Shingles, also known as herpes zoster, is a painful skin rash that affects approximately 1 in every 3 people in the United States. This year, almost one million people will develop shingles.
While the rash typically clears up in two to four weeks, a common complication is postherpetic neuralgia (PHN). PHN can result in persistent pain in areas where the rash occurred, even months or years after the rash has resolved.
Anyone who has had chickenpox can develop shingles. However, it is more common and more severe in older adults. Shingles is also more common in people with weakened immune systems such as individuals with leukemia, HIV infection, or individuals on immunosuppressive therapy after organ transplantation. Most people only have one episode of shingles but it can occur multiple times.
What causes shingles?
Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After an attack of chickenpox, the virus stays inactive in the body. Reactivation of the virus can lead to shingles.
What are the symptoms?
The following are the most common symptoms of shingles. However, each individual may experience symptoms differently. Symptoms may include:
- Pain, burning, itching, or tingling in the area of the skin one to five days before the rash appears
- Red rash which starts as small, red spots that turn into blisters
- Blisters may break open and crust
Other symptoms of shingles may include:
- Upset stomach
Complications of shingles include:
- Postherpetic neuralgia (PHN) due to damaged nerves
- Vision loss
How do you prevent spreading the virus?
An individual cannot spread shingles. However, they can pass on the varicella zoster virus during an active shingles episode via contact with fluid from blisters. This can cause chickenpox in people who have never had the chickenpox or have not been vaccinated against chickenpox. A person is not contagious before the blister appears or after the blister has crusted. Those with a rash should keep the rash covered and avoid touching or scratching the rash. If you do touch the rash, wash your hands thoroughly.
How is shingles diagnosed?
Please visit your Primary Care Physician (PCP) if you develop a rash. By looking at the rash, your doctor can tell whether you have shingles and start you on treatment if you do. In some cases, the doctor may scrape a sample of the blister and perform a test for the varicella zoster virus.
How is shingles treated?
Specific treatment for shingles will be determined by your physician based on:
- Your age, overall health, and medical history
- Extent of the condition
- Your tolerance for specific medications, procedures, or therapies
While there is no cure for shingles, prompt treatment with antivirals can shorten the duration of symptoms and reduce the risk of developing complications. Your doctor may also prescribe therapies to alleviate pain. Wet compresses, calamine lotion, and colloidal oatmeal baths can also help with itching.
How can you prevent shingles?
There are currently two vaccines approved for the prevention of shingles: Zostavax® and Shingrix®. The Centers for Disease Control and Prevention recommends the following:
- Avoid either vaccine if you are pregnant or think you might be pregnant, have any severe, life-threatening allergy to either vaccine, or are moderately or severely ill (e.g. suffering from flu).
- Shingrix is the preferred vaccine for the prevention of shingles. The vaccines is given as two separate intramuscular doses, separated by two to six months. It is recommended for all healthy adults aged 50 and older, regardless if they have had an episode of shingles or not. Patients who have previously gotten Zostavax should still get Shingrix, but not less than two months apart.
- Zostavax is a single subcutaneous injection that is recommended for adults 60 years and older who cannot receive Shingrix (e.g. lack of availability or allergic to a component of Shingrix). Avoid this vaccine if you have a weakened immune system due to a medical condition (such as cancer or AIDS) or medical treatment (such as chemotherapy).
Where can you get the shingles vaccines?
- You can go to Vons/Albertson pharmacy locations to receive one of these vaccines - a prescription is required. It is encouraged that you call the pharmacy first to schedule an appointment and ensure the vaccine is in stock.
- For commercial Sharp Community Medical Group HMO members, there is no charge for getting these vaccines. If you are a senior member, please check with your health plan on whether or not these vaccines are covered under your prescription benefit as copays may apply.