Frequently Asked Questions About Shingles
Shingles is a common illness affecting about 1 million Americans annually. If you have had chickenpox, you are at risk, because shingles is caused by the chickenpox virus reactivating in your body. The virus can live in your nervous system in inactive form for decades. Researchers aren't sure exactly why it becomes active again, but shingles becomes more likely in people who have a compromised immune system due to illness, medications, stress or other factors. Shingles also is associated with aging.
While most people associate shingles with a rash, oftentimes the disease starts first with no rash. Instead, initial symptoms include burning, itching or tingling sensations in a part of your body, most often on the side of your torso. You also may feel generally unwell, with such symptoms as headache, nausea, fever and/or chills. The trademark shingles rash will start anywhere from 1 to 14 days later in the area where you experienced pain or burning. The shingles lesions often are painful and itchy.
The shingles rash typically is in a stripe, band or clusters, with blisters that resemble chickenpox (but not as many and not as scattered as with chickenpox). They will be open and oozing for the first few days, then will scab over and gradually disappear over the next 2 weeks or so. The rash usually is confined to one side of your body, such as one side of your torso or one side of your face. However, shingles can appear anywhere on your body and even in rare instances can develop in your throat, ears or eyes.
The shingles virus, or herpes zoster, is part of the herpes family of viruses. The antiviral treatments used for other herpes viruses, such as herpes simplex, also work for shingles. These drugs include acyclovir (Zovirax) and valacyclovir (Valtrex).
It's important to see your doctor as soon as you suspect shingles—the drugs are most effective if they are taken within 24 to 72 hours of the appearance of the rash. They can help the blisters heal more quickly, reduce your pain, and cut your chance of getting complications.
Other treatments your doctor may prescribe for shingles include numbing agents you can apply directly to your skin to ease the pain, narcotic medications, anti-inflammatory corticosteroids, tricyclic antidepressants, and anticonvulsants.
The Shingrix was approved by the U.S. Food and Drug Administration in 2017. It is a two-shot process, with injections given 2 to 6 months apart. It is greater than 90% effective in preventing the illness.
Shingrix is recommended for:
- People 50 and older
- People 18 years and older whose immune system is weakened or compromised by a medical condition (such as HIV/AIDS or severe combined immunodeficiency) or immune-suppressing medications (such as anti-rejection drugs or many chemotherapy medications)
The Shingrix vaccine can reduce shingles symptom severity in those who do get it after having had the vaccine, and can cut the likelihood of shingles complications (such as nerve pain that continues after the rash clears up). Side effects may include pain, swelling and itching at the injection site and headache. Consult with your doctor to see if the vaccine is right for you.
An older vaccine, Zostavax is no longer available in the U.S. If you previously received Zostavax, talk with your healthcare provider about when you should get the Shingrix vaccine.