Shingles - Oh the Pain!

The agony of shingles is well-known, but sufferers can take comfort in the fact that their grandchildren will almost certainly be spared. Shingles only affects those who’ve had chicken pox, and the chicken pox vaccine available for more than a decade has reduced the incidence of both diseases.

Shingles and chicken pox arise from the same virus, varicella-zoster, a member of the herpes family. “The virus remains dormant in your nerve cells long after the chicken pox disappear,” says pediatrician and internist Michelle Henning, D.O., of Lehigh Valley Hospital and Health Network. “In 20-30 percent of the population, it can reawaken with a vengeance many years later, causing a painful rash along the pathway of the affected nerve.”

You’re more likely to get shingles, Henning says, if your immune system is compromised by some other illness, chemotherapy, steroids or aging. About half the cases diagnosed each year are in people over age 60.

“The sooner you get to the doctor for antiviral medications,” Henning says, “the more likely you’ll lessen the severity of the symptoms and the risk for long-term effects.” Antiviral drugs like acyclovir (Zovirax), famcyclovir (Famvir) or valacyclovir (Valtrex) only help if started within three days of the onset of shingles symptoms. Those include:

• An achy, flu-like feeling without a fever
• A hypersensitive patch of skin that burns and itches at the same time, often along the waist. (The odd name “shingles” comes from the Latin word for belt, singulum.) Shingles also are common on one side of the torso, the lower body, neck or face (an especially dangerous place because the eye may be affected).
• A rash that is painful and blistery

In the acute phase, which lasts 10-14 days, the rash blisters and is painful, says Henning’s colleague, neurologist John Castaldo, M.D. “Shingles isn’t contagious, but during this phase you can transmit chicken pox to a person who has never had it.” To ease the discomfort in the first week, Castaldo treats his patients with oral corticosteroids like prednisone and topical anesthetics like lidocaine along with the antiviral drug.

After 10 days, the rash starts to scab over and most people begin to feel better. For the unlucky ones, a complication called post-herpetic neuralgia (PHN) sets in, and the nerve pain is much worse than during the original infection. “It’s so excruciating,” Castaldo says, “that people can scarcely bear to move, or wear clothes—and it can last for years. You definitely will want to see your doctor for further treatment options.”

As is so often the case, he says, the best treatment for shingles is prevention. All children should be vaccinated against chicken pox, as should adults who haven’t yet had it. A powerful new anti-shingles vaccine for adults who’ve had chicken pox is newly approved by the FDA.

Want to Know More about the new shingles vaccine and other necessary immunizations? Click here.

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