Shingles--not just for your grandparents

So, let talk about shingles . Wait, aren’t I too young for that? Actually, no, you can get shingles at any age. That is if you ever had the chicken pox (and yes the chicken pox vaccine, though much lower chance, still puts you are risk for getting shingles).


Well, maybe we should start with what it is. When you get chicken pox, or have the vaccine, the virus *can* insert itself into a nerve and lay dormant. For some people, this I where the story ends. For others, not so much…


Shingles (usually) presents as a painful, tingly, sometimes itchy rash that is a linear fashion on one side of the body. Sometimes, a rash never occurs—these are the tough ones to diagnose. The rash then turns into small blisters—called vesicles—that eventually scab and then dry up.


For some, this is all she wrote. For others, it is the rest of the story that is not the best part.

After shingles nerve pain—called postherpetic neuralgia—can lead to pain in the same area for weeks into years. (There can be other long term complications from shingles as well.)


Well, how did I get it? Great question! That dormant chicken pox virus in your nerve gets turned on. Usually through a stress to the body. Can be physical stress (i.e., a really bad cold or flu, high fever…), or emotional/mental stress.


*YOU CANNOT GET SHINGLES FROM THE CHICKEN POX*


The reason for this, is you already have the chicken pox asleep in your nerve. You aren’t going to get it again. But on the flip side—if you have an active outbreak of shingles, you can infect someone with the chicken pox if they come in contact with the rash and have never been exposed to the chicken pox (i.e., they don’t have immunity through previous infection or a vaccine). Now a days, this is more of a concern if a child under the age of 1 comes in contact with the shingles as the chicken pox vaccine is not given until the age of 1, or someone is unvaccinated.


So what happens if you are concerned you have shingles? Well, for starters, call you doctor early on. The sooner we get you treatment, the better chance you have to actually benefit from the treatment. This includes antiviral therapy (valacyclovir or acyclovir), and also sometimes steroids to help with the inflammation and the tissue pain, as well as gabapentin which also helps settle down the nerve irritation. Usually it is better in about a week, though it can come back anytime the body is stressed.


There is a vaccine, actually a second one now. It is call Shingrix. It is pretty good. The CDC recommends that healthy 50 and over receive this 2-shot series.


Take home message from today—anyone that had the chicken pox (vaccine) can get shingles. If you have shingles or someone you know has shingles, keep away from someone that has not ever had the chicken pox or vaccine. Then, call you doctor immediately. The sooner you get treatment, the more options your doctor will have to treat you.


…until next time, IrishDoc07

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