Shingles is a harmless skin disease? And who has ever had cold sores, protected from it? Half-truths like these abound when it comes to shingles. FOCUS Online uncovers false myths and explains what is really true.

One in three over the age of 50 gets shingles. The risk increases with age. But even younger people do not have to be automatically immune to the viral disease. The prerequisite for this is that you have had chickenpox before.

Because shingles, also known as herpes zoster, is a new flare-up of the chickenpox infection. The varicella viruses responsible retreated to nerve nodes after the chickenpox infection. They remain dormant until certain factors weaken the immune system. This can be stress, another infection, alcohol and other risk factors. However, all of them reactivate the viruses. The pathogens leave the nerve nodes, migrate along the nerves to the surface of the skin and trigger the typical blisters here. Along the way, sometimes massive, even permanent pain can occur.

Admittedly, the topic is not that simple and it is therefore understandable that there are some misconceptions about shingles – which can ultimately endanger your own health. Zoster can result in risky complications, from permanent pain – the dreaded post-herpetic neuralgia – to vision and hearing damage. There is also a link between shingles and the risk of heart attack and stroke. So here are nine common statements about shingles and their truth:

That’s not true. Even those who have already had herpes zoster can get it again. A study shows that around six percent of those affected get shingles again. Because some pathogens can retreat into nerve nodes, as after chickenpox, i.e. after the initial infection with varicella viruses, and under certain circumstances become active again. This risk mainly exists in old age, because the immune system then naturally no longer reacts as strongly. The “guarding” of the dormant viruses by the immune system is therefore less strict and they can break out again.

That’s not true. Chickenpox and shingles are caused by varicella viruses, cold sores by herpes simplex viruses. Although both belong to the herpes virus family, they cause different diseases. Therefore, cold sores do not protect against shingles.

Unfortunately not. The opposite is true: anyone who has had chickenpox can later develop shingles. If you have not had chickenpox or are protected by the chickenpox vaccination, you will not get shingles. Because shingles includes: First the primary infection with chickenpox, then a latency phase in which the virus remains inactive in the body, and only then the reactivation of the varicella and thus the shingles.

It is true that the virus is very contagious. But you can’t catch herpes zoster from someone who just has shingles – only chickenpox; assuming you haven’t had this childhood disease before and haven’t been vaccinated against chickenpox. The fluid in the zoster vesicles is particularly infectious, as it contains a large number of varicella. If you have had chickenpox or been vaccinated against it, you cannot catch chickenpox from someone with zoster.

Incorrect. The nerves on which the pathogens move to the surface of the skin are the first to be affected by the varicella virus. Around a week before the skin turns red and the typical rash develops, the affected nerves experience severe pain. They can be so severe that people worry they may have renal colic or bile problems. The cause of the severe pain is minor damage to the nerves caused by the vandalizing viruses. So shingles affects the nerves first and then the skin.

Not necessarily true. The rash always spreads only on one side, i.e. on one side of the body axis (vertical axis from the crown of the head to the pelvis), and not around the entire waist like a belt. In addition, herpes zoster does not only occur in this area, i.e. band-like starting next to the spine around the body forwards towards the stomach, but can also be localized above, below, on the head, an arm or a leg.

This is not good advice. You are on the safe side if the skin change is clarified by a doctor. It is true that shingles often heals on its own in young, otherwise healthy people without medication. But that is not always the case. In any case, herpes zoster should be looked after by a doctor in patients over 50 years of age if the blisters appear on the head (face, ear, neck and so on) or in people of any age if there are previous illnesses.

Unfortunately, this is not the case for many sufferers. Firstly, the risk of heart attack and stroke is still significantly higher months after the illness has been overcome. More precisely: Up to six months after the shingles disease, it is more than twice as high as before. On the other hand, up to 20 percent of those affected suffer from complications such as postherpetic neuralgia (PZN). The nerve pain remains, even if the skin changes have long since subsided. Pain therapy is then important so that the pain does not become chronic and last for months. Only when the damaged nerves have recovered does the pain go away in most of those affected.

Not correct. There is a vaccine that protects against shingles. The Standing Committee on Vaccination (Stiko) has approved this adjuvanted subunit inactivated vaccine for people over 50 years of age. The zoster vaccination is highly effective and protects up to 90 percent against reactivation of varicella, as studies show. Incidentally, the vaccination is also useful for those who have already had shingles. Because a second reactivation may well be possible. Ask your doctor about the zoster vaccination.