What Causes Shingles And How To Treat It
Shingles, also known as herpes zoster, is a painful rash that develops usually on the torso but can occur anywhere on the body. The same virus that leads to chickenpox, called the varicella-zoster virus, is what causes shingles.
While this rash isnt life-threatening, it can be extremely painful. Lets take a closer look at what causes shingles, the symptoms usually associated with the virus, and some ways you can treat or prevent it.
How To Avoid Getting Shingles More Than Once
Getting the shingles vaccine protects you against shinglesand from a shingles recurrence too.
Zostavax, approved in 2006, was once the only shingles vaccine available to older individuals. As of November 2020, Zostavax is no longer available in the US.
Another vaccine, Shingrix, was approved in 2017 by the FDA for adults 50 and older, and its said to be over 90% effective, according to the CDC.
This new vaccine is a very important one for all of us to consider, Dr. Cutler said. In my practice we routinely recommend this vaccine to everyone over 50.
With the possibility that shingles can recur, experts urge anyone who has had shingles to be vaccinated as well. I believe that its imperative that you work with your health care provider to get vaccinated as soon as youre in this age range or have had shingles, Dr. Cutler said.
Shingrix is given in two doses, scheduled two to six months apart. Its important to note that you should also get Shingrix even if you had Zostavax, the older shingles vaccine, Dr. Cutler added. You should also get it if you dont know if you had chickenpox as a child.
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What Are The Side Effects
The shingles vaccines are very safe.
Common side effects to the vaccines include headache as well as soreness, redness and swelling where the vaccine was given. Itching and a rash may also occur after getting Zostavax® II. Other reactions that may occur after getting Shingrix® include fever, muscle soreness, fatigue, shivering, nausea, vomiting and diarrhea.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility of anaphylaxis, which is a life-threatening allergic reaction. This may include hives, difficulty breathing, or swelling of the throat, tongue, or lips. The chance of true anaphylaxis is about 1 in 1 million vaccine doses. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number. Learn more about anaphylaxis on our vaccine side effects page.
It is important to always report serious or unexpected reactions to your health care provider.
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Can You Still Develop Shingles If Youve Been Vaccinated For Chickenpox
Yes. Despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective, and the effectiveness of vaccines lessens with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who didnt.
What Is Herpes Zoster
Shingles, like a number of itchy, highly communicable skin conditions, is caused by the herpes virus. Herpes zoster, the specific form of the herpes virus, is also responsible for chickenpox. Unlike some forms of herpes, herpes zoster is not a sexually transmitted infection. The shingles and chickenpox viruses are unique because they can lie dormant in the body for years. During herpes zosters resting phase, a person will notice no symptoms. Its only when the virus resurfaces that symptoms crop up again. Once a person has herpes zoster, their chances of having another flare up are high. Herpes zoster is highly contagious, and is spread by skin to skin contact, or contact with the fluids that may be contained in shingles or chickenpox lesions.
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Can You Get Shingles More Than Once
Shingles is a severe skin rash caused by the herpes zoster virus, which also causes chickenpox. Those affected typically only experience the condition once . However, in rare cases, shingles recurs.
Estimates vary as to how common recurrence is. Some populations, including those that are immunocompromised, are more prone to it. One wide-ranging study found that as many as 5% of those who experience the condition develop it again within eight years.
Clearly, its worth looking at why this happens, what the risk factors are, as well as how to prevent shingles relapse.
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How Long Does Shingles Last
Most cases of shingles last three to five weeks.
- The first sign is often burning or tingling pain sometimes it includes numbness or itching on one side of the body.
- Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
- A few days later, the rash will turn into fluid-filled blisters.
- About one week to 10 days after that, the blisters dry up and crust over.
- A couple of weeks later, the scabs clear up.
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How Long Between Shingles Attack And Recurrence
The time between an initial shingles case and its relapse can vary a great deal, and there is no established figure. However, researchers have noted most of these flare-ups arise in the four- to eight-year window following an initial attack. Recurrence within three years is much rarer.
Factors such as overall health status and the presence of other diseases can spur attacks, and there are preventative medications and approaches.
Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
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How Do People Get Shingles
People get shingles when the virus that causes chicken pox, varicella zoster, is reactivated in their body. The varicella zoster virus doesn’t leave the body, even after a person has recovered from chicken pox. It can flare up again, causing shingles, often many years after a person has had chicken pox. The virus tends to reactivate when a person’s immune system is weakened because of another health problem.
When To Get Vaccinated To Prevent Shingles
To prevent shingles, the CDC recommends the Shingrix vaccine if you are 50 or older. The risk of serious complications from shingles does increase with age.
According to the CDC, about one in 10 people who get shingles also develop postherpetic neuralgia, a type of nerve pain that can last for months or even years.
“Although postherpetic neuralgia is rare, it’s devastating when it happens to a patient and the pain is very debilitating,” Dr. Thomassian says.
Some older adults might think it’s OK to skip the shingles vaccine, but they are putting themselves and those around them more at risk, Dr. Thomassian says.
If you are a parent or a guardian, it’s also important to make sure your child gets the chickenpox vaccine.
“No one really thinks about shingles when they’re making the decision to vaccinate their child against chickenpox,” Dr. Thomassian says. “But as we’ve seen with the COVID-19 vaccines, getting vaccinated for chickenpox and shingles doesn’t just help one person, it helps everybody.”
