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Shingles
Ruth, a 79-year-old woman, said her case of shingles was
causing her so much pain she couldn’t bear to put on her
clothes or have sheets touch her skin. Ruth was sick for several
months. Her friend, Sarah, had it easier. Shingles made Sarah
feel sick for a few days, and she had some discomfort. But she
was back to her old self in a few weeks. Sarah noted, “Having
shingles wasn’t so bad.”
What is Shingles?
Shingles is a disease that affects nerves and causes pain and
blisters in adults. It is caused by the same varicella-zoster
virus that causes chickenpox. After you recover from chickenpox,
the virus does not leave your body, but continues to live in some
nerve cells. For reasons that aren’t totally understood,
the virus can become active instead of remaining inactive. When
it’s activated, it produces shingles.
Just like chickenpox, people with shingles will feel sick and
have a rash on their body or face. The major difference is that
chickenpox is a childhood illness, while shingles targets older
people. Most adults live with the virus in their body and never
get shingles. But about one in five people who have had chickenpox
will get shingles later in life—usually after the age of
50.
When the activated virus travels along the path of a nerve to
the surface of the skin, a rash will appear. It usually shows
up as a band on one side of the face or body. The word “shingles”
comes from the Latin word for belt or girdle because often the
rash is shaped like a belt.
Who Is at Risk?
Anyone with the varicella-zoster virus in their body can be at
risk for getting shingles.
Right now there is no way of knowing who will get the disease.
But, there are things that make you more likely to get shingles.
- Advanced age. The risk of getting shingles increases
as you age. People have a hard time fighting off infections
as they get older. The chance of getting shingles becomes much
higher by age 70.
- Trouble fighting infections. Your immune system is
the part of your body that fights off infections. Age can affect
your immune system. So can an HIV infection, cancer, cancer
drugs, radiation treatments, or organ transplant. Even stress
or a cold can weaken your immune system for a short time and
put you at risk for shingles.
What Are the Symptoms of Shingles?
Most people have some of the following symptoms.
• Burning, tingling, or numbness of the skin
• Feeling sick—chills, fever, upset stomach, or
headache
• Fluid-filled blisters
• Skin that is sensitive to touch
• Mild itching to strong pain
Shingles follows a pattern. A few days after the tingling or
burning feeling on the skin, a red rash will come out on your
body, face, or neck. In a few days, the rash will turn into fluid-filled
blisters. The blisters dry up and crust over within several days.
The rash usually happens on one side of the body. Most cases of
shingles last from 3 to 5 weeks.
Do You Need A Doctor?
George, age 67, had a red rash on his face
and felt sick. His wife urged him to see a doctor, but he told
her, “It’s just a rash. I’ll be all right in
a few days.” His wife insisted that he go to the doctor.
The doctor told George that he had shingles and ordered some medicine
for him.
It’s important to go to your doctor no later than 3 days
after the rash starts. The doctor needs to see the rash to confirm
what you have and make a treatment plan. Although there is no
cure for shingles, early treatment with drugs that fight the virus
can help. Shingles can often be treated at home. Patients with
shingles rarely need to stay in a hospital.
How Is Shingles Treated?
For people with severe symptoms, there are many medications your
doctor can prescribe to treat shingles. These include medicines
that:
• Fight the virus—antiviral drugs
• Lessen pain and shorten the time you’re sick—steroids
• Help with pain relief—antidepressants and anticonvulsants
• Reduce pain—analgesics
When started within 72 hours of getting the rash, these medicines
help shorten the length of the infection and lower the risk of
other problems.
Why Does the Pain Go On and On?
After the rash goes away, some people may be left with long lasting
pain called post-herpetic neuralgia or PHN. The pain is felt in
the same area where the rash had been. For some people, PHN is
the longest lasting and worst part of shingles. The pain can make
some people feel weak and unable to do things they usually enjoy.
Those who have had PHN say the pain is sharp, throbbing, or stabbing.
