Many of my patients are over the age of 50 and as a result may have more skin related conditions than people who are younger. One such condition that seems to be more common in older people is Shingles, a viral infection that causes a painful rash. It is estimated that half the population who live to the age of 85 will experience shingles at some point in their lives. Age is not the only factor influencing the onset of shingles; those with weakened immune systems are also at risk. Cancer, prolonged use of steroids, HIV/Aids, and drugs designed to prevent rejection of transplanted organs are a few ways in which your immune system may be lowered. Although shingles is not a life-threatening condition, it can cause a great deal of pain and discomfort. I encourage my patients to become familiar with the symptoms and signs of shingles because early treatment can help shorten the infection and lessen the chance of complications. Usually shingles affects only a small section of your body and most often appears as a band of blisters that wraps around the middle of your back to your chest. It can sometimes occur around one eye or on one side of the neck or face. The first symptom is pain, which in some cases is so intense it can be mistaken for another problem affecting your heart, lungs, or kidneys. Other signs include burning, numbness or tingling followed by a red rash. Eventually you develop blisters that fill with fluid, break open and crust over. When the blisters begin to heal they can cause itching. What Do Chickenpox Have to Do with Shingles? Most people don’t realize that the varicella-zoster virus; the same virus that causes chickenpox is responsible for shingles. If you have had chickenpox as a child the virus is still there, sleeping in the nerve tissue near your spinal cord and brain. It may not show up until years later when it reactivates as shingles. No one really knows why the virus wakes up but it is usually linked to stress, aging, or a weakened immune system. When it becomes active again, it can only cause shingles, not chicken pox. The varicella-zoster virus is part of the same group of herpes viruses that cause cold sores and genital herpes. Even though varicella-zoster is considered part of this group, it is not to be confused with the virus responsible for cold sores or genital herpes, a sexually transmitted disease. If you have never had the chickenpox virus or vaccine, you are at risk of contracting shingles from someone who has the virus. This transmittance usually occurs through direct contact with open sores of the shingles rash. Once infected, the person will develop chickenpox not shingles. It is not contagious however, to anyone who has had the virus at some time in their life. It is important to note that chickenpox can be highly dangerous to certain groups of people who might be more susceptible than others such as someone with a weak immune system, newborns, and pregnant women. You are still contagious until your shingles blisters scab over so be sure to avoid physical contact with anyone, especially those mentioned here. You Have Shingles Most of the time shingles will go away on its own but you may need treatment to manage your pain. There is a medicine that is often prescribed that fights the virus called antiviral. This drug helps reduce pain and complications as well as shorten the course of the virus. When you begin to feel pain or burning, and before blisters appear, you should start taking medication within a 24 hour period. The medication is usually taken orally, in pill form, and in larger doses than prescribed for herpes simplex. Depending upon the severity of your case, your doctor may prescribe strong anti-inflammatory medicines such as prednisone to reduce swelling. Other medications include antihistamines, over the counter pain medication, and topical creams. There are also things you can do at home to relieve your discomfort: •Apply cool wet compresses to reduce pain. •Take soothing baths such as colloidal oatmeal or starch baths to relieve itching. •Apply lotions such as calamine. •Rest in bed until your fever goes down. •Keep skin clean and do not reuse contaminated items. •Items that are non-disposable should be disinfected and/or washed in boiling water before reusing. •Cover the rash with a dressing or clothing to decrease the risk of spreading the infection to others. •Avoid contact with other people while lesions are oozing to prevent infection from spreading especially to anyone in the high risk category. Is Prevention Possible? There are a couple of methods that are currently being used to reduce the incidence of shingles. 1. VZV vaccine or chickenpox vaccine may decrease the incidence of shingles by boosting the immune system’s ability to fight off chickenpox or keep the virus inactive. This is effective about 79%-90% of the time and is usually given to children. After about 15-20 years the immunity may begin to decline so a booster for use in adults is under investigation for future prevention. 2. Zostavax, a new vaccine is recommended for all adults ages 60 and older by the U.S. Centers for Disease Control and Prevention (CDC). Data shows that the vaccine prevents about 51% of shingles cases and is most effective in the 60-69 age groups.1 If you have any of the symptoms mentioned in this article be sure to call your health care provider, particularly if you are subject to a weakened immune system. Early detection will make the difference in the course shingles will take and the severity of your pain. Don’t delay in getting the care you need to prevent or treat this very painful virus from happening to you. Jay Brachfeld, M.D.

Author's Bio: 

•BS Chemistry Massachusetts Institute of Technology •MD State University of New York at Buffalo School of Medicine •Dermatology Residency: Baylor College of Medicine •Board Certified in Dermatology •Member American Academy of Dermatology

Jay Brachfeld, M.D.