If you have had chickenpox in the past, then you are at risk for shingles. Known as Herpes Zoster, shingles is a localized, blistering rash which can become painful. It's caused by a herpes virus called varicella zoster — the same virus which causes chickenpox.
When one gets chickenpox and gets better, the virus does not just go away. It hides away in the nerve roots of your body and can reactivate years later.
Symptoms include itching, tingling, pain and a blistering rash. Itching and pain can occur before the rash appears. The rash can appear on the face, neck, trunk, arms or legs and usually crusts over in two to three weeks, but may last up to one month.
It is believed at least 90 percent of people age 40 or older have had chickenpox. According to the Center for Disease Control and Prevention, it is estimated that one in three people will develop shingles in their lifetime. In the U.S., there's an estimated one million episodes annually.
Shingles in itself is not contagious. If you have not had chickenpox or the varicella vaccine, avoid touching the rash of a person with shingles. If you touch the rash of a person with shingles and have not had chickenpox or the varicella vaccine, you could get chickenpox.
The most common and challenging problem with shingles is the pain (postherpetic
neuralgia). This can last weeks, months or even years. Others include Ramsay Hunt syndrome (herpes zoster oticus). This occurs when shingles affect the facial nerve close to the ear. It can cause facial muscle weakness or deafness of the affected ear. And herpes zoster ophthalmicus can lead to eye pain, blurred vision, temporary or permanent blindness.
Treatment should be started within 72 hours of symptoms and include antiviral medications. Sometimes patients may require pain medicines as well.
The Zostavax (varicella) vaccine is now approved by the FDA for persons age 50 and older. The vaccine is a live attenuated virus and is given in a single dose. You are encouraged to get the zoster vaccine regardless if you have had a history of shingles or not.
Who should not get the vaccine? Pregnant women, patients with active untreated tuberculosis, patients with diseases or malignancies of the immune system (HIV/AIDS, cancer) — anyone with a history of anaphylaxis or allergy to the vaccine ingredients.
Unfortunately, the Zostavax vaccine is not always covered by insurance. If you are 65 or older and you have Medicare Part D, it should be covered at your local pharmacy. For those 50 and older, your insurance may or may not cover the vaccine. Not all physician offices carry the vaccine. It is best to call your insurance carrier prior to getting the vaccine to ensure it will be covered.
Dr. Aunita M. Hill is a board-certified internist on staff at Missouri Baptist Medical Center. She is a member of the BJC Medical Group of Missouri. For a referral, call (314) 996-LIFE.