Q: I’ve been hearing a lot about shingles lately. What is it?
A: Shingles is a painful skin rash caused by the chickenpox virus. After you get better from chickenpox, the virus is dormant in the nerve roots. In some people, it stays dormant forever. In others, the virus wakes up when disease, stress, or aging weakens the immune system. Some medicines can also trigger the virus to wake up and cause a shingles rash. After the virus becomes active again, it can only cause shingles, not chickenpox. It is estimated that approximately 50 percent of people who live to the age of 85 will have an episode of shingles. There is a small chance a person with a shingles rash can spread the virus to another person who hasn't had chickenpox and who hasn't gotten the chickenpox vaccine. Most people who get shingles will get better and will not get it again.
The shingles appears in a band, strip, or small area on one side of the face or body. Shingles symptoms happen in stages, and may start with a headache, fever, malaise and/or sensitivity to light. Later, there may be pain, itching or tingling in a certain area, where the rash may occur a few days later. The rash starts as red papules which turn into clusters of blisters. The blisters fill with fluid and then crust over. After the blisters crust, in about 7-10 days, they are no longer infectious. It takes 2 to 4 weeks for the rash to fully heal, and it may leave scars. Some people only get a mild rash, and some do not get a rash at all.
Shingles is treated with medicines that include antiviral medicines and medicines for pain. Starting antiviral medicine within 72 hours of the start of shingles symptoms can help the rash heal faster and be less painful. Good home care also can help with recovery. It is important to take care of any skin sores and keep them clean. Also take medications as directed and talk to the doctor if pain is bothersome.
There is a shingles vaccine for people who are 50 years and older; however, the Advisory Committee for Immunization Practices recommends this vaccine for people 60 years and older. Talk with your doctor about when the shingles vaccine may be appropriate for you. The vaccine can lower chances of getting shingles and prevent long-term pain that can occur after shingles. And if you do get shingles, having the vaccine makes it more likely that you will have less pain and your rash will clear up more quickly.
If you have shingles, avoid close contact with people until after the blisters crust over, and no new blisters appear. It is important to avoid contact with people who are at special risk from chickenpox, such as: pregnant women, infants, children or anyone who has never had chickenpox; anyone who is currently ill; or anyone with a weak immune system. Covering shingles sores with a type of dressing that absorbs fluid and protects the sores will help prevent the spread of the virus to other people.
By Ellen Wenberg, family physician, ThedaCare Physicians-Waupaca
