Shingles

What is shingles?

Shingles, a viral infection, is primarily recognized for its ability to cause a painful rash on either the body or face. Although it is usually a harmless rash that resolves on its own, it can also manifest on the tip of the nose, suggesting nerve involvement near the eye.

Shingles, also called herpes zoster, is caused by the varicella-zoster virus (VSV), the same virus that causes chickenpox. If a person has had chickenpox, they can develop shingles. The virus can remain inactive in the body for many years, even decades, until a trigger causes it to become active again.¹

One way to determine if you have shingles is by the appearance of a painful rash that can persist for about 3 months and potentially result in further issues.¹

Shingles can affect people of all ages, but the likelihood of developing it rises with age. It is estimated that approximately one-third of the population in the United States will experience shingles at some stage in their lifetime, with around 1million new cases reported each year.²

What are the symptoms of shingles?

There are two stages of symptoms:²

• Pre-rash stage: The affected region where the rash will emerge can be uncomfortable, often causing sensations of burning, tingling, tickling, or numbness. Additionally, a fever may also develop.
• Rash stage: Shingles results in an excruciating skin eruption, typically seen as a line of blisters on your midsection, that can wrap around either your right or left flank. It typically crusts over in a matter of weeks and resolves within a month.

Other symptoms may include:²

• Blisters filled with fluid that can break easily
• Chills
• Headache
• Itching
• Pain on one side of the body
• Pain when the rash is touched
• Red patches on the skin
• Upset stomach

What types of complications are common with shingles?

One of the most frequent issues associated with shingles is post-herpetic neuralgia (PHN), which can persist in the area where the rash originally appeared even after the rash has disappeared. This condition is extremely uncomfortable and can linger for weeks, months, or even years, causing sensations of pricking, itching, and heightened sensitivity to touch.³

Ten to 18 percent of people who have had shingles will experience PHN. The risk is lower for those under 40 but increases with age. There is no known reason why PHN happens.

Other complications include:³

• Bacterial infection
• Brain inflammation
• Death
• Decreased appetite
• Depression
• Exhaustion
• Eyes issues, including vision loss
• Hearing issues
• Insomnia
• Pneumonia
• Poor concentration

Individuals who have a weakened immune system have a higher chance of experiencing a more intense and prolonged rash, as well as facing potential complications associated with shingles.³

How do you treat shingles?

There are treatments that can help reduce the duration and intensity of shingles. They are most effective when administered promptly after the onset of the rash. Therefore, it is important to schedule an appointment with a healthcare provider at the first signs of shingles.

Treatments include:⁴

• Antiviral medications: Acyclovir, Valacyclovir and Famciclovir are the most commonly prescribed medications.
• Pain medications: Depending on the severity of your pain, you may either take over-the-counter pain relief medications or get a prescription from your provider.

How do you manage the symptoms of shingles?⁵

To effectively manage your symptoms, it is important to consistently tend to the rash each day until it resolves. Use a fragrance-free soap to wash the affected area and dry it completely. Next, apply petroleum jelly and cover the rash with a clean, non-adhesive bandage or wrap.

Make sure to clean your hands using soap and warm water after coming into contact with the rash. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.

To alleviate the itchiness caused by shingles, try using moist cold compresses, calamine lotion, or taking warm oatmeal baths..

It is crucial to prioritize self-care while experiencing shingles. This includes reducing stress, getting ample rest, and wearing loose, breathable fabrics like cotton or linen.

It is advisable to refrain from using corticosteroids, such as hydrocortisone cream, as a means to alleviate itching. Doing so could potentially worsen or intensify your infection’s symptoms.⁶

How do you prevent shingles?

Recombinant zoster vaccine (Shingrix) can help prevent shingles and any complications. It is over 90% effective at preventing shingles and PHN.⁴

According to the CDC, individuals who are 50 years or older should receive two doses of Shingrix. This is especially important for those with weakened immune systems, who may experience more severe complications from shingles. However, the vaccine is also recommended for anyone over the age of 19.

A provider can write a prescription for you and guide you to the best place to be vaccinated.

How often do you need to get the shingles vaccine?

Shingrix offers a strong level of immunity – nearly 90%– for the first 7 years after vaccination.⁷

What causes shingles?

After reaching the age of 50, the chances of developing shingles are higher due to the potential for the varicella-zoster virus to persist in your body for many years.⁷

Optum Pro Tip: You can’t get shingles from someone who has shingles. However, you can get chickenpox from someone who has shingles, even if you never had chickenpox or received the chickenpox vaccine.

Other reasons for shingles may include:⁸

• Autoimmune diseases treated with immune-suppressing drugs, such as rheumatoid arthritis, Crohn’s disease and lupus
• Diseases that damage your immune system, such as HIV
• Having had surgery such as bone marrow and kidney transplants, which require treatment with immunosuppressants
• Immunosuppressant medications like chemotherapy, long-term corticosteroids and anti-inflammatory medications

Multiple theories suggest that stress may be a contributing factor to the development of shingles. However, it has not been proven that stress is a direct cause of shingles, as it primarily weakens the immune system.⁹

1. References:
   1.CDC. Shingles. Last updated February 3, 2022. Accessed April 30, 2024.

   2.CDC. Shingles: Signs and Symptoms. Last updated May 10, 2023. Accessed April 30, 2024.

   3.CDC. Shingles: Complications of Shingles. Last updated May 10, 2023. Accessed April 30, 2024.

   4.CDC. Shingles: Prevention and Treatment. Last updated May 10, 2023. Accessed April 30, 2024.

   5.American Academy of Dermatology Association. Shingles: Tips for managing. Accessed April 30, 2024.

   6.National Library of Medicine / National Center for Biotechnology Information. Short-term efficacy and safety of prednisone in herpes zoster and the effects on IL-6 and IL-10. Accessed April 30, 2024.

   7.CDC. Shingles (Herpes Zoster): Vaccination. Last updated January 24, 2022. Accessed April 30, 2024.

   8.CDC. Shingles (Herpes Zoster): Cause and Transmission. Last updated January 24, 2022. Accessed April 30, 2024.

   9.Healthline. Understanding What Causes Shingles to Activate. Last updated September 18, 2023. Accessed April 30, 2024.