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September 2009 - Shingles
Shingles — What You Should KnowBy Karen Rodgers, APNP, Nurse Practitioner
Froedtert & The Medical College of Wisconsin Senior Health Program
Shingles, otherwise known as Herpes Zoster, is a painful rash caused by the reactivation of the virus that causes chicken pox. After a person has had chicken pox, the virus can lie dormant in the nerves for years. It is not certain what activates or “awakens” the virus, but it usually occurs when the immune system is weakened, as with age, illness or stress. Unfortunately, age tends to be a significant risk factor, with more than half of all shingles cases occurring among adults over age 60.
| Signs and symptoms of shingles may vary, but typically include pain and a blistering rash. The pain is usually noted several days before the rash. The shingles rash is unique because it follows a nerve pathway, and occurs in a patch on only one side of the body. The most common sites for the rash are the face, chest, back and buttocks. Pain is usually significant and may be cause by burning, itching, tingling, or extreme sensitivity on the skin. A fever or headache may also develop. |
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Early diagnosis and treatment of shingles are very important. Treatment is most effective when started within 48 hours of symptoms. Early treatment can also help reduce the risk of complications. Your healthcare provider can diagnose shingles based on symptoms and the hallmark rash and blisters. Treatment usually involves an oral antiviral medication, strong pain relievers and sometimes an anti-inflammatory agent. People with shingles can pass the chicken pox virus to people who have not had chicken pox. Ttherefore, until the blisters scab over, it is best to avoid individuals with a weak immune system, newborns, and pregnant women.
Unfortunately, for one in five people, and up to one in three elderly people, the pain continues in the same spot long after the blisters have cleared. This complication, known as postherpetic neuralgia, is the result of damaged nerve fibers sending exaggerated messages to the brain. It can be very painful and difficult to treat effectively.
Fortunately, there is a vaccine for shingles that is strongly recommended for people age 60 and older who have had chicken pox. It is given as a single injection and is safe for anyone who has already had shingles. The vaccine will decrease the chance of developing shingles and, most importantly, will reduce the severity and the risk of complications if shingles does develop.
For questions or concerns about shingles or to receive the vaccine, please contact your healthcare provider.
Author: Karen Rodgers, APNP Last Review Date: Sept. 1, 2009
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