Are You At Risk for Shingles?

By Beth Israel Deaconess Medical Center Staff

If you're a senior, chances are you've known somebody who has suffered a bout of shingles. There's no mistaking its telltale painful rash, and its connection to chickenpox is commonly discussed. Still, questions linger for many. Am I at risk? Should I get vaccinated? Is it contagious?

Shingles usually shows up as a red rash that often appears on one side of the body, typically accompanied by a sensation ranging from tingling to burning and itching to a deep pain. It is indeed caused by the same virus as chickenpox. If you've ever contracted chickenpox, the virus stays in your body, lying dormant in your nerves. In about 10 to 20 percent of people, it will one day resurface as shingles.

"People over age 50 are more at risk because our immune systems weaken as we age," says Suzanne Salamon, MD, Associate Chief of Gerontology at Beth Israel Deaconess Medical Center. Medications such as chemotherapy drugs or prednisone can also weaken the immune system enough to give the virus an opportunity to present. Other risk factors include underlying cancer and chronic lung and kidney disease.

Treatment

Salamon urges patients to contact their physician the moment they notice a rash. Treatment is most effective when it's started within 72 hours.

"The goal of antiviral treatment is to reduce the severity and duration of pain and help the skin rash heal more quickly," she says. Cold compresses and over-the-counter ointments such as capsaicin cream can also ease symptoms.

Complications do arise on occasion. About 10 percent of shingles sufferers will develop post-herpatic neuralgia, which results in a lingering pain. Timely treatment for shingles can help prevent this complication.

Salamon also cautions that shingles which develop around the eyes – known as ocular shingles – can be particularly dangerous.

"It's really important to see an eye doctor as soon as these appear," she says. Left untreated, ocular shingles can lead to hospitalization or even blindness. Antiviral eye drops are usually an effective treatment.

Shingles cannot be spread from person-to-person, but shingles can cause chickenpox in someone who has never had this virus, if that person comes in contact with fluids from a shingles blister.

Prevention

A shingles vaccine has been available for about a decade. It's about 60 percent effective, and not always fully covered by insurance. However, Salamon believes it's the best prevention option available.

"Anyone over 50 who has had chickenpox should consider getting the vaccine," she says. She's encouraged by news of a new vaccine in development that promises better results.

Salamon points out that there are some people who should not get vaccinated: pregnant women and people with diseases or medications which lower the immune system. And, if you're unsure whether you've ever had chickenpox, it may be a good idea to request a simple blood test to find out. Since the vaccine contains a live virus, it can actually destroy someone's natural immunity to shingles by introducing the virus that wasn't previously present in the body.

While it's less likely you'll get shingles if you've already had it, the chances range from about six percent to 25 percent. Therefore, it is recommended that even if you have had shingles, you should get the shingles vaccine.

So know your medical history and stay vigilant. It's the best way to make sure shingles doesn't get the best of you.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor. Posted August 2016