Tuesday, July 16, 2024

How Is Shingles Treated In The Elderly

Questions To Ask Your Doctor

Shingles: Signs, Symptoms and Treatment with Dr. Mark Shalauta | San Diego Health
  • Ive had chickenpox. Am I at risk of developing shingles?
  • What is the best treatment for my shingles?
  • The pain from shingles isnt going away. What can I do to make myself more comfortable?
  • Im on treatment for shingles. When should I call my doctor if things dont get better?
  • I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
  • Is the shingles vaccine right for me?
  • Are there any risks associated with the shingles vaccine?
  • Will my post-herpetic neuralgia ever go away?
  • If Ive never had the chickenpox, should I still get the shingles vaccination?

Shingles, caused by the same virus that causes chickenpox, may have innocuous beginnings, but can cause serious health complications in seniors. As an uncomfortable skin condition, shingles in the elderly should be identified and treated to reduce the risk of additional dangers.

Herpes zoster is the clinical term used to describe shingles. The varicella-zoster virus is the parent virus that causes both the chickenpox early in life and, possibly, shingles later in life. After recovering from chickenpox, the virus survives and remains in some nerve cells.

The majority of adults who had the chickenpox will not develop shingles later, since the varicella-zoster virus remains inactive in these individuals. However, about one out of every three adults is susceptible to the varicella-zoster becoming active again and can develop a case of shingles.

Shingles In Older Adults

Shingles is a painful skin rash caused by the varicella zoster virus, sometimes called herpes zoster. It often appears in a band, a strip, or a small area on one side of the face or body.Shingles is most common in older adults and people who have weak immune systems. It can flare up because of stress, injury, certain medicines, and other reasons. Most people who get shingles will get better and will not get it again. But it is possible to get shingles more than once.The good news you can’t catch shingles from someone else who has shingles. But, there is a small chance that a person with a shingles rash can spread the virus to another person who hasn’t previously had chickenpox or who hasn’t had the chickenpox vaccine.

  • Flu like symptoms, without fever
  • Pain in certain areas of the body
  • A rash with blisters that fill with fluid and then crust over

Often, it takes weeks for the rash to heal, and may leave behind scarring. Not all people will suffer from all the symptoms of shingles. Some will experience the lesser symptoms while other will have more severe symptoms.

Complications And Side Effects Of Shingles In The Elderly

Home / Blog / Healthcare / Complications and Side Effects of Shingles in the Elderly

While many people know that shingles are related to the chickenpox virus, theyre often unaware of the complications of shingles in the elderly. A rash that develops on one side of the body or face can be quite painful. Shingles typically appear as blisters that begin scabbing over within about one week and clear up within two to four weeks.

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Most people who develop shingles experience a rash that develops in a stripe on the right or left side of the body. In rare cases, the shingles rash may appear more similar to chickenpox and be more widespread. This is usually more common in individuals with weakened immune systems.

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How Do Caregivers Help Seniors Manage Shingles

Antiviral medication is the first line of defense for seniors suffering from an outbreak of shingles. Antiviral medications include three types: acyclovir , valacyclovir , and famciclovir.

Seniors who experience mild pain from shingles may take over-the-counter drugs, like Tylenol or Advil. Serious pain may require corticosteroids or opioid pain relievers these pain medications should be weighed carefully, since they can interact adversely with medicines the senior currently takes.

Aside from medicine, aging adults will feel relief from wearing loose-fitting clothing. Natural fiber clothes are recommended. Itchy skin may be relieved by applying calamine lotion. Caregivers might also prepare an oatmeal bath for the care recipient as a soothing remedy.

The affected skin should be kept clean. Apply a cool washcloth to the seniors skin to reduce pain the cloth may also be used to dry the blisters. Caregivers should monitor the senior so that she does not scratch the blisters, which can lead to an infection or scarring.

Pain management strategies also include relaxation and adequate rest. Caregivers might encourage activities that distract the senior from her shingles pain, such as watching TV, reading, chatting with a companion caregiver, engaging in craftwork, or working in the backyard garden.

