Shingles, also called herpes zoster, is caused by the varicella zoster virus, the same virus that causes chickenpox. Shingles can be a painful rash that goes away after a few weeks — no fun, but manageable. Or it can be hellish.
Half of everyone who reaches age 85 will have experienced shingles some time along the way. Here's what you need to know about preventing and treating the condition.
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Q: What is shingles? If I've had chickenpox, will I definitely get shingles?
A: Shingles is a viral infection of the nerves. After a bout of chickenpox, leftover varicella virus hides out in the nervous system in an inactive state, held in check there by the immune system. If the immune system weakens, the snoozing virus can come roaring back to life, replicate and cause the havoc we experience as shingles. It's not clear why the virus remains dormant in some people but not others.
Q: What symptoms should I watch out for?
A: The primary symptom is a rash, which often appears as a red band on one side of the torso, and is followed by blisters. Chills, nausea, headache and a tingling pain or itch on one side of the body are additional possible symptoms. Shingles may affect nerves in other parts of the body, including those in the arms or legs and may result in muscle weakness in the affected limbs. Some of the worst cases involve nerves around the eye, which can lead to inflammation in the cornea and even vision loss.
Between 10 and 20 percent of people with the condition experience postherpetic neuralgia, persistent nerve pain in the area affected by shingles. Postherpetic neuralgia pain is hard to predict. It can last for months, even years. Yet it can also end abruptly (and mercifully) for no apparent reason.
Q: What's my risk?
A: The risk of shingles increases with age because the strength of the immune system declines as we get older. Shingles starts to become more common in our 50s, but anyone harboring the varicella virus in their nervous system and who has an impaired immune system is vulnerable. This includes people with HIV/AIDS, some kinds of cancer (especially Hodgkin's disease) and organ transplant recipients. Some studies suggest that stressful events can bring shingles on.
Q; Is shingles contagious?
A: You cannot catch shingles from someone else. But a person who has never had chickenpox or received the chickenpox vaccine can contract chickenpox through contact with a shingles rash.
Q: How can I protect myself?
A: A shingles vaccine is sold under the name Zostavax. In the trial that led to its approval by the Food and Drug Administration in 2006, the vaccine reduced the risk of shingles by half. And, by all accounts, it's safe. Federal vaccine officials have recommended that everyone 60 or older with a healthy immune system be vaccinated against shingles, advice that applies to people who have already had a case, because recurrences do happen. The onetime vaccine is not a minor expense, but it is covered by Part D Medicare plans.
Q: What are the treatment options?
A: Shingles has no cure, but rashes usually subside and heal within a few weeks. Your doctor may recommend painkillers and anti-inflammatory medications to ease pain and discomfort. Early treatment of shingles with antiviral drugs has been shown to reduce the severity of the attack. Antidepressant medications and antiseizure medications can reduce postherpetic neuralgia pain. Topical creams containing capsaicin (the substance that makes chili peppers spicy hot) or lidocaine (which also comes as a patch) may provide a little relief.
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