuralgia (PHN) is the most common complication of shingles. It occurs when damaged nerve fibres continue sending pain signals to the brain long after the rash has healed. PHN can last for months, and in some cases, years. The pain is often described as burning, throbbing, or electric-shock-like, and it can significantly affect sleep, mood, and daily activities.
PHN is more likely in people over 60, those who experienced severe pain during the initial rash, and those whose rash covered a larger area of skin. According to international research, up to 20% of shingles cases in people over 50 result in PHN — making early treatment and prevention all the more important.
When Shingles Affects the Eye
If shingles develops on the forehead or around the eye (known as herpes zoster ophthalmicus), it can affect vision. This occurs in roughly 10-15% of shingles cases and requires urgent medical attention. If you notice a rash near your eye, or experience blurred vision, eye pain, or sensitivity to light alongside shingles symptoms, contact your GP or attend an emergency department immediately.
Treatment: Acting Quickly Matters
Antiviral medications — such as aciclovir or valaciclovir — are the cornerstone of shingles treatment. They work by slowing the reproduction of the virus, reducing the severity of the rash, and lowering the risk of complications like PHN. However, they are most effective when started within 72 hours of the rash first appearing.
This is why early recognition is so important. If you suspect shingles, contact your GP as soon as possible. Do not wait to see if the rash worsens — the earlier treatment begins, the better the outcome.
Your GP may also prescribe:
- Pain relief — from over-the-counter paracetamol to stronger prescription medications for more severe cases
- Calamine lotion or cool compresses — to soothe the rash and reduce itching
- Gabapentin or pregabalin — if nerve pain develops or persists after the rash has cleared
Keep the rash clean and dry, avoid scratching or bursting blisters, and wear loose-fitting clothing over the affected area.
Prevention: The Shingrix Vaccine in Ireland
The most significant development in shingles prevention is the Shingrix vaccine. Unlike the older Zostavax vaccine (a live vaccine), Shingrix is a recombinant, non-live vaccine that is over 90% effective at preventing shingles in adults over 50 — and crucially, its effectiveness remains high even in people over 70 and those with weakened immune systems.
The HSE has included the shingles vaccine in Ireland’s National Immunisation Programme. Eligible adults can receive the vaccine free of charge through their GP. The vaccine is given as two doses, with the second dose administered two to six months after the first.
If you are over 50, ask your GP whether you are eligible for the free shingles vaccine. Even if you have already had shingles, vaccination is recommended to reduce the risk of recurrence — yes, shingles can strike more than once.
Living Well After Shingles
For most people, shingles resolves fully within a few weeks. But if you are left with ongoing nerve pain or fatigue, there are supports available:
- Pain management clinics — available through HSE referral for persistent PHN. Your GP can arrange this.
- Physiotherapy — gentle movement and stretching can help manage pain and maintain mobility.
- Psychological support — chronic pain can take a toll on mental health. Do not hesitate to speak to your GP about counselling or community mental health services.
- ALONE and Age Action Ireland — if shingles leaves you feeling isolated or struggling with daily activities, these organisations offer practical support and befriending services.
At Críonna Health, we believe that understanding conditions like shingles — and knowing what supports are available — is a key part of ageing well. Knowledge is power, and acting early can make all the difference.
Key Takeaways
- If you had chickenpox, the virus is already in your system — shingles is a reactivation, not a new infection.
- See your GP at the first sign of a painful, one-sided rash — early antiviral treatment within 72 hours is critical.
- Ask your GP about the Shingrix vaccine, especially if you are over 50.
- Postherpetic neuralgia is the main complication — but it is manageable with the right support.
- You are not alone. Irish supports from the HSE, ALONE, and Age Action Ireland are there to help.
📷 Photo by Matteo Vistocco (@mrsunflower94) on Unsplash
