House call: Shingles painful, preventable

If you are old enough to have had chickenpox as a child, or even as an adult, you become increasingly at risk of developing shingles as you age. Shingles is caused by the same virus (varicella-zoster) that made you sick with chickenpox. After you recover from chickenpox, the virus is still in you, but it is dormant in the nerves near your brain and spinal cord.

Eventually, the virus may become active again, but this time instead of getting chickenpox, you become ill with shingles. Shingles is a painful rash in one area of the body, usually only on one side and in a limited area. On occasion, the rash can appear on your face and people with weak immune systems may have a widespread rash. You may experience pain, itching or tingling in the area of the rash before it appears.

I had shingles when I was about 45. It may have been brought on by a weakened immune system due to stress, while downhill skiing for the first time with my teenage sons. Although I was terrified, they and the cute girl in the rental shack with Jedi mind tricks persuaded me to try it. On my second day of skiing, still with visions of long leg casts dancing in my head, the symptoms started with waves of pain in my left shoulder area. A few days later I was not surprised to find a big red blotch forming there, recognized it as shingles and got anti-viral medication right away. I was lucky that it resolved very quickly. Like chickenpox, if not caught early and treated with anti-viral drugs the rash will blister and then crust over before it goes away. It is contagious for chickenpox, not shingles, until it is completely crusted over.

Although you cannot pass shingles on to another person who has had chickenpox or the chickenpox vaccine, you can infect people with chickenpox who have had neither. If you have shingles, it is important to avoid contact with infants who are too young to have had the chickenpox vaccine, children who have not been vaccinated for some reason, and adults who never had chickenpox. Chickenpox can be a dangerous illness, especially in those who are in their teens and older.

Shingles usually clears up after two to four weeks, but some people continue to have pain in the area after the rash and blisters have healed. This pain, called post-herpetic neuralgia, can be severe, but it usually goes away within a few months. In some cases, especially in the elderly, the pain may last years. Shingles near the eyes can damage your vision and even cause blindness. Occasionally, shingles and chickenpox can also cause pneumonia, hearing problems, brain inflammation and death.

As you get older, the risk of shingles increases, it is likely to be more painful, and you are more likely to have post-herpetic neuralgia. Because of this there is now a vaccine to prevent and lessen the effects of shingles. It is recommended that people older than 60 get the vaccine.

Currently, around 1 out of every 3 adults in the United States will develop shingles, so you may want to consider getting the vaccine when you turn 60 to avoid the possibility of severe and sometimes debilitating pain that can last months or even years. Talk to your doctor about your risks. Also, check into whether the vaccine is covered by your health plan.

Most children are now vaccinated against chickenpox, so over time we may be lucky enough to see not only chickenpox become a thing of the past, but shingles too.

Dr. Bob Riggs is a family medicine physician practicing at Group Health’s Riverfront Medical Center.