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When Should I See A Doctor
See your doctor at the first sign of shingles. Getting treated early can help it go away faster and may help you avoid related problems. For instance, shingles on the face can cause hearing or sight problems, including blindness.
If you have a weak immune system and can’t get the vaccine, early treatment is your best defense against shingles.
Sometimes what seems to be shingles is really herpes simplex. Though it usually appears as “cold sores” around the mouth or genitals, this form of herpes can show up elsewhere. A different treatment is used to clear it up. Your doctor can do tests, such as a viral culture, to confirm whether you have shingles and to get you the right treatment.
What Problems Can Happen
Most cases of shingles heal on their own, with or without treatment, and won’t lead to any other problems. In rare cases, shingles can lead to complications, including:
- Ongoing pain : Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
- Vision problems: Shingles near or in an eye can lead to vision loss.
- Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
- Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis .
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Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
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How Do I Protect Myself From Shingles
The best protection from shingles is vaccination. People can still get shingles after receiving the varicella vaccine but they are 4 to 12 times less likely to do so than if they haven’t been immunized. The vaccine is recommended for most people 60 and older.
Some people should not receive the vaccine for example, those with certain allergies or who are taking certain medications. A health professional can advise who should not be vaccinated due to contraindications to the vaccine.
People between 50 and 59 years can request the vaccine from their health professional.
Adult Exposure To Chickenpox Linked To Lower Risk Of Shingles
UK vaccination policy assumes complete immunity and may need revisiting, say researchers
Adults who are exposed to a child with chickenpox in the home are around 30% less likely to develop shingles over 20 years, finds a study in The BMJ today.
The results support the theory that re-exposure to the herpes zoster virus in adulthood , boosts immunity to shingles, but does not provide complete protection.In light of these findings, the researchers call for a review of the UKs childhood varicella vaccination policy, which assumes complete immunity for between 2 and 20 years.Primary infection with varicella zoster virus causes chickenpox, typically in children. After this initial infection, the virus remains in the body as a dormant infection, and reactivation, often decades later, causes shingles.
The theory that re-exposure to the varicella zoster virus in adulthood boosts immunity to shingles has gained widespread support. As such, the UK and many other countries dont offer routine childhood varicella vaccination as this would remove circulating virus in the community.
But more recent data suggest that boosting may not be long lasting.
So a team of UK researchers set out to estimate the risk of herpes zoster after exposure to a household member with varicella.
Average age at zoster diagnosis was 41 years and at first known exposure to varicella was 38 years.
22/01/2020
Notes to Editors
Funding: Health Data Research UK
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What Chickenpox Has To Do With It
If youve had chickenpoxand 99.5% of Americans born before 1980 havethen youre at risk of getting shingles. Shingles is what we call a reactivation infection, explains Anna Wald, M.D., head of the allergy and infectious disease division at University of Washington Medicine in Seattle. Most people get chickenpox when they are young. The virus becomes latent, so it stays in your nervous system, she says. Later in life, when the immune system starts to weaken, that same virus can reactivate and cause shingles.
Is A Vaccine Available To Prevent Shingles
Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.
Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.
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What Is The Risk Of Getting The Shingles Virus A Second Time Or More
November 11, 2021 By Will Sowards
Shingles is a common viral infection that is caused by the varicella-zoster virus, the same virus that causes chickenpox. Like chickenpox, shingles causes a painful rash to appear on the skin. If you had chickenpox as a child, you have a higher risk of developing shingles as an adult. Shingles normally affects people over 50, but it can affect anyone.
The chickenpox virus lies dormant in your nerves after it subsides. It can reawaken later in life as the shingles virus. When the virus reactivates, the infected nerves, and the skin the nerves go to, become inflamed, causing a burning or stabbing pain. A few days later, when the virus reaches the skin, a rash of blisters appears. The skin may be very sensitive, unable to tolerate even the lightest touch.
While chickenpox cannot reactivate until later in life, the same cannot be said of shingles. After the rash has cleared up, the virus remains dormant in the nerves and can reactivate at any time. Some patients have had multiple relapses of the shingles virus.
While the chance of shingles recurring is rare, there are some factors that can increase the risk. An immunocompromised person has a higher risk of getting shingles more than once. Immune health can become compromised by many factors such as cancers, autoimmune disorders, age, anxiety and stress, chronic conditions, gender, and increased levels of pain.
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Can I Still Get Shingles If Ive Had Chickenpox
This is a bit of a trick question. You can only get shingles if youve already had chickenpox. Shingles can develop in anyone who has had chickenpox. If you havent had chickenpox but are exposed to someone with chickenpox or shingles, regardless of your age, you will develop chickenpox first. Age is an important factor when thinking about shingles. Its most common in adults over 50, but anyone can contract shingles. With age, the likeliness of developing postherpetic neuralgia rises drastically. Not only is the risk higher with age, but the pain caused by the condition intensifies with age, though its not understood why this seems to be the case.
Even without PHN, shingles is an extremely painful and disruptive condition. Doctors have developed a shingles vaccine called Zostavax that can be administered yearly. The vaccine can be administered if youre over 50 years old. If youre over 60, its highly recommended that you get the Zostavax vaccine. The shingles vaccine can reduce your chances of developing shingles by 50%, and it also makes the virus less communicable if you do catch it. Symptoms of shingles are less severe with vaccinated individuals, and theyre far less likely to develop postherpetic neuralgia after the shingles clears up.
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