The Healthy Senior: Shingles Are Not Fun

. April 30, 2018.
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A comedian in a recent routine made a humorous reference to “shingles.” But those who have experienced shingles don’t find it funny.

Shingles is a painful skin disease caused by the chickenpox virus, awakening from a dormant state to attack your body. Some people report fever and weakness when the disease starts. Within two to three days, a red, blotchy rash develops which erupts into small blisters that look like chickenpox. And it’s very painful. That doesn’t sound very funny.

A common ailment

Anyone who has had chicken-pox can get shingles. Half of all Americans will get shingles by the time they are 80. Shingles occurs in people of all ages, but it is most common in people between 60 and 80. Each year, about one million Americans are diagnosed with shingles.

“People with immune problems can get it earlier than 60,” explains Dr. Craig Burkhart, a Sylvania dermatologist. So, it’s important to spot the symptoms and get treated right away.

The inactive virus rests in nerve cells near the spine. When it reactivates, it follows a single nerve path to the skin. The shingles rash helps to confirm a diagnosis; the rash erupts in a belt-like pattern on only one side of the body, or it appears on one side of the face. It usually begins as a patch of red dots which then become blisters.

“It is self limited, meaning the body will control it,” says Dr. Burkhart. But, if left untreated, he explains, “it can cause scarring and skin manifestation…the nerve condition can be devastating.”

Treatments available

Physicians treat shingles with antiviral and pain medications. The antiviral medications work faster if they are started early—within 72 hours from the appearance of the rash.

Dr. Matthew Molenda of Bravia Dermatology provided some insight on treatment options. “Sometimes steroids or other medications are also prescribed to minimize the risk of long term pain, called post-herpetic neuralgia, that can result after shingles. The earlier the treatment, the less likely there will be long term pain,” he explains.

If you have had chickenpox, shingles is not contagious. If you have never had chickenpox, you can catch the virus from contacting the fluid in shingles blisters. You will likely not get shingles, but you could get chickenpox.

Symptoms and related issues

The pain of shingles can be severe. Pain symptoms that are strong and last for months or years are called postherpetic neuralgia (PHN). Persistent pain is a common symptom in people over 60. However, most victims of shingles overcome their symptoms in about a month and it is unlikely that they will contract shingles again.

Outbreaks that start on the face or eyes can cause vision or hearing problems. Even permanent blindness can result if the cornea of the eye is affected. In patients with immune deficiency, the rash can be much more extensive than usual and the illness can be complicated by pneumonia. These cases, while more serious, are rarely fatal.

Vaccinations are important to prevent Shingles. “Shingrix and Zostavax are two of the most common (vaccines) used in adult patients over 60 years old,” said Dr. Molenda.

The Food and Drug Administration last year approved the Shingrix vaccine to prevent painful shingles in people 50 and older. The vaccine prevents more than 90 percent of shingles cases, even at older ages. Zostavax, an earlier shingles vaccine that remains on the market, prevents about half of shingles cases in those over age 60 and, with less demonstrated effectiveness, among elderly patients.

Check your health insurance provider to determine the coverage it offers for the new vaccine.

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