Viral Skin Infections

Chickenpox is a very common viral skin infection. Although it is often thought of as a condition that only infects children, you can get chickenpox at any age. Contrary to popular belief, it is possible to catch chickenpox more than once, but it is unusual.

Chickenpox presents as a spotty, red rash and can be extremely itchy. These spots can appear anywhere on the body, including inside the mouth and on the genitals, which can be extremely painful. Spots may appear in a small cluster on one part of the body only or they may be more widespread, appearing on several different body parts. The number of spots and where they appear varies from person to person. The spots don’t start to appear until around one to three weeks after you have contracted the virus.

Chickenpox first presents as small red or pink spots, but they may also be the same colour as the surrounding skin. At this stage, chickenpox spots may be harder to identify on black or brown skin. The spots then turn into itchy blisters which may burst before scabbing over.

Chickenpox is highly contagious from two days before the spots appear. Once all the spots have scabbed over, then the person is no longer infectious. People with chickenpox may also have a high temperature, experience aches, pains and a loss of appetite. The symptoms of chickenpox are the same for adults and children, although adults may experience the spots and high temperature for a longer period of time.

Although it will make you feel miserable, chickenpox is generally not considered to be a serious condition. However it can be very dangerous for pregnant women, newborn babies, older people and people with weakened immune systems, so you should stay away from other people, including staying off work and keeping children off school, until the infectious phase has passed.

Complications of chickenpox can include hepatitis, pneumonia and a brain infection called encephalitis. Scratching chickenpox may cause the spots to become infected with bacteria, which will require treatment. Scratching chickenpox can also lead to scarring.

Shingles is a painful skin infection that is caused by the chickenpox virus. Once you have had chickenpox, the virus stays in your body and can reappear as shingles later in life. A weakened immune system, caused by certain medical conditions and treatments, such as chemotherapy, can make a person susceptible to an outbreak of shingles. But high stress levels can also play a part in the appearance of shingles.

The first signs of shingles is a tingling or painful feeling in an area of skin, accompanied by a headache or just feeling generally unwell. A painful, red, blotchy rash, will follow a few days after these symptoms.

A shingle rash only appears on one side of the body, most often the chest or stomach. However it is possible for singles to appear anywhere else on the body, including the eyes and genitals.

Just like chickenpox, shingle rash turns into oozing blisters before drying out and scabbing over. It takes around four weeks for shingles to go, although you may experience pain in the affected area for many weeks after the rash has disappeared.

Although shingles cannot be passed on, anyone who has not had chickenpox before can catch the infection, so it is important to stay away from work and other people to avoid passing it on. Varicella zoster, the virus which causes shingles, is dangerous to pregnant women, babies under one month and people with weakened immune systems. So it’s particularly important to stay away from these at risk groups.

Cold sores are caused by the herpes simplex virus type 1, which is different to the virus which causes genital herpes. Once you have contracted the virus, it stays in your body for the rest of your life, so people with the virus may find they get cold sores regularly. Cold sores can be triggered by stress, the menstrual cycle, certain weather conditions or they may just happen spontaneously.

Just like shingles, the first signs that a cold sore is on the way is a tingling, burning or itching feeling on the skin. Within 48 hours, small blisters will appear, which will burst and scab over usually within 10 days. Although cold sores often appear on the mouth, they may appear anywhere on the face.

Cold sores are highly contagious, from the moment the ‘tingling’ feeling starts, right up until the cold sore has fully healed up. They can be passed on by kissing, or close skin to skin contact. It’s important not to kiss or be in close contact with anyone when you have a cold sore. You should also never share items such as towels with someone because of the risk of passing the virus on. You should take particular care around pregnant women and people with weakened immune systems. Never kiss a newborn baby when you have a cold sore. This can lead to neonatal herpes, which is very dangerous to infants.

Molluscum contagiosum, sometimes just referred to as MC, is a viral skin infection that mainly affects children, although adults can get it too.

It’s generally a harmless condition that gets better on its own, but it can spread around the body, meaning it could take as long as 18 months for the infection to go. The condition presents as small, firm, raised spots, with a small dimple in the middle, which generally appear in small clusters. Although these spots are not painful, those who have them may find them to be rather itchy.

Although they may appear on various parts of the body, they are most commonly found in the armpits, backs of the knees or in the groin area.

MC can be spread by close direct skin-to-skin contact, sharing or touching contaminated objects (for example, towels and clothing) and intimate or sexual contact.

