When you were a kid, did you scratch your way through a case of chickenpox? If so, you met the virus that causes shingles.
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Called varicella-zoster, it didn’t leave after your chickenpox faded. Instead, the virus laid low in your nervous system.
For one in three adults, the zoster virus re-emerges decades later as shingles. Each year, about 1 million Americans develop the painful rash. Those over 60 are especially at risk.
“Anyone who has had chickenpox is at risk of developing shingles at some time in their life,” says Daniel Allan, MD.
How shingles develops
Sometimes a headache, nausea, fever or chills will herald shingles’ arrival. And the area the rash will be targeting can become painful, numb or tingly a few days in advance. Once the rash hits, blisters form, along with pain described as stabbing, shooting or burning.
“The initial rash is often confused with insect bites,” says Dr. Allan. ““The pain can show up before the rash, continue through the rash and most importantly, it can continue after the rash has healed up.”
The shingles rash typically appears as a band stretching across one side of the trunk. It can develop elsewhere, however. If the rash goes near the eye, immediate care is needed to avoid eye damage.
The shingles rash often lasts for a couple of weeks
Antiviral medication will shorten the duration and pain of shingles if given right away. “Generally, we recommend that patients see their doctor within two to three days of onset. That’s when the prescribed medications are more effective,” says Dr. Allan.
It’s important to keep an oozing rash covered. You can’t spread shingles itself. But you can spread the virus, which can cause chickenpox in those who haven’t had chickenpox or haven’t been vaccinated against it.
“Anyone with active shingles should also avoid pregnant women because of risk to the fetus,” he adds. “Once all the lesions have scabbed or crusted over, you’re no longer contagious.”
Shingles can strike at any time
Unlike chickenpox, shingles can recur — though not always in the same spot.
Shingles can and does develop in younger people. But it is riskier for older people, who are more likely to develop chronic pain from nerve damage (post-herpetic neuralgia), and for those with autoimmune diseases, because getting shingles increases their risk of stroke.
“The shingles vaccine is recommended for adults 50 and older. It’s extremely useful,” says Dr. Allan.
The Shingrix® vaccine, approved in 2017, reduces your risk of getting shingles by more than 90 percent and offers the best protection against post-herpetic neuralgia.
Many patients with post-herpetic neuralgia require treatment with pain relievers, nerve blocks or implanted nerve stimulators to relieve pain.