Shingles is a painful, blistering, skin rash typically found on the back and sides of the chest( but can occur anywhere on the body, including the scalp face and genitalia). The rash is classically located on one side of the body and follows the nerve dermatome around from the spine.
It is caused by the herpes zoster virus, the same virus that causes chickenpox. After a chickenpox infection, the virus becomes inactive but remains in the nerve tissue. Years later, the virus may reactivate as shingles. Stress, cancer, or other medical problems can trigger an outbreak. In some cases shingles pain may linger after the rash has cleared . This is called post herpetic neuralgia, a long-standing sometimes disabling condition.
Treating it early, especially within the first 72 hours of onset, can significantly reduce the incidence of post herpetic neuralgia.
Shingles usually starts as itching and pain on the skin that develops into blisters. The rash often wrapping around one side, from the middle of the back to the front of the chest. The blisters form which gradually break open, ooze and crust over. Other symptoms include insomnia, nausea and fatigue, weakness ,depression and anxiety, very similar to flu symptoms . The full rash forms in about a week or so ,blisters break open and form scabs that sometimes leaves scars after healing. The whole process takes 2 to 3 weeks and may last up to 10 weeks. For some people the rash barely develops. It’s unclear why some people have worse symptoms or develop post herpetic pain, but age and stress may be factors. Cancer or other immune deficiencies increase the risk for widespread zoster. Approximately one in 100 people get shingles in any given year. People over 50 and those who never had the chickenpox vaccine are more likely to develop shingles. Shingles is also more common in people with cancer and those who take immunosuppressive drugs such as cortisone.
If you do develop early symptoms of shingles ( tingling, blistering rash) see your doctor. Treatment with antiviral medications early on can reduce the spread of the rash and help prevent the pain and post herpetic neuralgia. If you can’t see a doctor, treat the itching with calamine lotion, anti-itch cream’s and antihistamines. Oatmeal baths may also help. Take acetaminophen or nonsteroidal anti-inflammatory such as ibuprofen. And remember the rash will be made worse by scratching the blisters or sores ,and wearing tight clothing.
Zoster vaccine(zoster vaccine live)
Zostavax is a vaccine that is used for adults 50 years of age or older to prevent shingles (also known as zoster).
Zostavax does not protect everyone, so some people who get the vaccine may still get shingles.
You should not get Zostavax if you’re allergic to any of its ingredients, including gelatin or neomycin, have certain conditions that weaken your immune system, take high doses of steroids or are pregnant or plan to become pregnant. You should not get Zostavax to prevent chickenpox. Talk to your healthcare provider if you plan to get Zostavax at the same time as Pneumovax 23( the pneumococcal vaccine polyvalent) because it may be better to get these vaccines at least four weeks apart.
Zostavax contains a weakened chickenpox virus. Tell your healthcare provider if you will be in close contact with newborn infants, someone who may be pregnant and has not had chickenpox or been vaccinated against chickenpox, or someone who has problems with their immune system. Your healthcare provider can tell you what situations you may need to avoid.
Zostavax works by helping your immune system protect you from getting shingles. If you do get shingles even though you have been vaccinated, Zostavax may help prevent the nerve pain that can follow shingles in some people. Zostavax is given as a single dose by injection under the skin.
Please follow up with your PCP for further information or discussion. The Zostavax vaccine is offered by many of the local pharmacies as well and is paid for through your insurance.
Dr Jeffrey M Bishop , Board Certified Family Medicine Physician. Retired from active practice. Presently involved in several entrepreneurial activities. Provider for the largest Telamedicine company in the US.