Shingles is far more than a skin rash. It is a nerve-driven viral condition that affects thousands of older adults in Singapore each year, often causing long-term pain and serious complications if untreated.
What started as a simple backache for Mr L quickly became one of the most excruciating experiences of his life. At first, he feared a heart attack. Instead, his doctor diagnosed shingles.
Like many older adults in Singapore, he had no idea that a childhood virus could return with such intensity.
Shingles (herpes zoster) is an often-underestimated threat, especially for older adults. It is easy to dismiss a tingling sensation or a patch of skin discomfort. Yet shingles is a condition that deserves attention, especially because of how it attacks the nerves, disrupts daily life, and increases health risks over time.
What Is Shingles?
If you have had chickenpox before, yes – shingles is caused by the very same virus: the varicella-zoster (herpes zoster) virus.
Shingles is a viral infection that damages the nerves and causes a painful rash. After a person recovers from chickenpox, the virus remains inactive in the body, hiding in the nerve cells.
As people age, the immune system naturally weakens. This allows the dormant virus to reactivate and travel along the nerves, causing inflammation, pain, and the trademark rash of shingles.
Why is Shingles So Common Among Older Adults in Singapore?
Shingles affects about 30,000 people in Singapore every year. More than 90% of adults aged 50 and above in Singapore carry this virus – meaning nearly everyone in this age group is at risk.
Most people in Singapore had chickenpox during childhood. With age, the immune system becomes less efficient at keeping dormant viruses under control. Stress, chronic diseases, and immune-suppressing medications also increase the risk.
When the immunity weakens, it can reactivate and cause shingles. And yes – this nasty virus can recur! Although many believe it strikes only once, the virus can reactivate multiple times in a person’s life.
What are Early Signs of Shingles to Watch Out For?
While painful rashes are the most common presentation of shingles, there are several others to look out for:
- Persistent and severe pain along a nerve pathway
- Itching or tingling sensations
- Burning sensations in the affected areas
- Shooting nerve pain
- Fever, chills, or headaches
- Discolouration on the affected skin
Shingles rash may appear as blisters near the waist, face, neck, chest, belly and back.
What Complications Can Shingles Cause?
The complications can be particularly serious for older adults and may last for months or even years:
- Long-term nerve pain (postherpetic neuralgia): A burning, stabbing pain that persists long after the rash clears. This is one of the most debilitating consequences of shingles.
- Bacterial skin infections: Blisters can become infected if scratched or improperly cared for.
- Higher risk of heart attack and stroke: Inflammation linked to shingles may temporarily increase cardiovascular risks.
- Vision, hearing, or facial nerve issues: If shingles affects the face, it may cause facial paralysis, vision loss, or even hearing difficulties.
- Brain inflammation (encephalitis) or pneumonia: Although rare, the consequences can be serious, especially in older adults or those with weakened immunity.
How Can Shingles Be Prevented?
Older adults should take proactive steps to protect themselves against shingles.
Vaccination is the strongest protection against shingles. Shingles vaccines can reduce the risk of the disease by more than 90 per cent, and they are recommended for adults aged 50 and above under Singapore’s National Adult Immunisation Schedule.
There are two types of shingles vaccine:
- Recombinant Shingles Vaccine (e.g. Shingrix vaccine)
- It contains code carrying shingles information for the body to recognise and build immunity from.
- It is not a live vaccine.
- It is administered into the muscles as a series of two doses, typically two to six months apart.
- Live Shingles Vaccine
- It contains weakened, live varicella-zoster virus.
- It is administered under the skin as a single dose.
Seek Treatment Quickly
Seek medical treatment promptly if you notice early signs such as pain, tingling, or burning on usually one side of the body – even before a rash appears.
Doctors may prescribe antiviral medications (e.g., acyclovir or valacyclovir). These medicines work best when taken early and can shorten the duration and severity of symptoms.
Pain relief, cool compresses, and careful wound care may also be recommended to reduce discomfort and prevent complications like skin infections.
Minimising Transmission
Can you transmit shingles to others? While Shingles itself is not directly spread from person to person, the virus can be passed to someone who has never had chickenpox through direct contact with the fluid from the shingles blisters.
To reduce this risk, keep the rash covered, practise good hand hygiene, and avoiding contact with vulnerable people. This includes those with weakened immunity or no history of chickenpox.
Shingles is More Than a Rash
If you are aged 50 or above, or caring for someone who is, shingles is not something to overlook. It affects quality of life, raises the risk of complications, and can cause long-lasting nerve pain.
Prevention, early recognition, and prompt treatment are essential. Speak to your doctor about vaccination and stay informed. Prevention is always better than cure.
References
- Shingles. Cleveland Clinic. Updated: 11 December 2024. https://my.clevelandclinic.org/health/diseases/11036-shingles
- Singapore’s first shingles awareness movement highlights growing risk in seniors. Channel News Asia. Updated: 3 November 2025. https://www.channelnewsasia.com/singapore/shingles-seniors-chickenpox-disease-awareness-5441981
- Health Experts Issue Warning on Shingles Posing Grave Risks Without Timely Intervention. Medical Channel Asia. Updated: 28 March 2024. https://medicalchannelasia.com/health-experts-issue-warning-on-shingles-posing-grave-risks-without-timely-intervention/
- Shingles and Heart Health: Important facts you need to know. Channel News Asia. Updated: 6 November 2025. https://www.channelnewsasia.com/advertorial/shingles-and-heart-health-important-facts-you-need-know-4963571
- Shingles (Herpes Zoster) Vaccine. Health Hub. Updated: 12 August 2021. https://www.healthhub.sg/medication-devices-and-treatment/medications/shingles-herpes-zoster-vaccine
- Subsidies allowed for shingles vaccine from September. The Straits Times. Updated: 11 February 2025. https://www.straitstimes.com/singapore/subsidies-allowed-for-shingles-vaccine-from-september
