Shingles

By Julie Wiekamp, MPAS, PA-C

Over 1 million Americans experience a shingles outbreak each year! In fact, the CDC estimates that 1 out of every 3 individuals will experience shingles over their lifetime. Routine vaccination decreases the possibility of shingles, while timely diagnosis and treatment help reduce complications.

Shingles is caused by the same virus that causes the chicken pox. After one has cleared their initial infection with chicken pox, the virus will lie dormant in the nerve roots. Under the right circumstances, the virus will reactivate along one nerve root, thereby causing the classic shingles rash.

One of the greatest risk factors for developing shingles is age. 20% of shingles cases will occur from ages 50-59, while 40% will occur in those aged 60 or older. Anyone with a suppressed immune system is also at increased risk of disease.

The shingles rash will usually contain several raised blisters atop a patch of reddened skin. The rash will typically follow a single nerve root distribution and is usually unilateral- meaning that it does not cross midline. The rash is contagious and may cause chicken pox in one who has not had the disease or been vaccinated. Once the lesions have crusted over, the risk of transmission is gone. The rash is usually accompanied by itchy, burning, tingly skin.

Sometimes shingles will cause fever, fatigue or other more severe conditions. A painful, burning sensation in the distribution of the rash may linger long after the blisters have disappeared. Sometimes, the pain, or postherpetic neuralgia, will persist for months. Reactivation of the shingles virus in the distribution of the eye is also very serious and requires urgent attention and referral to opthamology.

Antivirals are the mainstay of treatment for shingles, especially if the diagnosis is made within 72 hours of onset. Antivirals are not as beneficial if given 72 hours after onset.

Shingles vaccinations are available. In fact, the CDC recommends healthy adults, ages 50 and older, receive 2 doses of the Shingrix vaccine.

Speak with your health care provider about any concerning rashes. It is best to start treatment for shingles as quickly as possible. Make sure you speak with your provider at your upcoming physical about routine shingles vaccination as well!