By Julianne Hale
Most of us know shingles is an irritating skin rash that somehow stems from chickenpox. But did you know that the older you get, the more likely you are to struggle with debilitating pain and a longer treatment process? Learn the basics here so you can take a proactive stance.
What is Shingles?
Shingles is a skin rash caused by the varicella-zoster virus. If you’ve ever had chickenpox, the varicella-zoster virus is still present in your body – and it will remain in your body for the rest of your life.
So why don’t you have sores right now?
Because the virus is in an inactive state. “After the initial infection, the virus is stored in the root of the spinal nerve and may never impact you again,” explains Amanda Mohr Thompson, certified family nurse practitioner with Skin Cancer & Cosmetic Dermatology Center. “However, if it is reactivated, shingles will erupt in the nerves of your skin.”
As many as 1 in 3 Americans will develop shingles within their lifetime, according to the Centers for Disease Control and Prevention (CDC). If you never had chickenpox because you had the vaccine, your chance of developing shingles is much lower. However, it’s possible that you could still get it since the vaccine exposed you to a weakened version of the live virus.
Shingles often starts with a fever, headache, or nausea. However, the most recognizable early symptom is a painful itching or tingling sensation along a stripe of skin called a dermatome. “Some describe it as a burning or throbbing sensation,” says Dr. John Tapp, internal medicine physician with Parkridge Medical Group – Diagnostic Center.
For some, the sensation will be felt along the trunk (chest, waist, back or rib cage area), while for others, it will be felt on the face or around the eyes. If diagnosis can be made at this stage, early treatment can potentially shorten the course of the virus (more on this later).
After two to three days, a rash with painful, fluid-filled blisters will develop along the dermatome. Blisters are usually intensely itchy, and over time they may break open and crust over.
Who Is at Risk
According to the CDC, risk for developing shingles increases dramatically once you turn 60. Half of people who live to be 85 will get shingles at some point in their lives.
“Older adults have a higher risk of shingles because the immune system weakens with age and is less able to fight the virus,” says Dr. Karin Covi, dermatologist with the offices of Dr. C. Rodney Susong. “The immune system also weakens in response to certain medications, and older adults are more likely to take these.”
Anyone with a weakened immune system, regardless of age, has a higher risk of developing shingles. So, if you suffer from cancer or an immune disorder, or take drugs that suppresses the immune system like oral steroids, you should take extra precautions against the virus.
When Shingles Turns Into to PHN
Most of the symptoms discussed so far are minor discomforts – they’re annoying, but tolerable. However, a common complication called post-heretic neuralgia (PHN) can impact shingles sufferers long after the rash is gone.
PHN causes severe, and often debilitating, pain in the area where the shingles rash appeared. “In someone with PHN, the nerves stay inflamed even after the rash has disappeared,” Thompson explains.
For most people, PHN lasts a few weeks or even months. However, in some, the pain can continue for years. Research shows 10 to 20% of all shingles patients will develop PHN, and that the older you are, the more likely you are to develop this complication.
When to See a Doc
As soon as you experience the localized pain described earlier, and suspect you may be developing shingles, call your primary care physician to make an appointment. The earlier you seek treatment, the better off you’ll be.
“If you can begin an antiviral medication within 72 hours of onset, the pain should not be as severe or last as long,” says Dr. Tapp. “You also should have fewer lesions and will have less viral shedding (a stage when the virus is active on the skin surface and is contagious), which will reduce your risk of transmitting the virus to others.”
“Starting an oral antiviral immediately, with or without an anticonvulsant like gabapentin, can shorten the course of the acute outbreak and diminish the likelihood of PHN,” says Dr. Covi.
Even if you miss the critical window before the rash develops, don’t hesitate to make an appointment. Antivirals like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex) can still lesson the severity and length of your symptoms. Your doctor may also prescribe pain medications – either topical or oral – to ease your pain and discomfort.
As you recover at home several over-the-counter remedies can help ease your pain and itchiness while the sores heal. These include taking cool baths with colloidal oatmeal, or applying cold wet compresses, calamine lotion, or topical creams containing capsaicin or menthol to the affected area. You can also take an over-the-counter pain mediation like Tylenol for fever and pain, or an over-the-counter antihistamine like Benadryl for itching.
In 2006, the FDA approved Zostavax – a vaccine designed to prevent shingles. Studies show a single dose can lower a person’s risk of developing shingles by about 50% and reduce risk of PHN by two-thirds, or 67%.
Current guidelines from the CDC recommend all adults ages 60 and up receive the vaccine. Even those who have had shingles before are advised to get it, as it may help prevent future incidents of the disease. All Medicare Part D plans cover the shingles vaccine, and most private health insurance plans cover it for people 60 and up. Some private health insurance plans even cover the vaccine beginning at age 50.
If you are 60+ and haven’t gotten the vaccine, now is the time to take this important preventative health step. No one wants the misery of an itchy, painful rash. Plus, why put yourself at risk for PHN when you can dramatically reduce your chance of developing shingles in the first place?
The Tennessee Valley is loaded with places to get a shingles vaccine. The first and most obvious option is to call and schedule an appointment with your family physician. If time is of the essence, consider dropping by your favorite local pharmacy. Walgreens and CVS both offer the vaccine at most of their locations and many other pharmacies do as well. Just call ahead of time to make sure they are available before you drop in.