What Are The Complications Of Shingles

5 Ways to Treat Your Senior Loved Ones Shingles

Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:

  • Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
  • Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.

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Shingles Complications In The Elderly

Heres how to protect the population thats at highest risk for shingles complications.

Everyone who has had chickenpox-which is about 99% of the U.S. population over the age of 50-has the varicella-zoster virus in their body, putting them at risk for developing shingles. Many of them may not realize just how painful and potentially debilitating shingles and its complications can be, especially among the elderly.

The segment of the population thats most at risk for developing shingles is people over the age of 60, where about half of all cases occur. This is primarily because aging takes a toll on an individuals immune system, making it harder for them to fight off infection. Stressful life events, immune-compromising conditions such as being treated for cancer, and even the common cold can weaken immunity.

Complications from shingles in the elderly can lead to serious, long-term health problems. They range from bacterial skin infections that can cause scarring and narcotizing fasciitis to hearing and vision loss, encephalitis, transverse myelitis, peripheral motor neuropathy, and postherpetic neuralgia .

Fortunately, a highly effective vaccine against shingles is available and recommended for people aged 50 and above. Shingrix has been proven to be more than 90% effective at preventing shingles and PHN.

Seniors should know that Medicare Part D will cover the shingles shot, as well as all other commercially available vaccines.

Therapy For Acute Pain

The acute pain of herpes zoster has a profound effect on health-related QOL. When clinicians consider the treatment of zoster-associated pain, however, they often focus on the chronic pain of PHN. The literature regarding the treatment of acute zoster pain is limited. Typically, narcotic analgesics, tricyclic antidepressants, nonsteroidal anti-inflammatory drugs , and acetaminophen are added to antiviral therapy, with varying degrees of efficacy., The treatment of choice depends on the severity of the pain. More studies are needed to determine the most appropriate therapies for acute zoster pain.

Antiviral Therapy. Acute pain may be reduced if appropriate antiviral therapy is started within 72 hours after zoster symptoms appear, although patients will still be at risk for the development of PHN.

Analgesic Drugs. A randomized, placebo-controlled study compared controlled-release oxycodone with gabapentin in patients with the acute pain of herpes zoster. Patients treated with oxyco-done experienced significant pain relief compared with those given placebo during the first 14 days of treatment, whereas gabapentin-treated patients did not show any difference compared with the placebo group.

Oral analgesics may be used to treat acute pain in zoster patients with ocular involvement. Clinicians should never instill topical anesthetics directly onto the cornea in these patients.

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How Is Shingles Diagnosed And Treated

If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.

Managing Shingles In The Elderly

New treatment for the pain of shingles

Remember the painful, irritating itch of chickenpox as a child? Unfortunately, one of three American adults will experience a second outbreak of the same virus in their lifetimes. When this infection returns, its called shingles.

The elderly, who are at particular risk for contracting shingles, should be closely monitored by a caregiver if an outbreak occurs. If left untreated, shingles side effects could become serious.

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How To Identify And Manage Shingles In The Elderly

Shingles, caused by the same virus that causes chickenpox, may have innocuous beginnings, but can cause serious health complications in seniors. As an uncomfortable skin condition, shingles in the elderly should be identified and treated to reduce the risk of additional dangers.

Herpes zoster is the clinical term used to describe shingles. The varicella-zoster virus is the parent virus that causes both the chickenpox early in life and, possibly, shingles later in life. After recovering from chickenpox, the virus survives and remains in some nerve cells.

The majority of adults who had the chickenpox will not develop shingles later, since the varicella-zoster virus remains inactive in these individuals. However, about one out of every three adults is susceptible to the varicella-zoster becoming active again and can develop a case of shingles.

Older adults, particularly those over age 60, are at a higher risk for complications when shingles erupts. Seniors immune systems naturally weaken with age, making it increasingly difficult for their bodies to fight off infections, like shingles. Complications linked with shingles can be life threatening.

