By Puja Chabra, MD
Nearly 1 out of every 3 people in the United States will develop shingles — a painful rash related to the chickenpox virus — during their lifetime, according to the Centers for Disease Control and Prevention (CDC).
While older adults are generally at greater risk for developing shingles, the CDC reports that rates of the virus have been increasing among younger and middle-aged adults.
If you have ever had chickenpox, talk to your doctor about your risk for shingles and how to protect against the virus and its potential complications.
Shingles is the reactivation of the varicella zoster virus, which is the same virus that causes chickenpox. After your chickenpox resolves, the virus remains latent in the body and can be reactivated as shingles at a later time.
More than 99% of Americans born before 1980 have had chickenpox, even if they don’t remember it, according to the CDC.
The risk for shingles and for having serious complications increases as you age. However, younger and middle aged adults can also develop the virus, which is often triggered by stress and a weakened immune system.
Other risk factors include:
• Cancer, especially leukemia and lymphoma
• HIV
• Bone marrow or organ transplants
• Medications that suppress your immune system, including steroids and chemotherapy
A Painful Rash
The telltale sign of shingles is a painful rash that develops on one side of the face or body, most commonly on the torso.
The rash consists of clusters of blisters that typically occur in a single stripe around either the left or right side of the body, though they can break out anywhere. The blisters normally scab over in seven to 10 days and clear up within two to four weeks.
Prior to the rash, people often have pain, itching, or tingling in the area where the blisters will develop. This can happen several days before the rash starts showing.
Some people may also develop a headache, fever, fatigue, chills, upset stomach, and sensitivity to bright light.
For most people, the pain associated with shingles can be intense for 10 to 14 days if left untreated.
Lasting Nerve Pain
The most common complication of shingles is postherpetic neuralgia, which is characterized by pain that persists in the area of the rash for more than 90 days.
About 10-18% of people who develop shingles will experience postherpetic neuralgia, according to the CDC, and the risk increases with age. Older adults are more likely to have longer lasting, more severe pain.
In cases where shingles involves the face and eye(s), blindness can occur. Rarely, shingles can lead to:
• Pneumonia
• Hearing problems
• Brain inflammation
• Death
Transmission
While you can’t catch shingles from someone who is experiencing an outbreak, you can develop chickenpox if you are exposed to someone with shingles and have never had chickenpox.
This is particularly dangerous for women in the third trimester of pregnancy who have never had chickenpox. Exposure increases the risk of neonatal varicella, or newborn chickenpox, which can be serious and even life threatening for an infant.
To prevent spreading the virus, the CDC recommends:
• Cover the rash
• Avoid touching or scratching the blisters
• Wash your hands often
• Avoid contact with the following people until the rash crusts — pregnant women who have not had chickenpox, infants, and people with weakened immune systems
Treatments and Vaccines Available
Getting the shingles vaccine can reduce your risk of developing shingles, as well as help prevent any long-term complications if you do have an outbreak.
Your doctor can help determine if you are a candidate for a vaccine.
It is important to note that while most people who get shingles will have it only once, it is possible to get it again, according to the CDC.
If you do experience a shingles outbreak, seek prompt medical attention. There are several antiviral medications available that can help decrease the duration and severity of symptoms and reduce the risk of complications. Ideally, these treatments should begin within 72 hours of symptoms developing.
If you are age 50 or above, or are concerned about your risk for shingles, speak with your doctor now to help prevent the rash later.
To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.
Puja Chabra, MD, is a primary care provider with Princeton Medicine Physicians, the primary and specialty care physician network of Penn Medicine Princeton Health.