Not too long ago, chicken pox was a common childhood illness. While there’s now a vaccine for chickenpox, many adults today did not receive the vaccine and contracted chicken pox as a child. Now they wonder if they are at risk for getting shingles (herpes zoster), as well. Learn the basics of shingles, how it’s linked to chicken pox and what to expect from a bout of shingles.
People who contract chickenpox get a rash of fluid-filled blisters that eventually rupture and scab over in a period of about a week. The itchy chickenpox rash is often accompanied by fever, headache, fatigue and loss of appetite. Chickenpox is highly contagious and can range from mild (with very few bumps) to severe (with the rash covering the body, including in the throat and the eyes). The chickenpox vaccine became available in the United States in 1995. Before that, chickenpox was extremely common, with an average of 4 million people getting chickenpox in the early 1990s. The chickenpox vaccine has been very successful at drastically reducing the number of people who get chickenpox -- the Center for Disease Control reports a 90% decrease in chickenpox cases, hospitalizations and deaths since the vaccine program began.
Both chickenpox and shingles are caused by the varicella-zoster virus. When you have chicken pox, the virus lies dormant in your nerve tissue, close to your spinal cord and brain. If the virus becomes active again, moving back to your skin, you will have shingles, also called herpes zoster. Anyone who has had chickenpox can develop shingles, although getting chickenpox does not automatically mean you will develop shingles. Because the chickenpox vaccine is a fairly recent development, many people today have had chickenpox and are at risk for getting shingles. Approximately 1 of 3 people in the United States will develop shingles, with around one million people being diagnosed with shingles every year. Your risk of developing shingles increases as you age, probably because your immunity decreases as you get older.
The primary symptom of shingles is a painful rash that usually develops on one side of the body, frequently on the torso, although it can appear anywhere on your skin. Before the shingles rash becomes visible, you will probably experience pain, tingling or itching in the area where the rash will appear. Once the rash appears, that area will be sensitive to touch, itchy and/or painful. The rash will be made up of blisters that will open and scab over in about a week and then disappear in 2-4 weeks. Other symptoms of shingles can include upset stomach, headache, fever, body aches and chills. Once the rash has disappeared, it is likely that you won’t have a recurrence. Most people who get shingles only have one episode in their lifetime. However, some people experience complications from shingles. The most common health problem stemming from shingles is postherpetic neuralgia (PHN). PHN occurs when nerves become damaged by the shingles virus, causing lingering pain in the affected area for months to years. Approximately 15% of people who have shingles develop PHN, and it is more likely to have PHN if you are an adult over 40.
The varicella-zoster virus that causes chickenpox and shingles can be transmitted to another person through the fluid in the blisters. The person that the virus is transmitted to will develop chickenpox, not shingles. It’s a good idea to cover your rash as long as it's in the blister-stage before it scabs over. You should also stay away from pregnant women, people with compromised immune systems, those who haven’t had chickenpox or the chickenpox vaccine and children younger than one years old. The best way to prevent shingles is to get the chickenpox vaccine. However, if you’ve already had chickenpox or are even unsure if you had the chickenpox, the Center for Disease Control recommends getting the shingles vaccine. There are two shingles vaccines -- Zostavax, which has been used since 2006, and Shingrix, which has been used since 2017 and is the recommended shingles vaccine. Some people are allergic to Shingrix and need to take Zostavax. Both vaccines are approved for use in adults aged 50 or older and can be effective for preventing a recurrence of shingles if you’ve already had one episode. If you develop shingles, there are some medicines for shingles you can take to shorten or limit the severity of the illness, as well as reduce your risk of having PHN. Your doctor can prescribe an antiviral, such as acyclovir, famciclovir, or valacyclovir. These antivirals are most effective within 72 hours of developing shingles, so you should call your doctor immediately if you suspect you have shingles. Your physician can also prescribe a corticosteroid, which will help with the inflammation and pain. Dermatologists recommend some treatments you can do at home, like taking ibuprofen or acetaminophen for pain, soaking in an oatmeal bath, applying cool compresses to your rash, and rubbing calamine lotion over the rash once it has scabbed.
Call Vanguard Dermatology in the greater New York City area to discuss your options for preventing and treating shingles. The board-certified dermatologists at Vanguard guide you whether you already have shingles or are working to deter chickenpox from developing into shingles.