Have A Rash Go To The Doctor

If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether or not you have shingles and can make a treatment plan. If you have a condition that weakens the immune system, the doctor may give you a shingles test. The shingles test can also help doctors diagnose shingles in people who dont have a rash. Although there is no cure for shingles, early treatment with drugs that fight the virus can help the blisters dry up faster and limit severe pain. Shingles can often be treated at home. People with shingles rarely need to stay in a hospital.

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Shingles Symptoms & When To Seek Treatment

Shingles usually affects a small part of one side of the body or face. Typically, the rash develops in a band that goes around the torso. The most common signs and symptoms of shingles are:

  • Pain, burning, tingling, or numbness
  • Sensitivity to touch
  • Sensitivity to light

Pain is often the first symptom and can be intense. Depending on the location of the pain, it can be mistaken for a heart, lung, or kidney problem. Some people experience pain without ever developing the rash, while for others, symptoms are mild and involve only itching. Most cases of shingles last about three to five weeks.

Can Shingles Be Prevented Or Avoided

Six Common Myths about Seniors and Shingles

The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.

When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.

The shingles vaccine is not recommended for anyone who:

  • Has had an allergic reaction to gelatin or the antibiotic neomycin
  • Has an allergy to any component of the shingles vaccine
  • Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
  • Is receiving treatment for cancer
  • Is being treated with drugs that suppress their immune system, including high-dose steroids
  • Is pregnant or might become pregnant within 4 weeks of getting the vaccine

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If Youre 50 Or Older Get Shingrix

  • Shingrix provides strong protection from shingles and long-term nerve pain.
  • Get Shingrix even if you already had shingles, because you can get the disease more than once.
  • Your risk of shingles and complications increases as you age.
  • You need 2 doses of Shingrix. Get the second dose 2 to 6 months after you get the first dose.

What Can I Do For The Pain

To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen or ibuprofen .

Applying a medicated anti-itch lotion to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.

If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.

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When To Talk With A Professional

If you havent talked with a medical professional about the shingles vaccine, be sure to do so soon. You should also consult with a health professional within 72 hours after the first sign of shingles.

Remember, a band of blisters on one side of the face or torso, or on one leg or arm, suggests shingles.

Even if youre unsure whether its shingles or some other conditions causing a rash, have it checked out. A medical professional can make an initial diagnosis just by visually inspecting your skin.

A small piece of skin tissue may be removed and sent to a lab to confirm the diagnosis or determine whether its something else.

Shingles: A Painful Skin Condition

What Are the Causes and Best Treatments for Shingles?

Shingles is a disease that affects the nervous system and causes a painful, blistering skin rash. It is caused by the same virus that causes chickenpox: varicella-zoster. Individuals who have had chickenpox recover, but the virus does not leave the body. Although it is dormant, it lingers in some nerve cells. For reasons that arent totally understood, the virus can reactivate years later, producing 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 usually occurs in 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 lifeusually 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.

Shingles is not contagious. You cant catch it from someone who has it, but you can catch chickenpox from someone with shingles. So, if youve never had chickenpox or been vaccinated, try to stay away from anyone who has the rash until theyve completely healed. Most people get shingles only once, but recurrences are possible.

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Know Your Risk Of Getting Shingles And Complications

About 1 out of every 3 people in the United States will develop shingles during their lifetime.

If youve had chickenpox, you are at risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they dont remember it.

Your risk of getting shingles and having serious complications increases as you get older.

About 1 in 10 people who get shingles develop nerve pain that lasts for months or years after the rash goes away. This is called postherpetic neuralgia and is the most common complication of shingles.

Shingles may lead to other serious complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia, hearing problems, brain inflammation or death.

Passing Shingles To Others

Its important to note that while shingles are not contagious and cannot be passed from one person to another person, the virus that causes it is contagious. This means that its possible to spread it from an individual who has active shingles to someone who has never had chickenpox.

In such a situation, the person contracting the virus would not develop shingles, but he or she would develop chickenpox. This virus can be spread through direct contact with the fluid produced by the blisters that appear with shingles. Before the blisters appear, the individual is not infectious. The person is no longer contagious after the rash has crusted.

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