The Dr. is In: How to prevent shingles

Two aunties were talking story over a pot of tea. They were concerned about a friend who had shingles and was miserable. They were trying to figure out whether or not their friend had gotten shingles from a grandchild with chicken pox, and if they should be worried they might get shingles from their friend. This scenario has several complexities. Let me try to clear things up.

Shingles, also known as herpes zoster, is a painful blistery rash that can lead to severe nerve pain for months after the rash has disappeared.

While most people who get shingles are over 50, it can affect anyone who has had chicken pox, even children. Nearly 1 in 3 adults in the United States will have shingles at some point in their lifetime and about 1 million get shingles each year. Circumstances such as decreased immunity or increased physical or emotional stress can be triggers for shingles to occur.

Chicken pox is caused by the varicella zoster virus. After the initial case of chicken pox, this virus lies dormant in the nerve root, waiting to be reactivated. Once it is awakened, it travels down the nerve to the skin, causing burning pain and tingling. This can be accompanied by headaches, stomach aches, chills and fever. A few days later, a cluster of small red bumps appears, often wrapping around one side of the torso, though it can also be on the face or limbs. The rash then turns into blisters, much like the original chicken pox. When these blisters break open, they release the virus. The lesions dry and scab 3-5 days after appearing and heal completely in about a month.

One common complication in about half of all people over age 50 who get shingles is a severe nerve pain that can last for months or years after the skin has healed. This condition is called post-herpetic neuralgia (PHN) and can range from uncomfortable to debilitating. Its unrelenting, sharp, stabbing, burning pain is presumably due to nerve damage.

Other complications include temporary or permanent vision, hearing or taste loss if the lesions reach the face and head. Nerve weakness has been known to occur. One can have recurrences of shingles.

While shingles is much less contagious than chicken pox, a person who has shingles can shed the virus while the blisters are open. Anyone who has not had chickenpox or its vaccine can be infected with the varicella zoster virus, and then would get the chicken pox, not shingles.

There are many treatments for shingles, but as with all viruses, it must run its course. Conventional treatments aim to decrease pain, speed skin healing and reduce complications by using antivirals, corticosteroids, pain relievers and NSAIDS. In some cases, injections are used to block nerve pain. Other treatments include cool compresses to decrease blister pain and topical capsaicin for PHN. In conjunction with conventional therapies, acupuncture and TENS have been shown to be beneficial in the prevention and treatment of PHN. Demonstrated efficacy for similar herpes virus families are honey, hypericum, zinc, vitamins C and E, and aloe.

If you suspect you have shingles, it is important to see your health care provider as soon as possible to get a definite diagnosis and treat it correctly. If you do have shingles, here are a few tips from the CDC to prevent spreading it: Avoid touching the rash and cover it with non-stick gauze, wash hands frequently, and avoid people who haven’t had chicken pox or who have weakened immunity.

Preventing this infection is important. Since stress and decreased immunity are factors in this condition, this gives yet another reason to live life with a resilient attitude, eat nutritiously, prioritize sleep, exercise appropriately and practice good hygiene. Two shingles vaccines are available if you are in a high risk category.

So, now that you and our aunties know more about shingles, they can feel confident in knowing how to prevent shingles and help their friend.