Ask a Health Care Professional – Shingles

By Latha Raja Shankar, M.D., Chief Medical Officer, Blue Cross and Blue Shield of New Mexico

One out of three people in the United States are likely to develop shingles in their lifetime. The data show that the rate of older adults getting shingles is also rising, with the incidence rate and complications from shingles much higher in older adults. If you’re over the age of 50, you should talk with your health care professional about the shingles vaccine.

What is shingles?
Shingles, also known as “herpes zoster” or just zoster, is caused by the same virus that causes chicken pox (varicella zoster). After a person has had chicken pox, the virus stays latent in the nerve ganglion and can cause shingles later in life.

How does shingles appear?
Shingles usually appears as a painful skin rash with blisters. Generally, shingles develops on just one side of the body or face. The most common place for shingles to occur is in a band around one side of the waistline. Sometimes, it starts with pain or a sunburn-like sensation, followed by development of a rash.

In addition, shingles can cause fever, headache, chills or upset stomach. Rarely, shingles can lead to complications such as pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death. The most common complication of shingles is long-term nerve pain, called post herpetic neuralgia. This pain can last for months or even years after the rash goes away. The risk of getting shingles and having associated long-term-pain increases with age.

What should you do if you have symptoms that could be shingles?
Contact your health care provider right away if you have symptoms commonly associated with shingles. This is particularly important if you have a rash on your face because shingles in this location increases the risk for eye damage, hearing loss and other complications.

There is no cure for the virus, but anti-viral medicines can be prescribed to decrease the duration, severity of symptoms and complications. To be effective, the antiviral medicine has to be taken as soon as the skin rash appears.

Someone with shingles cannot give shingles to others but can transmit chicken pox to those who are vulnerable. To avoid potential contagion, keep the rash covered if feasible, wash hands and avoid contact with premature infants, pregnant women who have either not had chicken pox or who have not been vaccinated for chicken pox, and other immunocompromised individuals.

Wear loose fitting clothing, avoid scratching, take pain medicines as needed, and apply calamine lotion and cool compresses to reduce itching. Avoiding stress can help reduce the severity of symptoms.

How long does shingles last?
Most cases of shingles last three to five weeks, with the following progression of symptoms:

  • Onset typically begins with burning or tingling pain, sometimes with numbness or itching on one side of the body.
  • Between one and five days, a red rash will appear.
  • A few days later, the rash will turn into fluid-filled blisters.
  • About one week to 10 days after that, the blisters dry up and crust over.
  • A couple of weeks later, the scabs will clear.

What are guidelines from the Centers for Disease Control and Prevention (CDC) for shingles?
Vaccination is recommended to reduce the risk of shingles and shingle related complications for adults 50 years old and older and for adults 19 years old and older who have weakened immune systems and are at risk for zoster infection. For both of these groups, vaccination is recommended regardless of prior history of the zoster virus. Please talk with your provider regarding your need for this vaccine and what type of vaccine is best for you.

Where can I learn more about the shingles vaccine?

  • Talk with your health care provider.
  • Call your local or state health department.
  • Visit the Food and Drug Administration (FDA) website, www.fda.gov/vaccines-
    blood-biologics/vaccines, for vaccine package inserts and additional information.
  • Contact CDC at 1-800-232-4636 (1-800-CDC-INFO) or visit cdc.gov/vaccines.

If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected]. BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.

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