Before there was a vaccine to prevent chickenpox, it was a common childhood illness. According to the Center for Disease Control and Prevention (CDC), one in three people who had chickenpox will develop a related illness called shingles as an adult. There are an estimated one million cases of shingles in the United States per year.
Shingles is a viral infection caused by the varicella zoster virus, the same types of herpes virus that causes chickenpox. “Varicella” is chickenpox, while “zoster” is shingles. In this video, San Diego Health host Susan Taylor talks about shingles with Mark Shalauta, MD, a family medicine physician at Scripps Clinic Rancho Bernardo.
Shingles develops in people who already have the varicella zoster virus in their body. After an outbreak of chickenpox, the virus lies dormant in the spine, If it reactivates, it will cause shingles.
“The longer it’s been since you’ve had chickenpox, the higher the likelihood of shingles,” says Dr. Shalauta. “It affects people of any age but is most common after age 50, and the older you are when you get shingles, the more painful it tends to be.”
It’s unknown what triggers the virus to reactivate. People who have a compromised immune system, or who are being treated with chemotherapy, have a higher risk of a shingles outbreak. Stress may be another contributing factor.
Shingles usually begins as a feeling of pain or sensitivity in the skin. An itchy, painful red rash develops on one side of the body within a few days, usually followed by fluid-filled blisters that break open and crust over. Shingles also may cause fever, headache, fatigue and sensitivity to light.
“The virus goes into a nerve right along the spine where it has been dormant,” explains Dr. Shalauta. “It doesn’t usually spread to other nerves and isn’t going to jump over to the other side of your body. If you have a rash on both sides, it’s unlikely that it’s shingles.”
While the rash usually wraps around the torso, it can develop anywhere. If it affects the chest, for example, the person may have chest pain and suspect a heart attack. It’s uncommon, but if shingles affects the head or neck, it may cause complications with vision or hearing.
According to the CDC, one in five people with shingles develops nerve pain that lingers after the rash has gone away. This condition, called postherpetic neuralgia, can cause debilitating pain.
If you think you have shingles, call your doctor, especially if you are age 60 or older or have it on your head or neck. Cold, wet compresses applied to the rash can help relieve itching. Antiviral drugs can help decrease the duration of the infection. Pain medications available over the counter may help decrease pain; if nerve pain is severe, prescription medications may be recommended.
While chickenpox spreads easily, shingles is not contagious. You cannot get shingles from someone else who has shingles. If you have had chickenpox and you touch a blister or rash on someone with shingles, you will not develop shingles.
“However, if you are not immune to chickenpox, you can theoretically get chickenpox from shingles,” says Dr. Shalauta. “I say theoretically because it’s a little difficult for that to happen, but do keep the rash covered to be safe.”
A shingles vaccine can help prevent an outbreak, and Dr. Shalauta recommends the vaccine for everyone age 50 and over who is not allergic to any of the ingredients. Even if you’ve never had chickenpox, it’s a good idea to get immunized against shingles.
“Basically, if you’re 15 or older, chances are very high that you’ve already been exposed and have immunity, so you don’t need to be tested for chickenpox,” he says. “Just go ahead and get the shingles vaccine.”