A wart is a small growth with a rough texture that can appear anywhere on the body. It can look like a solid blister or a small cauliflower on the surface of the skin. Although some people may not be concerned about the appearance of a wart and may experience no physical discomfort, others may find them itchy, painful or unsightly.

Warts are contagious and can be passed on through direct skin-to-skin contact or contact with contaminated surfaces or objects.

Measles is an infection that spreads easily and can cause serious complications if it spreads to other parts of the body, such as the brain.

Measles usually starts with cold-like symptoms, quickly followed by the appearance of white spots in the mouth. The characteristic blotchy red rash appears on the skin a few days later, starting on the face and behind the ears before spreading to other parts of the body.

Babies and people with weakened immune systems are more at risk of measles’ complications, which can include seizures, meningitis, blindness and pneumonia. Pregnant women who contract measles are at risk of miscarriage, stillbirth or going into premature labour.

Hand, foot and mouth disease is an extremely common childhood condition, which can also affect adults too. The condition is characterised by painful ulcers in the mouth and raised red, pink or dark spots on the hands and feet, although these may also appear on the bottom and thighs too. These spots turn into blisters which can be very painful. It is highly infectious and can be passed on via coughs, sneezes, faeces and the fluid in the blisters.

Some people find that self-care is enough to help them or their child through an episode of chickenpox. This includes taking paracetamol for a fever, applying soothing cream (such as calamine lotion) or taking an antihistamine to relieve the itching.

However you may be prescribed anti-viral medication, particularly if your chickenpox is severe, or you are at risk of developing severe complications from the virus.

The anti-viral aciclovir can be taken within 24 hours of the rash appearing, reducing symptoms and speeding up recovery time. This medicine is not suitable for children under the age of 14.

If you know you have been exposed to the varicella zoster virus, but have yet to experience symptoms, you may want to try antibody treatment. If there are no antibodies already in your system, then you can have an antibody injection.

However for this treatment to work, you must have the injection within 10 days of coming into contact with someone with chickenpox symptoms. The antibody injection will probably not prevent you from having chickenpox, but it will help your body to fight the virus and your symptoms will be less severe.

There is a chickenpox vaccine, but it is not routinely available as part of the childhood immunisation programme. You can pay privately for this vaccination if you are looking for peace of mind.

Just like chickenpox, for some people, self-care with paracetamol and calamine lotion is enough to get them through an episode of shingles. But in some cases, a prescription for anti-viral medication is necessary. Commonly prescribed anti-viral medicines include aciclovir, valaciclovir and famciclovir, with a course of tablets usually lasting between seven and 10 days. It’s important to note that this medication will not kill the virus, but can reduce the severity and/or duration of shingles and prevent complications, such as postherpetic neuralgia (nerve pain). Medicines are most effective when taken within 72 hours of the rash appearing. However, if you are at risk of severe shingles or complications, then anti-viral drugs can be started up to a week after the rash appears. It is likely you will need anti-viral medication if you are aged over 50, have a weakened immune system, have shingles affecting the eye, moderate to severe pain and moderate to severe rash.

If your shingle pain is particularly severe, you may need a stronger prescription painkiller, like codeine. Some antidepressants and anticonvulsants have been shown to effectively treat shingle pain. However, if you are prescribed these, it may take some time before you notice these particular medications working.

Paracetamol and a medicated gel can help to relieve the pain and discomfort associated with cold sores. An anti-viral cream can be prescribed to help clear up a cold sore more quickly. It usually takes up to 10 days to work.

If your cold sores are very large, painful or keep coming back, then you may be prescribed aciclovir anti-viral tablets or liquid.

Doses vary depending on who is taking the medication. Always follow the instructions when taking any type of medicine.

MC usually clears up on its own, but adults and older children may undergo treatment if the condition is affecting their mental well-being or quality of life. MC can be treated with creams or gels which can be applied directly to the skin or perhaps cryotherapy, which freezes the spots and causes them to die and fall off. It may be more difficult to treat if you have a weakened immune system.

Most warts will disappear on their own, but this can take months, or even years, so many people opt to have them removed. Cryotherapy uses cold temperature to kill the cells within the wart, blocking the blood supply to the area and causing it to naturally fall off. Alternatively, a wart can be cut away and removed using excision removal, which is carried out under a local anesthetic.

There is no specific treatment for measles, although paracetamol and ibuprofen can be taken to bring down a high temperature. Measles usually goes of its own accord within seven to ten days.

This condition usually clears up on its own within seven to 10 days and can be managed by keeping hydrated and taking over-the-counter painkillers if required. However, if the mouth ulcers are causing pain, then using mouth ulcer gels, sprays or mouthwashes may help with this.