Authors

  1. Wilson, Denise D. PhD, APN, FNP, ANP, GNP

Article Content

When a person has chicken pox (varicella), the virus does not go away. It stays in the sensory nerves of the body and can come back at any time. When the virus reactivates, the condition is known as herpes zoster or "shingles."

 

Who can get shingles?

Anyone who has had chicken pox can develop shingles, but it is more common in people 60 years old or older.

 

What makes the chicken pox virus reactivate?

This usually occurs when your immune system is not working as well as it did when you were younger. It can also happen during times of stress or if you have a chronic medical condition like diabetes. Taking certain medicines regularly, like corticosteroids or medicines used for psoriasis, rheumatoid arthritis, or inflammatory bowel diseases, can also increase risk.

 

How do I know if I have shingles?

At first, some people think they are coming down with a virus. They may be tired and have a fever, chills, muscle aches, headache, or an upset stomach. Within 1 day to 3 weeks later, there is usually a burning or tingling type of pain in the skin. The most common places for the rash to appear are the chest, abdomen, back, and around the eyes. The rash usually appears on only one side of the body. The skin may become pink or red at first, and then blisters appear.

 

Can someone catch shingles?

No, someone cannot catch shingles. However, the blisters contain the chicken pox virus, so if someone who has never had chicken pox comes in contact with fluid draining from the blisters, they can develop chicken pox. It is important that the blisters are kept covered until they crust over and dry out. People who have shingles should avoid contact with anyone who has not had chicken pox or is pregnant, has AIDS, is receiving chemotherapy, or has had an organ transplant.

 

How is shingles treated?

See your healthcare provider as soon as possible to avoid complications from shingles. Antiviral medicines used to treat shingles work best if they are started within 72 hours of when the rash appears. Over-the-counter medicines, such as acetaminophen or ibuprofen, can be used to relieve the pain from shingles. Take all medicines as directed by your healthcare provider.

 

What complications might occur?

A bacterial skin infection may develop due to open blisters. It is important to keep the skin clean and dry and to avoid picking or scratching the blisters to minimize the risk of infection. Cool, damp compresses made with aluminum acetate powder can be applied twice a day to help dry out the blisters. This will also help to relieve pain. Contact your healthcare provider if you notice any increased redness or pain in the area, thick colored drainage, or a fever. Your healthcare provider may advise you to apply an antibacterial ointment and cover the area with a sterile dressing until the blisters are healed.

 

The most common complication of shingles is a condition called postherpetic neuralgia in which pain continues long after the rash is gone. For some people, the pain can continue for 6 months or more. This happens in 20% of people 60 to 65 years of age and in 30% of people over 80. There are oral and topical medicines available to help treat nerve-related pain.

 

Shingles that occur around the eye, a condition known as herpes zoster ophthalmicus, may result in damage to the eye. This condition needs immediate care, and your healthcare provider will refer you to an eye specialist for a careful examination and for any additional medicines that might be needed.

 

Is there anything I can do to avoid shingles?

There is a zoster vaccine that helps protect against shingles by boosting your immunity to the virus. It is recommended that anyone 60 years of age and older receive this one-time vaccination. People who have AIDS, blood cancers, and tuberculosis cannot receive the vaccine. Be sure to inform your healthcare provider if you have any of these conditions, if you are taking any medicines that affect your immune system, such as corticosteroids or other immunosuppressant drugs, or if you are allergic to gelatin or neomycin.

 

Does my insurance cover the vaccine?

Insurance coverage varies, so it is important that you check with your insurance company. For individuals on Medicare, the vaccine may be covered by the Medicare Part D prescription plan.

 

Fast Fact

Antiviral medicines used to treat shingles should be started within 72 hours of when the rash appears.

 

Did You Know?

The Centers for Disease Control and Prevention (CDC) estimates that almost one out of every three people in the United States will develop shingles.

 

RESOURCE

 

1. Centers for Disease Control and Prevention. http://www.cdc.gov/shingles/about/index.html.