By Eugene A. Ryfinski, M.D.
Have you ever had chickenpox?
If so, did you know you are at risk for developing shingles?
According to the Centers for Disease Control and Prevention (CDC), more than 99% of Americans born before 1980 have had chickenpox, meaning almost all older adults in the United States are at risk for shingles.
And while an increasing number of younger people are also developing the virus, according to the CDC, the risk for shingles and serious complications increases sharply with age.
People 50 and older can protect themselves against shingles and its painful complications by getting vaccinated.
What is shingles?
Also known as herpes zoster, shingles is a painful rash caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox.
After chickenpox resolves, the virus lies dormant in your nervous system but can reactivate at any time and cause shingles.
The reasons why the chickenpox virus reactivates and causes shingles are not well understood, though the risk increases with a decline in your immune system. This decline can be caused by:
• Increasing age
• Cancer, especially leukemia and lymphoma
• Bone marrow or organ transplants
• Medications that suppress your immune systems, including steroids and chemotherapy
It is important to note that individuals vaccinated against chickenpox can still develop shingles, but they are less likely to suffer from severe symptoms.
The CDC reports that for reasons unknown there has been a gradual increase in shingles cases among younger adults over a long period of time.
About one out of every three people in the Unites States will develop shingles during their lifetime, according to the CDC.
What are the signs of shingles?
Shingles is characterized by a rash that typically occurs on one side of the body in one or two adjacent dermatomes where the virus has been hiding. Dermatomes are defined areas of the skin that are supplied by one of the nerves coming out of the spine.
The most common area for shingles to develop is on your trunk, which is supplied by the thoracic nerve, but it can develop anywhere on your body. However, it rarely crosses the midline, meaning it usually does not affect both sides of your body at the same time.
Shingles usually starts with pain, itching or tingling in the affected area. After a few days, clusters of blisters normally develop. These blisters eventually dry and crust over, and typically heal in two to four weeks.
Some people may also develop a headache, fever, fatigue, chills, and sensitivity to bright light.
It is rare for shingles to be transmitted from one person to another though it can spread through direct contact with fluid from the blisters.
If you have symptoms of shingles, contact your doctor. The sooner you begin treatment, the better.
What are the complications of shingles?
The most common complication of shingles is a condition called postherpetic neuralgia, which is characterized by long-term nerve pain that persists in the area of the rash.
This pain can last for weeks or months, and in some cases, years. The risk for developing postherpetic neuralgia increases with age. As the CDC reports, older adults are more likely to have longer lasting, more severe pain.
Approximately 10-18% of people who get shingles will develop postherpetic neuralgia, according to the CDC.
In cases where shingles involves the face and eye, blindness can occur. Rarely, shingles can lead to:
• Hearing problems
• Brain inflammation
Can shingles be treated?
Shingles can often be treated with anti-viral medication that shortens the duration and severity of the virus. However, these medications are most effective if you start taking them as soon as possible after the rash appears.
Your doctor may also recommend over-the-counter or prescription medication to relieve the pain and itching.
Once you’ve had shingles, the risk for developing it again is low.
How can shingles be prevented?
If you are 50 or older, the CDC recommends getting vaccinated.
As with any vaccine, side effects can occur. The most common are soreness and swelling in your upper arm where the vaccine was given. While you may experience pain for a few days after getting the vaccine, the CDC notes that pain will be less severe than having shingles and the complications from the disease.
If you are concerned about your risk for shingles, talk with your doctor about getting vaccinated.
To find a primary care physician affiliated with Penn Medicine Princeton Health, call 1-888-742-7496 or visit www.princetonhcs.org.
Eugene A. Ryfinski, M.D. is board certified in internal medicine and a member of the medical staff at Penn Medicine Princeton Health.