Qian Wang, M.D.

By: centraljersey.com
Each year, more than 600,000 Americans are diagnosed with shingles, a painful skin disease caused by the reactivation of the chickenpox virus.
While shingles occurs in people of all ages, the condition most often afflicts older adults between the ages of 60 and 80. In fact, according to the National Institute of Aging, nearly half of all Americans will have had shingles by the time they turn 80.
Although there is no cure for the disease, recognizing the symptoms early and seeking prompt medical treatment can help reduce the severity and shorten the length of the virus.
– What is shingles?
Shingles is a disease that affects the nerves and is caused by the same varicella-zoster virus that causes chickenpox in children. Once you have been infected by the virus, it stays in your body for life, often lying dormant for years and then flaring up when your immune system becomes weak.
When reactivated, the virus travels along the path of a nerve to the surface of the skin, resulting in a painful rash that appears as a band on one side of the face or body. Not surprisingly, the word "shingles" originates from the Latin word for belt, because that’s often the shape of the rash. – Who is at risk?
Anyone who has had chickenpox is at risk for shingles. However, the risk increases as you age, largely because your body’s ability to fight off infection weakens.
Moreover, people with compromised immune systems such as those diagnosed with HIV or who are undergoing treatment for cancer are at greater risk for developing shingles. In addition, stress can cause your immune system to weaken and put you at greater risk for shingles.
What are the signs and symptoms of shingles?
Common symptoms of shingles normally develop in stages and include severe pain or tingling, possibly itchy rash and blisters that look like chickenpox. The rash and blisters affect only one side of the body, typically on the back, chest, rib cage or waist. Often, the face and eye area are affected.
Some patients also report feeling feverish and tired during the early stages of the virus, but it is the intense pain that leads them to the doctor. The pain is often described as a sharp, burning sensation that in severe cases makes getting dressed or simply laying under a sheet almost unbearable.
As the virus progresses, the blisters will fill with fluid and then dry up and crust over within several days. Most cases of shingles last from three to five weeks.
Be sure to see your doctor within 72 hours of the first signs of a rash or the development of severe pain. Early treatment can reduce the severity of the virus and speed healing. – How is shingles treated?
Doctors will typically prescribe anti-viral medications to combat shingles. Additionally, they may prescribe other drugs to relieve the pain associated with the condition. There is no cure, however, and the virus must run its course.
What are the complications of shingles?
For most patients, the virus clears up without any complications, but for some, the pain may linger for months. This is called post-herpetic neuralgia and can be distressing and disruptive, causing depression, anxiety, sleeplessness and weight loss.
The older an individual is when he or she develops shingles, the greater the chance of suffering from post-herpetic neuralgia. Doctors may prescribe steroids, anti-depressants and anti-convulsants to help manage post-herpatic neuralgia.
Other complications include infection at the site of the blisters. To avoid infection, keep the area clean and try not to scratch. In instances where blisters are on the face or near or in the eye, it is important to see your doctor immediately. Left untreated, they could cause lasting eye damage or even blindness.
Can shingles be prevented?
There is no way to completely prevent shingles, but there is a vaccine that helps reduce the risk of developing the condition and decreases the severity if it occurs. The vaccine is available for healthy patients 60 and older at University Medical Center at Princeton.
Individuals should talk to their doctor about whether the vaccine is right for them. The vaccine is typically not recommended for people with compromised immune systems.
If you have shingles, the National Institute on Aging provides the following tips to help you feel better:
– Make sure you get enough rest, avoid stress as much as you can, and eat well-balanced meals.
– Simple exercises like stretching or walking can help. Check with your doctor first.
– Dip a washcloth in cool water and apply it to your blisters to ease the pain and help dry the blisters.
– Do things to take your mind off the pain. Watch TV, read interesting books, talk with friends or work on a hobby you like.
– Try to relax. Stress can make the pain worse.
– Share your feelings about your pain with family and friends. Ask for their help.
As a health care resource for older adults, Princeton HealthCare System regularly offers programs at local senior centers and active adult communities, including the Monroe Township Office on Aging/Senior Center, West Windsor Senior Center and K. Hovnanian’s Four Seasons at Historic Cranbury. For more information, call 888-897-8979 for more information or visit www.princetonhcs.org.
Qian Wang, M.D., is board-certified in internal medicine and specializes in geriatric medicine. She is a member of the medical staff at University Medical Center at Princeton.