Shingles: A Serious and Painful Disease
Shingles From the Chicken Pox Virus
Shingles is a viral infection causing a painful rash that looks like a band of blisters that can appear many places on your body. It is caused by Herpes zoster, which is the same virus that causes chicken pox. Anyone who has had chicken pox is at a higher risk for shingles because after you have had chicken pox, the virus lies dormant in nerve tissue near the spinal cord and brain.
In the United States, 9 out of 10 people have had chicken pox. Years later, it may reactivate in the form of shingles. While not life-threatening, it can be extremely painful.
Risk factors include:
- Advancing age (shingles is more common in people over 50 years of age)
- Weakened or compromised immune system (for example, from medications such as cancer treatments)
About 1 million people in the US get this disease annually, but a person will typically contract it only once in a lifetime. Shingles is highly contagious during the fluid-filled blister phase and spreads through direct contact. Once the blisters crust over, they are no longer contagious.
Rate of Shingles by Age Group
The first sign of shingles is usually a burning or tingling pain, or it may be numbness or itch in a particular area of the body or face which includes eyes, mouth and ears. Several days or a week later, the rash appears. It is fluid filled blisters, similar to chicken pox on one side of the body. It can be so painful that that gentlest breeze or touch may hurt. Pain relieving drugs and antiviral medications may be used to treat shingles. They include acyclovir and valacyclovir.
Shingles can occur anywhere on the body, but the most typical site of the rash is a band on the back called a dermatome, which spreads from the back and can reach to the breast bone on the chest only on one side of the body or face. The rash can last up to 30 days, and the symptoms usually disappear when the rash dries up.
The severity of the disease can be lessened if you receive treatment within 72 hours of the blisters forming. There are some strong antiviral medications, such as Acyclovir, Valcyclovir, or Famcyclovir. Tylenol is given for pain. Blisters should be covered until they are crusted over, and don’t scratch blisters as they can become infected. The blisters break and form small ulcers that begin to dry and form crusts which fall off in about 2-3 weeks.
Other symptoms can include abdominal pain, chills, difficulty moving some facial muscles, drooping eyelid, fever and chills, general ill-feeling, genital lesions, headache, hearing loss, joint pain, loss of eye motion, swollen glands, taste problems, and vision problems. It is uncommon to have all these symptoms, but it shows the seriousness of shingles.
In addition, postherpetic neuralgia may occur. This is nerve pain that occurs after the initial phase. It is typically caused by a damaged peripheral nerve that is acctually caused by the reactivation of the varicella zoster virus (Shingles).
Shingles Virus Explained
Unusual Severe Cases
There are rare cases where shingles can be severe and cause critical illness, including pneumonia or encephalitis which, of course, requires hospitalization. Some people can develop a long-lasting pain condition called postherpetic neuralgia which is more common in the elderly. Again, early treatment for shingles helps prevent this complication.
Prognosis of Disease and Prevention Vaccine
The prognosis for healthy people who receive treatment quickly is good. The lesions heal, the pain subsides within 3-5 weeks, and the blisters usually don’t leave scars. However, shingles is more serious if you are immunosuppressed, for example, an HIV patient, someone on chemotherapy, someone one on immunosuppression drugs for autoimmune diseases and people who have received organ transplants.
A VZV vaccine called Zostavax was approved by the Food and Drug Administration in May 2006, for use in people 60 years and older, who have had chicken pox. A panel of the AMA recommends people over 60 get the one time injection, even if they have had a case of shingles in the past. The risk of getting shingles is reduced by 50% and of postherpetic neuralgia 67%.
The panel states “This vaccine represents an important medical breakthrough aimed at improving health in older people," said Anne Schuchat, MD, assistant surgeon general and director of the Centers for Disease Control and Prevention's National Center for Immunizations and Respiratory Diseases. People who have had chicken pox have about a 25% chance of developing shingles if they are not immunized.
Shingles Vaccine-Mayo Clinic
Shingles is a serious and painful disease, and if you weren’t familiar with it before, you know what signs to look for now. If you start to experience the symptoms I described, certainly contact your doctor immediately for treatment to lessen the severity of the disease.
As you reach the age of 60, discuss the preventative vaccine with your doctor. It is not always covered by insurance, and the vaccine is about $200. I chose to have the vaccine after a discussion with my doctor, and my insurance paid a big $37. I made the decision based on my particular medical background, and I have had no side effects from the vaccine. I think it was a good decision in my case
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
How long can the pain last from singles?
Typically, the worst of the pain is over after 72 hours with treatment, but the pain can last for a week or more until the blisters crust over.Helpful 43
Are shingles contagious?
Shingles are contagious until the blister phase of the rash is gone.Helpful 5
With a mild case of shingles, can I still go to a pool with chlorine in it?
If you still have the rash, you need to wait until it is healed over.Helpful 12
I have Shingles. I have taken Valacyclovir & Methylprednisolone pills since July 29th, 2018, so is it safe to have intercourse next week?
If the open sores are scabbed over, it is safe to have any contact with others.Helpful 6
I had a very bad case of shingles in May. The scars are still on my thigh. I got the new vaccine four days ago, and I am having a terrible reaction. I feel like the shingles are under my kneecap. Also, the pain is going down the same leg where the shingles were I also have PHN. Is the shot reacting against me? I also had Guillian Barre Syndrome, and had a bad reaction to the flu vaccine.
I am sorry you had extreme reactions to these injections. I have had them all without any problems, so I can only answer based on my knowledge. I think a doctor should be able to help you.
However, Postherpetic neuralgia (PHN) may occur after having Shingles, and sometimes it will resolve on its own. It occurs most frequently in people over 60. I know it can be extremely painful. A doctor can prescribe pain medicines, anticonvulsants or anti-depressants.
I have compassion for you as I have persistent nerve pain following back surgery, and there is a large nerve that travels down the leg. I have a lot of pain in my knee also. I have seen a pain management doctor, and I had an injection in my back, which contained some type of cortisone. It was an uncomfortable injection, but within 24 hours I started experiencing some relief. I don't know if this is the answer for you. I hope ultimately that having had the shingles vaccine will prevent further outbreaks of this awful disease.
I hope I have given you good information, but a doctor should be able to tell you more.Helpful 3