If you had chicken pox as a child, you probably have vivid memory of the intense itching and scratching you experienced. You also probably remember the oatmeal baths and the tiny embarrassing spots all over your body (that your mother may have even taken photos of). But, how much do you know about chicken pox’s adult presentation- shingles? Many people know it’s related to chicken pox, and that it is a very painful condition, but they don’t know exactly what shingles is or what it does to the body.
Shingles is a reactivation of the varicella zoster virus the same virus that causes chicken pox. Shingles is a painful skin rash. Often, this disease is known to affect “old people,” but anyone can develop shingles. In fact, one in three people will have shingles in their life. Each year, there are around 1 million cases of shingles diagnosed in America.
To have shingles you must have contracted chicken pox as a child. The virus remains dormant in the body’s spinal cord but can reactivate years later. If your immune system is compromised (HIV, certain cancers, medications), you are also at a higher risk of developing shingles.
Shingles is contagious to individuals who haven’t had chicken pox. This primarily applies to neonates. Pregnant women are advised to stay away from an individual experiencing acute shingles. The virus can take 10 to 20 days to develop after exposure. A person with shingles can only spread the infection if their skin rash is still blistering.
Shingles usually starts off as a pain or tenderness, but will turn into an itchy, painful, blistering rash. Many patients experience shooting pains, burning, and even feel like something is crawling under their skin. The rash will appear anywhere on the body where a nerve is inflamed. The pain can outlast the rash. Unfortunately, there is no cure for this virus, and it never leaves the body. Since shingles follows reactivated virus living in the nervous system the rash develops along the involved nerve. This means shingles is a rash that presents on only ½ of the body. If you have a rash going across to both 1/2s of the body it isn’t shingles. If could be primary chicken pox if you are the rare person who never got exposed as a child. Immune deficiency status patients can also develop disseminated active varicella infection but this is extremely rare.
For treatment, patients with shingles can be prescribed antiviral medications which specifically kill the virus. If you start treatment within the first 3 days of seeing a rash, you have a lessened chance of having problems later, including post herpetic neuralgia, which is pain and nerve problems that occur as a complication of shingles. Post herpetic neuralgia is most prevalent in those you developed shingles after the age of 50.
A shingles vaccine, Zostavax®, does exist and it is recommended for people ages 60 and older; this age group has the highest risk of developing the disease. The FDA has approved this shot for people ages 50 to 59. The shot cannot completely prevent a person from developing shingles (post marketing suggests a 66% efficacy), but it can reduce the chances of developing it, while also reducing the pain and duration of the disease if it activates.
A May,28,2015 science article gave interim information about a potentially far more effective vaccine that I expect to see in the market eventually. The trial needed more follow-up but the interim analysis indicated a 97% efficacy!
The best way to prevent shingles is to practice healthy living habits so that your immune system is working properly. A person should eat a balanced diet, manage stress, get the proper amount of sleep, and exercise regularly.
If you think you may have shingles or even chicken pox, don’t wait; see a doctor as soon as possible to treat your symptoms before they get worse. Eye and ear involvement is a significant concern. Dr. Kordonowy of Internal Medicine, Lipid & Wellness of Fort Myers can exam your skin and determine if your rash/blisters are indeed the varicella zoster virus. To schedule an appointment with Dr. Kordonowy, call 239-362-3005, ext. 200 or click here. Dr. Kordonowy offers direct patient care membership and concierge services including the unique Inpatient Advocate Service™.
