RABIATUL Adawiyah Zakaria woke up one morning with pain on one side of her face.
It felt like a toothache and she assumed it was her wisdom tooth giving her problems.
Soon, the 19 year old noticed what looked like pimples appearing on her cheek. Even with proper cleansing, the pimples, which appeared more like blisters, didn't go away.
When she sought treatment from a doctor, she was told she was probably experiencing a bacterial infection or a reaction to skincare products and was prescribed a cream.
But Rabiatul soon realised that the blisters were spreading upwards, from her cheek towards her eye, and the pain was getting very severe.
Her family started to worry too as it didn't seem like a standard case of skin rashes.
It soon turned into an excruciatingly painful experience, with Rabiatul enduring a sharp stabbing, burning pain.
"I even tried traditional medicine but nothing worked and went back to consult dermatologists before I was finally diagnosed with shingles."
She was forced to take a semester off from her university studies to recover and subsequently, the scarring on her face had to be treated as well.
What remains today is a slight, barely discernible scar near her eye, but even today, 18 years after the episode, her experience with shingles has left her with a deep fear of the disease.
Shingles is caused by the reactivation of the varicella zoster virus (VZV), the same virus that causes chickenpox.
Rabiatul had suffered a bout of chickenpox when she was around 4 years old.
The disease can cause unbearable pain. The elderly are more at risk for this disease because as people age, the cells in the immune system lose the ability to mount a strong and effective response to infection, increasing the risk of developing shingles.
Shingles typically presents as a rash, with painful blisters across the chest, abdomen or face.
SEVERE PAIN
The pain is often described as aching, burning, stabbing or shock-like. Following the rash, a person can also experience post-herpetic neuralgia (PHN), pain lasting from at least three months up to several years.
PHN is the most common complication of shingles, occurring in up to 10-20 per cent of all cases depending on the person's age.
"Almost all patients will complain of pain and it's a very excruciating pain. The pain is deep inside because it involves the sensory nerves and it can last for weeks, months or years. You don't know how long it will last," says consultant dermatologist and honorary secretary of the Dermatological Society of Malaysia Dr Peter Ch'ng.
Shingles is actually a self limiting disease he adds. This means even if the patient doesn't do anything, it will heal with scars after one or two weeks.
However, when skin has opened up, there's a chance of getting a secondary bacterial infection and all its ensuing complications.
For this reason, patients should seek treatment as soon as possible if they suspect shingles.
Dr Ch'ng says most patients would turn to general practitioners initially, but some of these doctors may not recognise shingles, causing a delay in treatment.
"The initial stage is sometimes really easy to miss. It could just be a few dots on the skin before it turns into blisters and then all the small blisters merge to become bigger blisters."
The disease is more common than one might assume. Dr Ch'ng says 1 in 3 people have a lifetime risk of shingles.
The blisters coupled with the debilitating pain can take a huge toll on quality of life.
The virus can also impact vision and even affect the heart, brain and entire body depending on one's immune situation.
Elderly patients with shingles have to be extra careful as there's an increased risk of getting a heart attack or stroke, he says.
Besides the elderly, immunocompromised individuals are more at risk and unlike some diseases which patients only get once, recurrent shingles can happen in about 6-10 per cent of cases.
Shingles - Fast Facts
*Elderly and immunocompromised most at risk
*Causes excruciating pain and blisters
*Can recur in some patients
*Patients will present with pain followed by blisters a few days later
*Vaccination is available to prevent the disease