65-year-old Harold had piles of work on his desk. His boss left several text messages to call him. His wife was in the hospital undergoing treatment. His son was having marital problems. Lots of stress in his life.
And now he had a burning rash on his right side above his waist. It tingled and hurt. Surprisingly bad.
Julia K. C. Sherrill, MD, Family Medicine – Taylor Clinic, describes shingles and offers some tips on its treatment.
What Is Shingles?
“Shingles is caused by a virus—similar to chickenpox—called Varicella zoster. It’s a latent infection that resides in your nerves if you had the chickenpox virus when you were younger,” says Dr. Sherrill.
“Shingles is not considered serious or life threatening, but it’s very painful.”
It’s often brought on by stress, says Dr. Sherrill.
Shingles affects around one million people in the United States each year.
Who Is Most at Risk?
Anyone who’s had chickenpox is at risk for developing shingles.
The Centers for Disease Control and Prevention reports that more than 99 percent of Americans age 40 and older had chickenpox as children, even if they don’t remember it.
Shingles is most common in people ages 60 to 69, though it can affect any age.
The older you are when you get shingles, the greater the likelihood you’ll have severe effects.
People with weakened immune systems, Dr. Sherrill says, are more at risk of developing shingles, such as people who have:
- Cancer or are undergoing radiation or chemotherapy
- Leukemia or lymphoma
- HIV or AIDS
Generally people have only one shingles flare-up in their lifetimes, but on occasion it is possible to have shingles more than once.
What Causes Shingles?
Shingles is caused by the same virus that causes chickenpox (Varicella zoster). Once you get chicken pox, the virus stays inactive in your body for the rest of your life.
“If a person had chickenpox—or even if they didn’t show any symptoms—the infection can reside in their sensory ganglia, and then they can have a reactivation of this latent infection,” explains Dr. Sherrill.
When you are under a lot of stress or if your immune system is suppressed, the virus can manifest itself in the form of shingles, in most cases a much more painful condition than the original chickenpox.
What Are the Symptoms of Shingles?
- Localized painful itching or tingling several days before the shingles develop
- Rash that turns into painful, fluid-filled blisters that scab over a week later
- Rash occurs in a bold band, called a dermatone, on either your right or left side
- Rash may occur on your face
- Other symptoms include:
Is Shingles Contagious?
Yes and no. People can’t get shingles from your shingles, but they might get chickenpox if they never had chickenpox or the chickenpox vaccine, Dr. Sherrill advises.
It’s possible to develop chickenpox if the fluid that seeps from shingles blisters is touched. Shingles is contagious when blisters are present; when the blisters have crusted over, you’re no longer contagious.
How Long Does Shingles Last?
In most cases, shingles lasts about two to four weeks. It generally leaves no scarring or ill effects.
However, some people develop a complication of shingles called post-herpetic neuralgia (PHN), severe and sometimes debilitating pain in the areas where they had shingles.
“Post-herpetic neuralgia occurs after the shingles and the rash are gone. This neuropathic pain can last for weeks, months or longer,” Dr. Sherrill says.
Ibuprofen and topical creams containing capsaicin may be helpful in controlling the pain associated with PHN.
Dr. Sherrill says one in ten patients have post-herpetic neuralgia as a result of shingles.
How Is Shingles Prevented?
Dr. Sherrill says shingles can be prevented with the shingles vaccine. The vaccine has an efficacy rate around 70 percent.
The shingles vaccine is available at most clinics and at some pharmacies and grocery stores.
How Is Shingles Treated?
Because shingles is caused by a virus, “it’s treated symptomatically with medications for the pain and inflammation and with antiviral medication,” explains Dr. Sherrill. Ibuprofen or acetaminophen may be helpful for the pain and swelling.
“We prescribe antivirals—acyclovir in particular. But you have to start it in the first three days or they really don’t help shorten the duration of the illness. And even then, the medication cuts down the length of time by only one day or so,” says Dr. Sherrill.
“Shingles is not considered serious or life threatening,” says Dr. Sherrill, “but it’s very painful. The only time it needs to be treated immediately is if it’s on your face or near your eyes.”