Their skin is so sensitive they can’t bear to wear even
soft, light clothing. People who have PHN call it a pain that
won’t go away.
The older you are when you get shingles, the greater your chance
of developing PHN. This pain can last for weeks, months, or even
years.
“I’ve had post-herpetic neuralgia for nine months,”
said Pete, an 80-year-old man. “I’ve lost 20 pounds.
I can’t find anything that helps with the pain.”
The PHN pain can cause depression, anxiety, sleeplessness, and
weight loss. Some people with PHN find it hard to go about their
daily activities like dressing, cooking, and eating. Talk to your
doctor if you have any of these problems. There are medicines
that may help. Usually PHN will get better over time.
What Are Other Complications?
In some cases, blisters can become infected. Scarring of the skin
may result. Your doctor can prescribe an antibiotic treatment.
Keep the area clean, and try not to scratch!
There are other problems to watch for. If blisters occur near
or in the eye, lasting eye damage or blindness may result. This
can be very serious. See an eye doctor right away.
Other problems may include hearing loss or a brief paralysis
of the face. In a small number of cases, swelling of the brain
(encephalitis) can occur. It’s very important to go
to the doctor as soon as possible— especially if you have
blisters on your face.
Can You Catch Shingles?
No, shingles is not contagious. You can’t catch shingles
from someone who has it. But you can catch chickenpox from someone
with shingles. So, if you’ve never had chickenpox, try to
stay away from anyone who has shingles.
Flo, a 77-year-old woman notes, “My daughter stayed
away when I had shingles. She’d never had chickenpox and
didn’t want to risk catching it. Good thing my sister lived
nearby and could help me during those first few weeks.”
Will Shingles Return?
Most people get shingles only once. But it is possible to have
it more than once.
What Can You Do?
If you have shingles, here are some things that may make you feel
better:
Make sure you get enough rest, avoid stress as much as you can,
and eat well-
balanced meals.
- Simple exercises like stretching or walking can help. Check
with your doctor first.
- Dip a washcloth in cool water and apply it to your blisters
to ease the pain and help dry the blisters.
- Do things that take your mind off your pain. Watch TV, read
interesting books, talk with friends, or work on a hobby you
like.
- Try to relax. Stress can make the pain worse. Listen to music
that helps you relax.
- Share your feelings about your pain with family and friends.
Ask for their help.
What’s In the Future?
The Shingles Prevention Study (SPS) is a 5-year nation-wide study
of an experimental vaccine to prevent shingles. This vaccine is
similar to the vaccine that children have been receiving since
1995 to prevent chickenpox. Scientists hope that the adult vaccine
to prevent shingles will be offered in the future.
Where Can I Get More Information?
For more information about shingles and pain management, you can
call or write:
National Institute of Allergy and Infectious Diseases
6610 Rockledge Drive MSC 6612
Bethesda, MD 20892
301-496-5717
www.niaid.nih.gov
National Institute of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
1-800-352-9424
301-468-5981 (TTY)
www.ninds.nih.gov
American Chronic Pain Association
P.O. Box 850
Rocklin, CA 95677-0850
1-800-533-3231
www.theacpa.org
National Chronic Pain Outreach Association
P.O. Box 274
Millboro, VA 24460
540-862-9437
www.chronicpain.org
National Foundation for the Treatment of Pain
P.O. Box 70045
Houston, TX 77270-0045
713-862-9332
www.paincare.org
VZV Research Foundation
40 East 72nd Street
New York, NY 10021
1-800-472-8478
www.vzvfoundation.org
For more information on health and aging, contact:
National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
1-800-222-4225 (TTY)
E-mail: niaic@jbsl.com
To order publications online:
www.niapublications.org
Please visit NIHSeniorHealth.gov (www.nihseniorhealth.gov),
a senior-friendly Web site from the National Institute on Aging
and the National Library of Medicine. This Web site features popular
health topics for older adults. It has large type, is simple to
use, and has a “talking” function that reads text
aloud.
National Institute on Aging
U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health
June 2004
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