1 in 3 people will get Shingles in their lifetime. Shingles is caused by a virus called varicella-zoster. This virus also causes chickenpox. Once chickenpox resolves the virus stays dormant in the nervous system for years. It gets reactivated and travels along the nerves to the skin and causes painful blisters seen in shingles. This is why you can only get shingles if you have had chickenpox in the past.
Our immune system plays a key role in keeping the virus from reactivating and therefore any condition that weakens our immune system predisposes an individual to getting shingles.
Old age, diseases like HIV/cancers, treatments with immune-suppressing drugs such as steroids, and chemotherapy are common predisposing factors.
The rash always involves one side of the body and never crosses the midline of the body.
The rash can last up 4 weeks. The pain improves as the rash heals, but in some cases, the pain can last for months to years.
Shingles can be complicated by:
1) Pain that can last for months or years called postherpetic neuralgia.
2)Shingles in or around an eye (ophthalmic shingles) can lead to an eye infection and loss of vision.
3)Neurological problems. Shingles can cause an inflammation of the brain (encephalitis), facial paralysis, or hearing or balance problems.
4)Bacterial skin infections can occur if the rash gets infected.
A person with shingles can transmit the varicella-zoster virus to anyone who is not immune to chickenpox. Once infected, the person will develop chickenpox, but not shingles.
The shingles vaccine is recommended for those 60 and older. It is a single dose for a lifetime and lowers the risk of shingles by about 51%. Shingles vaccine helps reduce recurrence in those who have already had shingles, and therefore people who have had shingles should consider getting vaccinated.
There is no need to screen for a history of varicella (chickenpox) infection or to conduct laboratory testing for serologic evidence of prior varicella infection. Even if a person reports that they have not had varicella, they can still receive the zoster vaccine.
Talk to your healthcare professional whether this vaccine is right for you.
Dr. Mahesh Ochaney is a solo practitioner who has been practicing Internal Medicine since 1991. Dr. Ochaney’s compassionate primary care has been recognized several times over the years, including being named a 2018 Top Doctor by Baltimore Magazine and receiving a State of Maryland Governor’s Citation.