Shingles Gets You When You're Down

The painful virus is something most of us know nothing about, until it’s too late.

If the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. PHOTO: WebMD

(SALEM, Ore.) - If the threat of a shingles diagnosis worries you, then you already know more than most people about this painful virus.

Shingles (also known as zoster) is a painful, sometimes debilitating rash that blisters. There are an estimated 1 million cases of shingles each year in this country. Almost one out of three people will develop shingles in their lifetime, and it is pretty awful.

The rash can appear anywhere but will usually be on only one side of the body, the left or right. The rash will first form bumps, then blisters, then scab over, and finally clear up over a few weeks.

This band of inflammation, pain and rash is the clearest sign of shingles.

How does the virus get into your system? From chickenpox. It is caused by the varicella-zoster virus, the same virus that causes chickenpox.

The reason behind a shingles breakout is not certain. Shingles happens most to a person with a weakened immune system, which is probably why older adults are more likely to get shingles. A healthy immune system (particularly the T cells) seems to keep the varicella-zoster virus at bay.

Even if you had chickenpox and fully recovered decades ago, the virus may lie dormant in your nervous system for years. Eventually, it may reactivate and travel along nerve pathways to your skin, producing shingles.

Reactivated: Shingles symptoms appear

Anyone who has recovered from chickenpox may develop shingles, even children, but not everyone will.

The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:

• Pain, burning, numbness or tingling
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Itching
• Fever
• Headache
• Sensitivity to light
• Fatigue

Pain is usually the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, it can sometimes be mistaken for a symptom of other types of problems affecting the heart, lungs or kidneys.

Some people experience shingles pain without ever developing the rash.

Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of your torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face. Rarely, it extends to both sides.

Shingles is very painful

This is why the rash can wrap around either the left or right side of your body, usually from the middle of your back toward your chest. Nerves, skin, and other nearby tissues get inflamed. It can also appear on your face around one eye. It is possible to have more than one area of rash on your body.

Factors that may increase your risk of developing shingles include:

• Being older than 50. Shingles is most common in people older than 50. The risk increases with age. Some experts estimate that half the people age 80 and older will have shingles in their lifetime.
• Having certain diseases. Diseases that weaken your immune system, such as HIV/AIDS and cancer, can increase your risk of shingles.
• Undergoing cancer treatments. Radiation or chemotherapy can lower your resistance to diseases and may trigger shingles.
• Taking certain medications. Drugs designed to prevent rejection of transplanted organs can increase your risk of shingles — as can prolonged use of steroids, such as prednisone.

When to see a doctor:

Contact your doctor promptly if you suspect shingles, but especially in the following situations:

• The pain and rash occur near an eye. If left untreated, this infection can lead to permanent eye damage.
• You're 60 or older, because age significantly increases your risk of complications.
• You or someone in your family has a weakened immune system (due to cancer, medications or chronic illness).
• The rash is widespread and painful.

How to beat back the virus

Antiviral medicines are administered to reduce the pain associated with shingles, and are most effective if they're taken as soon as possible after shingles has started. Studies show that taking an anti-inflammatory like prednisone along with an antiviral helps reduce the pain from shingles and makes the rash heal faster.

Are you contagious?

Yes. You’re contagious to anyone who isn’t immune to chickenpox until your shingles blisters scab over. This usually means direct contact with the open sores from the rash, but you should avoid physical contact with anyone not immune, especially people with weakened immune systems, pregnant women and newborns.

Most adults in the United States had chickenpox when they were children so they should be immune, as are those who have received the routine childhood vaccination that now protects against chickenpox.

If a person does become infected, they will develop chickenpox, not shingles. It’s important to remember that chickenpox can be dangerous, even deadly, for some people.

After Shingles: Ongoing Complications

Ongoing pain, called postherpetic neuralgia (PHN). Sometimes, shingles pain continues long after the blisters have healed. This is from damaged nerve fibers, which send confused and exaggerated messages of pain from your skin to your brain and can last weeks, months, or even years after the rash goes away.

Vision loss. Shingles in or around an eye can cause painful eye infections that may result in vision loss. If the virus is in the ophthalmic branch of the trigeminal cranial nerve, parts of the eyes and the eyelids get inflamed.

Neurological problems. Depending on which nerves are affected, shingles can cause an inflammation of the brain (encephalitis), facial paralysis, or hearing or balance problems.

Skin infections. If shingles blisters aren't properly treated, bacterial skin infections may develop.

Avoid Shingles with the Vaccine

The shingles vaccine shot contains a weakened chickenpox (varicella-zoster) virus, made with the same strain (the Oka/Merck strain) as the chickenpox vaccine that children get, but it's at least 14 times stronger. The vaccine primes your immune system to defend against the disease.

According to Harvard Health, the Advisory Committee on Immunization Practices, the group that sets vaccine policy for Americans, made its official recommendation for the shingles vaccine in 2008. The committee suggests that ages 60 or older should get the shot, even if they've already had shingles, but many choose to get it at 50, depending on their own situation.

Getting the vaccine can roughly cut your chances of getting shingles in half, and if you’ve already had shingles, the CDC says the vaccine may help prevent it from coming back.

Some people who get the vaccine still get shingles, but will usually have shorter periods of shingles-related nerve pain that develops and continues after the typical rash disappears in about 10% to 15% of people with shingles.

Now is when we should all be thinking about shingles- before we get it. Of course, there is only so much one can do to prevent coming down with any illness, but it is well worth the time and effort to avoid getting shingles.

Most people get through shingles just fine, but life is definitely less painful without it.

Sources: The Mayo Clinic; Centers for Diseases Control (CDC); WebMD; Harvard