Shingles Frequently Asked Questions (FAQ)

Shingles is one of those conditions that many of us have heard about but never witnessed first hand. That's because only about one in 10 healthy adults who've had chickenpox eventually develop shingles (which is about a million cases a year), usually after age 50. But for those who are unlucky enough to develop the condition, it can be an extremely painful and unpleasant experience that can last 3 to 5 weeks (and earning the nickname in some parts of the world as "St. Anthony's Fire").

Below is exploration of Shingle's causes, treatments and possible prevention.

What is Shingles?

From the NIH:

Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chickenpox — the varicella-zoster virus. The first sign of shingles is often burning or tingling pain, or sometimes numbness or itch, in one particular location on only one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with the varicella-zoster virus, some of the virus particles leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles.

How is it diagnosed?

From Aetna/Harvard Medical:

Shingles can be difficult to diagnose before visible signs of the disease appear. Once a rash and blisters appear, your doctor probably will diagnose shingles based on your symptoms and the appearance of your skin. Rarely, when the diagnosis is less certain, the doctor may scrape tissue, collect cells from the affected skin and examine them under a microscope for cellular changes consistent with a herpes zoster infection.

Can Shingles be prevented?

From the MayoClinic:

The varicella virus vaccine (Varivax) — approved by the Food and Drug Administration in 1995 — has become a routine childhood immunization, given between ages 12 months and 18 months. The vaccine is also recommended for older kids and adults who've never had chickenpox.

The varicella virus vaccine prevents chickenpox for most people. If chickenpox does develop after vaccination, it's typically less severe.

The Food and Drug Administration (FDA) has also approved a vaccine (Zostavax) to help prevent shingles in adults age 60 and older. In one study involving thousands of participants, the shingles vaccine reduced the overall risk of shingles by about 50 percent for adults age 60 and older. For adults ages 60 to 69, the vaccine reduced the risk of shingles by 64 percent.

The shingles vaccine is given as a single injection, preferably in the upper arm. The most common side effects are redness, pain and swelling at the injection site, itching and headache.

Can stress cause Shingles?

According to MedicineNet.com:

The immune system becomes less efficient with age. It is believed that this is the reason that shingles is more common in the elderly than in younger people, but the exact reason why the virus begins to start reproducing again is unknown. Stress can also weaken the immune system. Studies have shown that persons experiencing significant psychological stress are more prone to infection than those who are not under stress. For this reason, stress can also precipitate outbreaks of shingles in some people.

What can be done about the pain?

From FamilyDoctor.org:

To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine like acetaminophen (one brand name: Tylenol) or ibuprofen (one brand name: Motrin). Aspirin is not recommended because using it might cause a liver problem called Reye's syndrome.

Putting a medicated lotion (two brand names: Benadryl, Caladryl) on the blisters might reduce the pain and itching. Putting cool compresses soaked in an astringent liquid (two brand names: Bluboro, Domeboro) on the blisters and sores might make them hurt or itch less.

If shingles causes severe pain, your doctor might have you take a prescription pain medicine.

Tai Chi?

According to Wikipedia:

A recent study evaluated the effects of two types of behavioral intervention, Tai Chi and health education, on healthy adults, who after 16 weeks of the intervention, were vaccinated with VARIVAX, a live attenuated Oka/Merck Varicella zoster virus vaccine. The Tai Chi group showed higher and more significant levels of cell-mediated immunity to varicella zoster virus than the control group which received only health education. It appears that Tai Chi augments resting levels of varicella zoster virus-specific cell-mediated immunity and boosts the efficacy of the varicella vaccine. Tai Chi alone does not lessen the effects or probability of a shingles attack, but it does improve the effects of the varicella zoster virus vaccine. [10]

Tips for helping a friend with Shingles?

From Shingles.com:

Here are some tips on how you can help a loved one who has shingles:

* Have the person with shingles see the doctor as soon as the shingles rash appears. Treatment within 2 or 3 days of the shingles outbreak may shorten the duration of postherpetic neuralgia (PHN).
* Talk to the doctor about treatments for the pain. Ask your doctor to refer you to a pain specialist if he/she is unsure of the best treatment.
* If clothing is uncomfortable, encourage the person with shingles to wear as little clothing as necessary.
* Cool compresses may relieve some of the discomfort, but if they make the pain worse, do not use them.
* Encourage the person with shingles to eat well—pain dulls the appetite, and the idea of eating may not be appealing.
* If insomnia is a problem, talk to the doctor about whether medication to help sleep is appropriate.

Pain can cause someone to be irritable, sad, or depressed. It's important to remember that their moodiness is not directed toward you, it is caused by the pain. You may be wondering when life is going to get back to normal. Having patience is important. Most cases of shingles last for about a month, and within a year of the rash, most people have little or no pain.

Are there any long-term effects from shingles?

From the CDC:

Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death. For about 1 person in 5, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.