If you’re over 50 you may be at risk for getting one of the most uncomfortable viral infections around – shingles.  It almost always affects older people for a variety of reasons that you need to know about. I’d also like to tell you what to do if you get shingles, and better yet, how you can prevent it.

What’s Your Risk For Shingles?

Recently, there has been a commercial on television about shingles. In it, several people describe getting a mysterious rash and then the debilitating pain that comes with it.  If you notice, the people featured in these ads are older adults – at least 50 or more years old. That’s because shingles almost always occurs in older people. Here’s why:

• Age. Your immune function and ability to fight off infections, viral and bacterial, weakens as you get older.  By age 70, your immunity to shingles is much lower. But, there are things you can do to strengthen your immunity to decrease your risk.

• Chronic illness. You may be fighting a chronic illness like lupus, arthritis, cancer, even allergies, that can weaken your immunity against the shingles virus.

• Chickenpox exposure. Most people over 50 have had chickenpox as a kid.  But, even after recovering from it, some of the varicella zoster virus (VZV) remained in your body. Some stayed behind in your nerve cells where it lays dormant until something happens to re-activate it.

Researchers don’t really know what that “something” is – but stress and other illnesses are top activators.  When the VZV virus does re-activate, it expresses itself as shingles rather than a second case of chickenpox. Not everyone who has had chickenpox will get shingles – only about 1 in 5.

What Is Shingles? What Does It Do?

Like the television ad reports, shingles causes a lot of distress – mostly pain in the area where it erupts.  Shingles starts like a rash in a belt-like shape. In fact, that’s how it got its name. The Latin name for belt is “cingulus”, pronounced shin-gu-les. It usually occurs along the lower back on one side, but can extend up higher as well. As the virus is contained in the nerve cells, it travels up to the skin where it creates a rash. That rash is usually the first tell-tale symptom of shingles. Here are some others:

• Tingling, burning, sensitive to touch skin
• A unilateral, itchy rash of fluid-filled blisters – try not to scratch at them as they can leave scars.
• Chills, nausea, fever, headache – these are all warning signs that a viral process is underway.
• Mild itching-severe pain at the site of the rash.

If you have these symptoms, you need to see your doctor within 3 days of the rash breaking out.  In some cases a shingles rash will disappear after this amount of time.  Your doctor needs to see the rash while it’s broken out to:

• Make the correct diagnosis of shingles
• Get you started on the appropriate treatment.  Starting early treatment can dry up the fluid filled blisters faster and reduce, or eliminate, the pain that can come with shingles.

Keep in mind that, even if you’re diagnosed with shingles, it doesn’t mean your going to have a terrible time of it.  Some people just get the shingles rash with only numbness and tingling in the skin of the rash as well as surrounding it.  However, if you get rash blisters near your eyes, this could result in permanent vision damage. See your doctor immediately.

Other people can sometimes develop what’s called “PHN” – post-herpetic neuralgia – or “nerve pain”.  Neuralgia can continue to develop and sometime it takes months before it eventually wears itself out. Older people, especially, are more prone to getting the PHN. If you develop PHN with your shingles, tell your doctor immediately so they can get you started on the best antiviral medications for it.

Keep in mind, though, that shingles is NOT contagious. You can’t pick it up by visiting someone who has it, nor can you get it from someone in public who may have it.  However, if you’ve never had chickenpox before, and you come in contact with someone with shingles, it IS possible to break out with a case of chickenpox.  If your kids, or grandkids, have not had chickenpox, keep your distance until the condition has cleared.

If you get shingles, you should be able to treat it at home. A hospital stay isn’t necessary unless you develop a skin infection in the rash. Trying not to itch the rash will help prevent an infection.   A small number of people develop symptoms of brain inflammation (encephalitis) from shingles.

What Can You Do To Prevent Shingles?    

Even if you’ve had chickenpox, you can decrease your chance of getting shingles by getting the Zostavax vaccine.  The CDC says that 99% of people have had chickenpox as kids even if they don’t remember having it. Researchers say that the vaccine decreases your risk of shingles by about 50%. It does this by stimulating your immune system with a “killed” version of the same varicella zoster virus. This tells your immune system to attack these viruses and stop them from erupting into shingles blisters.

Not everyone is a candidate for a shingles vaccine.  This includes:

• If you have allergies to any of the ingredients in a shingles vaccine.
• You have HIV, or some other chronic immune system-weakening condition.
• Are undergoing cancer treatment with chemo or radiation.
• Taking steroids for any condition (like asthma, lupus, etc)

If you’re over 50 and have had chickenpox before, you’ll want to do the following things to decrease your risk of getting shingles:

• Avoid major stress, if possible. This seems to be one of the biggest culprits in aggravating the VZV virus to re-activate.

• Boost your immune system:  Eat an optimally nutritional diet. Be sure you’re not deficient in Vitamin D which is an immune-system boosting nutrient. Be sure to get plenty of Vitamin C as well. Regular exercise also helps boost your immune system by aiding in clearing stress hormones from your blood.  So does adequate sleep – be sure to get a minimum of 6 hours per night.

Shingles is one of those age-related “complications” that many people will face! Yet, if you do everything possible to strengthen your immune system, reduce stress in your life and get a vaccine, your risk of developing shingles will be significantly decreased.

Stay Well,
Ron Blankstein, M.D.

http://www.nia.nih.gov/health/publication/shingles

http://www.cdc.gov/shingles/