If you’re had chickenpox, the memories of the uncomfortable, itchy virus likely stick with you. While that misery is in the past, the virus that causes chickenpox stays in your body and can cause havoc later on if it returns as shingles.
The viral infection is often painful and can cause complications. The good news is that a vaccine is available to decrease the risk of developing shingles.
Mark Norris, MD, a family medicine physician with ThedaCare Physicians-Appleton North, shares key facts to know about shingles and the vaccine that can prevent it.
Understanding Shingles
Anyone who has had chickenpox carries the inactive varicella-zoster virus in their body permanently. The varicella vaccine that protects against chickenpox became available in 1995. That means many U.S. adults had chickenpox when they were children.
The varicella-zoster virus can reactivate at any time and cause shingles, also sometimes called herpes zoster. One in three people ages 50 and older will develop shingles in their lifetime.
“Though shingles is rarely fatal, it’s often quite painful and can lead to complications,” Dr. Norris says. “Because the risk of developing shingles increases with age, we recommend the Shingrix vaccine for adults starting at age 50.”
Risk Factors
Age is the biggest risk factor for developing shingles. It’s most common in adults ages 50 and older. The risk for severe complications increases in those ages 60 and older.
Other risk factors for developing shingles include:
- Diseases that weaken the immune system: These include HIV/AIDS and cancer.
- Cancer treatments: Radiation and chemotherapy can decrease resistance to diseases.
- Certain medications: Drugs that prevent rejection of transplanted organs and long-term use of steroids such as prednisone can up the risk.
Symptoms
Shingles symptoms typically affect one small section on one side of the body — often the face, neck, chest, stomach or back. Symptoms can begin before a rash appears.
The most common symptoms are:
- Pain, burning or tingling
- Sensitivity to touch
- A red rash that begins a few days after the pain
- Fluid-filled blisters that break open and crust over
- Itching
Other symptoms can include:
- Fever
- Headache
- Sensitivity to light
- Fatigue
“Shingles doesn’t always have a rash, so if you’re experiencing symptoms, it’s best to seek medical care,” Dr. Norris says.
Diagnosis
Seek medical care as soon as possible if you suspect shingles. Prompt treatment can reduce the risk of complications.
Causes for special concern include:
- Pain and rash occurring near an eye: Untreated infection may lead to permanent eye damage.
- Individuals 50 or older: Age increases the risk of complications.
- Weakened immune system in yourself or someone in your household: This may be due to cancer, medications or chronic illness.
- Widespread and painful rash.
To diagnose the condition, your doctor will complete a physical exam and take your health history, including asking whether you’ve had chickenpox. If you have a rash, they may test the blisters for the chickenpox virus.
People with shingles infection cannot transmit the virus to others. However, they can transmit the chickenpox virus, mainly through direct contact with open sores.
Individuals with active shingles should avoid physical contact with anyone who hasn’t had chickenpox or the chickenpox vaccine. That includes people with weakened immune systems, pregnant people and newborns.
Treatment
While there’s no cure for shingles, prescription antiviral medications can ease symptoms, shorten the course of the illness and reduce the chance of developing nerve damage and other complications.
Other treatments can include:
- Creams or lotions to help ease itching
- Cool compresses applied to affected skin areas
- Antibiotics applied to the skin, taken by mouth or given intravenously if there are signs of bacterial infection in the affected area
- Steroids
- Antidepressants or anticonvulsants for nerve pain
Complications
Complications are more likely in older adults and can include:
- Postherpetic neuralgia (PHN): This continuous, chronic pain lasts even after the skin sores have healed. The pain may be severe in the area where the blisters were present. The affected skin may be sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. Early treatment of shingles may prevent PHN.
- Bacterial infection: This is an infection of the skin where the rash happens. Rarely, infections can lead to more problems, such as tissue death and scarring.
- Vision problems: When an infection happens near or on the eyes, a corneal infection can occur. This can lead to temporary or permanent blindness.
- Neurological problems: Shingles may cause inflammation of the brain (encephalitis), facial paralysis, or problems with hearing or balance.
Shingrix Vaccine
Shingrix is a vaccine that’s more than 90% effective in preventing shingles and its complications. It’s given in two doses administered six months apart.
The shingles vaccine doesn’t guarantee you won’t get shingles. However, it’s likely to reduce the course and severity of the disease. It also lowers your risk of developing PHN.
“I’ve had to hospitalize patients due to the pain of shingles,” Dr. Norris says. “I’ve also had several patients (after getting shingles) tell me they wish they would have gotten the vaccine. When I mention that to my patients, it usually changes their mind on it.”
People eligible for Shingrix include adults ages 50 and older and those 19 and older who have weakened immune systems due to disease or medication. Individuals who have had shingles can still receive the vaccine, as the virus can return.
Shingrix replaces the former Zostavax vaccine, which was discontinued in 2020. People who received Zostavax should receive Shingrix for improved protection against shingles.
If you’re seeking additional reasons to get vaccinated, two recent studies offer new insights. The vaccine has been shown to help reduce the risk of developing dementia and decrease the risk of cardiovascular events.
Commercial insurance typically covers the cost of Shingrix. People with Medicare should receive the vaccine at a retail pharmacy because payment is covered through Medicare Part D.
“As always, prevention is better than cure,” Dr. Norris says. “If you’re eligible for shingles vaccination, we urge you to do so to decrease the likelihood of infection and complications.”
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