Understand the Shingles Virus and Your Risk

You may be familiar with chickenpox, the contagious virus that causes an itchy, sometimes painful rash and mostly affects children. Chances are you had chickenpox yourself when you were younger. More than 99 percent of Americans born before 1980 had the chickenpox at some point in their lives, according to the Centers for Disease Control.

It turns out that even when chickenpox goes away, it sometimes doesn’t stay away. The virus can come back years, even decades, later.

It starts with flu-like symptoms, maybe a fever or headache. A few days later, you may feel itchy, tingly, or have pain in a certain spot. Then, the telltale rash appears.

This is the progression of shingles, a skin rash caused by the chickenpox virus. About 1 in 3 Americans will develop shingles in their lifetime, according to the CDC.

What Is Shingles?

Shingles usually appears in older people who have had chickenpox. It is caused by the varicella-zoster virus and may also be called herpes zoster.

“It’s a viral infection, but it’s different than a lot of other viral infections,” says Alex Viehman, MD, a clinical assistant professor in infectious diseases at UPMC Presbyterian. “Instead of clearing the (varicella-zoster virus), it goes into a nerve in your body.”

Where the varicella-zoster virus goes in the sensory column on your spinal cord determines where the shingles will present later, Dr. Viehman says.

The virus remains dormant in your body until something reawakens it. A weakened immune system, chemotherapy, certain medications, stress, illness, or injury are possible causes of shingles. People over age 50 are at higher risk.

Shingles is characterized by a painful rash, usually on one side of your midsection or on your face. The rash turns into blisters, which crust over.

Shingles lasts around seven to 10 days in most cases. Luckily, most people do not have a recurrence of the virus.

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Can Shingles Cause Complications?

Although most people who get shingles do not experience further problems, there is a risk of complications.

The most common problem that shingles can create is long-term nerve pain, known as postherpetic neuralgia (PHN). PHN comes after the shingles is healed. People with PHN experience sensitivity and pain in the area where the shingles was, and the pain can last for months and years.

“It can be very difficult to treat because usual medications work more for non-nerve pain,” Dr. Viehman says. “The nerve pain can be trickier to treat.”

Other complications include:

  • Visual problems, including vision loss
  • Pneumonia
  • Hearing problems
  • Brain inflammation
  • Death

Is the Shingles Virus Contagious?

It’s possible that the varicella virus can be spread to people who haven’t had chickenpox or gotten the chickenpox vaccine. Adults who didn’t have chickenpox as a child are at risk of a more severe case of the condition if they get the varicella virus from someone who has shingles.

In general, however, you’re not likely to catch shingles from someone else.

If you know or think you have shingles, be careful around:

  • Pregnant women
  • Newborns
  • People who are sick
  • People with weakened immune systems

These individuals are at higher risk of getting the virus, and it’s best to keep your distance until the blisters heal.

Cover any sores or unhealed blisters and wash your hands to help prevent spreading the virus.

How Is Shingles Treated?

Your doctor will likely be able to identify shingles by the rash. If unsure, your doctor may test cells from the rash to identify the virus.

Antiviral medications acyclovir and valacyclovir are used to lessen pain, speed up healing, and lower the chance of complications. The sooner you start treatment, the more effective it is.

Bland, non-medicated ointments, lotions, or creams also can be used. Cold compresses can also give some relief.

What About the Shingles Vaccine?

Vaccinating against shingles may be a preventive option. It is not used as treatment. The vaccine also doesn’t ensure that you won’t develop shingles, but it does help reduce your risk of complications.

There are two types of shingles vaccines:

  • Zoster vaccine live (ZVL or Zostavax)
  • Recombinant zoster vaccine (RZV or Shingrix)

Shingrix, developed in 2017, is the preferred vaccination for adults 50 and over. It is delivered in a two-shot series, with the shots separated by two to six months.

“Shingrix, in the trial, showed a lot better efficacy,” Dr. Viehman says. “It lasted longer, and it worked better in elderly people.”

Dr. Viehman says Shingrix can cause side effects, and it can be difficult to find. But according to the CDC, getting two doses of Shingrix can lessen your risk of developing shingles and PHN by more than 90 percent.

Talk to your doctor right away if you have signs of shingles. The sooner you get treatment, the better your chances of healing faster.

Have you had your vaccination for the shingles virus? If you haven’t get in touch with the UPMC Department of Family Medicine to schedule your vaccination today.

About Infectious Diseases

If you have a disease caused by bacteria, fungi, parasite, or virus, the UPMC Center for Care of Infectious Diseases can help. We have specialty units for prevention and treatment of HIV-AIDs, postsurgical and transplant infections, and illnesses caused by international travel. Our faculty research infectious diseases and participate in clinical trials to learn more and develop better treatment and prevention methods.