Shingles

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Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. If you have ever had chickenpox, you are at risk of developing shingles. Those who have had chickenpox in the past and have other health conditions, such as chronic renal failure, diabetes mellitus, rheumatoid arthritis, or chronic pulmonary disease, are at the greatest risk of complications and increased severity. 

Per the CDC, 1 out of every 3 people will develop shingles in their lifetime. About 1 million people get shingles each year in the United States. Though your risk of shingles increases as you get older, children can get shingles as well. 

Anyone who had chickenpox in the past may develop shingles - even children can get shingles. The virus can spread from a person with active shingles and cause chickenpox in someone who had never had chickenpox or received the chickenpox vaccine. The virus can spread via direct contact with fluid from the rash blisters. 

A person is not infectious before the blisters appear. Once the rash crusts, a person is once again no longer infectious. A person with shingles is less contagious than from someone with chickenpox. Additionally, if the shingles rash is covered the spread of the virus is lower.

The most common sign of shingles is a painful rash that develops on one side of the body, generally in the shape of a single strip. The rash involves blisters that usually scab over in 7 to 10 days. The rash will clear up within 2 to 4 weeks. In rare cases, the rash can occur on the face, which can affect the eye and vision. 

Several days prior to the rash appearing on the body, someone may experience pain, itching, or tingling. These symptoms will occur in the area the rash will develop. 

Other common symptoms of the shingles include:

• Fever
• Chills
• Headache
• Upset stomach

If you have shingles, the best thing you can do is to cover your rash at all times. Do not scratch or touch the rash, as this can lead to scarring and spread of the virus. It is important to wash your hands often to prevent further spread of the virus. Until a crust or scab appears, avoid contact with:

• People who have never had chickenpox or been vaccinated, especially pregnant women
• Individuals who have weakened immune systems 
• Premature infants

The most common complication of shingles is long-term nerve pain or postherpetic neuralgia. Postherpetic neuralgia occurs in the areas where the shingles rash was on a person's body. It may last months to years after the rash has disappeared. About 10 to 18% of people will experience postherpetic neuralgia and increases with age. 

Other possible complications include vision loss in those with shingles on their face, pneumonia, hearing problems, brain inflammation or death.

Antiviral medicines are used to treat shingles and shorten the length and severity of the illness. Common antivirals used include acyclovir, valacyclovir, and famciclovir. Antivirals are most effective when started as soon as possible after the rash appears. 

Additionally, some individuals may need pain medications if pain is experienced. Over-the-counter pain medications, such as acetaminophen (Tylenol) or ibuprofen (Advil), may help relieve the pain and discomfort caused by shingles. If these products are not controlling the pain, a doctor may need to write for a prescription.

Itching may be relieved with wet compresses, calamine lotion, and colloidal oatmeal baths. 

The ONLY way to prevent getting shingles is by getting the vaccine. Currently, there are 2 vaccines available, Zostavax and Shingrix. Shingrix is the preferred shingles vaccine and is the one we carry at our pharmacy. 

The CDC recommends anyone 50 years or older to get the Shingrix vaccine series. Shingrix is a 2 dose series, with the second dose given 2 to 6 months after the first dose. 

• Even if you have already had shingles, it is still recommended that you get Shingrix to prevent a future shingles outbreak
• If you have already received Zostavax, you still need 2 doses of Shingrix