Q: My friend recently went to the doctor for a rash and was told she had shingles. What is shingles and how do you get it?

  • Wednesday, April 8, 2009

Stephen Murk, M.D.

•A: (also called herpes zoster) is a painful rash caused by the chickenpox virus. After we have chickenpox, the virus remains in our body, living quietly in nerve cells. Later in life, the virus may become active again causing the rash we know as shingles.

Shingles can occur at any age but is more common in adults over 50 and in those who have weakened immune systems.

Shingles often begins with unusual sensations (burning, itching, tingling, etc.) in an area followed by the painful rash which occurs a day or two later. The rash appears as clusters of small blisters surrounded by redness. New clusters can show-up for several days. The blisters become open sores that eventually crust over and heal. Healing time can vary but is typically 2 to 4 weeks.

Shingles always occurs on one side of the body in the distribution of one of the nerves. This sometimes helps distinguish it from other types of rashes. It can occur anywhere on the body but is most commonly seen on the chest, abdomen and back. It does, however, occur on the face where it can be more troublesome, especially when it affects the eye (where it can cause permanent damage).

Discomfort from shingles can vary from mild to severe. Many people have pain that interferes with sleep and other daily activites. Usually as the rash heals, the pain or discomfort goes away. Sometimes however, pain from shingles can last for weeks or remain permanently. This prolonged or chronic pain is referred to as post-herpetic neuralgia. Post-herpetic neuralgia occurs in a minority of patients but is more common after the age of 60.

Is shingles contagious?

The virus that causes shingles can be spread from person to person by direct skin contact with the rash. It is important to keep in mind, however, that the contacted person can only be infected by the virus if they have not previously had chickenpox or the chickenpox vaccine. This is a minority of people. Also, a newly infected person would develop chickenpox, not shingles.

My friend is taking medication for shingles. Why?

The rash from shingles will eventually clear-up without taking medicine. Antiviral medications are available, however, that reduce the severity of the rash and speed-up the healing process. These medications also decrease the risk of developing prolonged or chronic pain (post-herpetic neuralgic) or will reduce its severity. It is important to keep in mind however, that the antiviral medications are only helpful when started early, generally within 72 hours of the appearance of the rash and the sooner the better. After 72 hours, the antiviral medications tend to be ineffective. So if you think you have the shingles, don't wait. Call your doctor as soon as possible.

In addition, pain medications, both over the counter and by prescription, are used for the discomfort associated with shingles.

What can I do to prevent the shingles? Should I get the “shingles vaccine”?

A vaccine is now available to prevent herpes zoster or shingles. Although the vaccine is not 100% effective, it greatly reduces the chance of getting shingles. Also, in those who get shingles after having the vaccine, the rash tends to be milder, of shorter duration, associated with less pain and with a lower risk of post-herpetic neuralgia.

The vaccine is given as a one-time dose (no series of shots or boosters required). Currently, the vaccine is recommended for all adults over the age of 60, especially those with chronic medical conditions or those who have previously had shingles.

Stephen Murk, M.D.
SeWee Internal Medicine
3044 Highway 17 North, Suite B
Mount Pleasant, SC 29466

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