Preventing and Treating Shingles

Chickenpox—usually thought of as a child-hood illness—can have lasting effects well into adulthood. Anyone who’s had chickenpox can develop shingles, also known as zoster or herpes zoster. Years after you’ve had chickenpox, the virus, which has been inactive in nerve tissue, can reactivate and appear in the form of shingles. The reason for this reappearance is unclear, but it may be due to lowered immunity to infections as you grow older, causing the risk to increase as you age.

One out of three people in the U.S. will experience shingles in their lifetime, according to the Centers for Disease and Control and Prevention (CDC). And although there’s no cure, there are treatment options that can make the symptoms less serious.

What Are the Symptons?

The first symptom of shingles is generally pain, which, depending on its location, can be mistaken as coming from other sources. Most commonly, a rash appears after the pain, but some people may experience discomfort and pain without a rash.

The shingles rash is extremely painful and generally develops on one side of the body. Although it can appear anywhere, it’s most often seen as a stripe of blisters wrapping around the left or the right side of your torso. Sometimes the rash appears around an eye or on one side of the neck or face.

The rash usually progresses into blisters that crust or scab over in about 7 to 10 days and clear up within 2 to 4 weeks. Some people still experience pain after the rash has disappeared. Other signs of shingles include: burning, numbness or tingling, sensitivity to touch, fluid-filled blisters, itching, fever, headache, sensitivity to light and fatigue.

Shingles is usually diagnosed based on the history of pain on one side of your body, accompanied by the distinctive rash and blisters. Your doctor may take a tissue scraping or culture of the blisters to examine.

The Complications

The most common complication of shingles is long-term pain that persists long after the rash has gone, a condition called Post Herpetic Neuralgia (PHN). People with PHN have severe pain in the areas where they previously had the rash. Though the pain from shingles usually resolves within 2 to 4 weeks, with PHN it can persist for years. This persistent pain is most common in people over 60.

Shingles around the eye can cause painful infections and even vision loss. The disease can also damage nerve fibers causing pain long after the disease is gone. And, if shingles blisters are not treated properly, they can become infected.

Risk Factors & Vaccination

People who develop shingles usually have only one episode in their lifetime, but some are unfortunate enough to have a second or even a third episode. Adults 60 or older are particularly at risk. Some estimates say half the people 80 and older will get shingles.

Risk factors include being over 50, having diseases that weaken your immune system, undergoing cancer treatments that lower your resistance, and taking certain medications (prolonged use of steroids).

For those at high risk, the CDC strongly recommends they talk to their healthcare provider about getting the shingles vaccine. The vaccine is a one-time dose that can reduce the risk of developing shingles and, more importantly, the long-term pain that shingles can cause. If you’re 60 or older and have had chickenpox, it’s recommended you get the shingles vaccine.

Two vaccines may help prevent shingles—the chickenpox vaccine, for adults who’ve never had chickenpox (most children routinely get this vaccine), and the shingles vaccine, approved by the FDA for those 50 and older. These vaccines don’t guarantee you won’t get the diseases but both will likely reduce their length and severity and reduce your risk of complications.

For people who’ve had chickenpox, shingles is not contagious. But, someone who has not had chickenpox and has direct contact with the shingles rash could contract chickenpox—but notshingles. Chickenpox can be very dangerous for newborns, pregnant women and anyone with a weak immune system, so if you have shingles don’t come into physical contact with them. When your blisters scab over, you’re usually no longer contagious.

Treatment

There’s no cure for shingles, but prescription drugs can speed recovery and reduce your risk of complications. Your physician may also prescribe creams or painkillers to make you more comfortable. Several antiviral drugs may be used to treat shingles—valcyclovir, acyclovir, famicyclovir—to help shorten the length and severity of the illness. To be effective, antiviral medications need to be started as soon as possible after a shingles infection is suspected. Analgesics may help ease discomfort and taking a cool bath or using cool, wet compresses on your blisters may also help with itching and pain.

Visit a your physician promptly if you have symptoms of shingles, especially if you experience pain or a rash around the eye, the rash is widespread and painful, you’re 60 or older (age increases your risk of complications.), or someone in your family has a weakened immune system.

Sonya Foster-Merrow, M.D., is on the Family Medicine staff at Pottstown Memorial Medical Center. A graduate of Tulane University School of Medicine, she did her residency at the University of Rochester and internship at Lancaster General Hospital. She is board certified by the American Board of Family Medicine and practices at Berks Family Care in Douglassville.