Vaccination is key to staving off painful shingles

Here’s one reminder of youth that seniors can do without: shingles.

The painful skin rash is caused by the same virus that brought on chickenpox, oh so long ago. The varicella zoster virus harbors in the body’s nerve cells after chickenpox infection clears, in essence biding its time – for decades – until it’s showtime once again. Shingles most commonly occurs in people 50 and older or those who have problems with their immune system.

The vaccine for it is approved for people 50 and older, and recommended for those 60 and older. Getting the vaccine in Florida has become easier since the state, in 2012, joined more than 40 others in allowing pharmacists to give the shots, not just doctors. That law included a requirement, though, that a physician has to prescribe the shots.

Almost 1 out of 3 people in United States will develop shingles during their lifetime, according to the Centers for Disease Control and Prevention. Nearly 1 million Americans experience the condition each year. As you get older, you are more likely to get the disease. About half of all shingles cases occur in people age 60 years or older.

Although shingles can occur anywhere on your body, it most often appears as a single line of blisters that wraps around either the left or the right side of your torso.

While it isn’t a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.

The vaccine costs about $200 and in some cases isn’t covered by insurance. While it’s effective, it’s not foolproof. Researchers say it appears to cut the risk of getting shingles by about half for older people.

What if you get shingles? Healthy people who receive antriviral treatment soon after the outbreak of blisters usuallly experience pain relief and healing, without lasting scars, in three to five weeks. Indeed, some who want to minimize their medications can simply let it run its course.

But the pain can be debilitating, says Dr. Susan Murphy, physician at Indian River Medical Center Internal Medicine, and complications can develop, especially in those with compromised immune systems. Moreover, it can damage vision if eyes become infected, which happens in a minority of cases.

Murphy says if blisters develop over eyes, for example, that’s a real red flag and the patient should see a physician quickly.

Sometimes people can develop symptoms without a rash, or the rash can develop after symptoms begin. And in some cases, people can develop postherpetic neuralgia, a nerve pain due to damage caused by the varicella zoster virus.

Citing studies, she said, the vaccine has shown a 50 percent reduction in shingles.

Murphy says if you’ve had shingles in the past, you’re still eligible to get a shot “which will boost the immune system. It’s a way to be vigilant.”

However, the vaccine doesn’t help with relieving symptoms once shingles occurs.

Symptoms of shingles include pain, burning, numbness or tingling, a red rash that begins a few days after the pain, fluid-filled blisters that break open and crust over

itching.

Some people also experience fever and chills, general achiness, headache and fatigue.

Other people may experience shingles pain without ever developing the rash.

Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze.

The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir. Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia. Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants (including pregabalin and gabapentin enacarbil), and topical agents.

For most healthy people who receive treatment soon after the outbreak of blisters, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters often leave no scars. However, shingles is a serious threat in immunosuppressed individuals — for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system.

A person with a shingles rash can pass the virus to someone, usually a child, who has never had chickenpox, but the child will develop chickenpox, not shingles. A person with chickenpox cannot communicate shingles to someone else.

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