What is shingles?

Shingles, formally called Herpes Zoster, is a painful rash caused a by the chickenpox (varicella) virus that stays in the body and returns years later.  Most scientists believe that during the chickenpox illness, some of virus particles leave the blisters and move into the body’s nervous system.  The viruses later become inactive and settle into nerve cells, which are responsible for telling the brain when it feels hot, cold or pain.  When the chickenpox reactivates, the virus moves down the nerves out onto the skin, and the characteristic shingles rash appears.  Because the nervous system is more involved with shingles than with chickenpox, shingles’ symptoms are often more severe.

What are the symptoms of shingles?

Shingles usually develops in individuals who are over 50 or whose immune systems weakened by stress, diseases or treatment.  Early symptoms of shingles include headache, light sensitivity and flu-like symptoms without fever.  Later comes numbness, itching or severe pain, usually in a band on one side of the body.  Finally, clusters of blister-like lesions appear on the skin. 

For the half a million or so Americans that develop shingles every year, the virus itself is painful enough.  In 20-30% of those individuals, however, pain continues after the rash goes away.  This persistent neurological pain is called, postherpetic neuralgia (PHN), and it can last for months, years, or the rest of a person's life.

Who is most likely to be affected by shingles?

Anyone who has had natural chickenpox may later develop shingles. Individuals who have had the chickenpox vaccine may also develop shingles, though they are much less likely to get the virus than those who’ve had natural chickenpox.  Shingles may affect any age group, but the virus is most common in those older than 50, and susceptibility increases with age.  Individuals who have had shingles, will likely not develop the disease again, but in rare cases, the virus reoccurs.  This usually happens in people with compromised immune systems, such as people with HIV or patients undergoing chemotherapy.

How is shingles treated?

Shingles can treated with antivirals such as acyclovir and famciclovir, which, if used during the first 72 hours of infection, can greatly reduce the duration and severity of the virus.  Starting antiviral treatment early is an important part of preventing postherpetic neuralgia.  If you have a rash on one side of your body, especially if you’re over 50, see your doctor immediately.  If you have shingles, ask your doctor about your risk for developing PHN, and ask about treatment options.

How can I protect myself from shingles?

Because shingles comes from the varicella virus, people sick with shingles will expose those around them to chickenpox, and those who have not yet had chickenpox may catch it.  Being around people with shingles won’t cause you to get shingles because shingles comes from your own chickenpox virus, not someone else’s.

In May 2006, the U.S. Food and Drug Administration approved the first shingles vaccine, Zostavax, for people 60 and older.  Zostavax, really a triple dose of the chickenpox vaccine, is hoped to prevent shingles, or at least lessen its severity, for people in this age group.  The vaccine is so new, however, that researchers aren’t yet sure if the vaccine is safe for people under 60, if it will be covered by Medicare, or if it will prevent shingles for more than a few years.

To find out if the vaccine is right for you, talk to your doctor.  To read more about shingles, check out Web MD’s shingles page:

www.webmd.com/solutions/sc/shingles.