Is this rash shingles?

Family Health
Apr 29, 2021

St. Joseph’s/Candler Primary Care Physician Dr. Andrew Mrugala discusses symptoms, treatment and vaccination for shingles

As a child, did you have the chickenpox? If you were born before 1995 – when chickenpox immunization began – then the chances are likely you did. That now puts you at risk of developing another irritating rash called shingles.

Also known as herpes zoster, shingles is a painful rash that can develop in anyone who previously has been infected with varicella-zoster, more commonly referred to as chickenpox, says Dr. Andrew Mrugala, a family medicine physician with St. Joseph’s/Candler Primary Care located in Pooler who is also board-certified in geriatrics. 

Dr. Andrew Mrugala

Shingles presents as a painful, blistering rash that follows the course of an underlying nerve along a part of the body, Dr. Mrugala says. The rash can appear anywhere on the body, but it typically is on only one side of the face or body. The rash lasts for one to two weeks and then gradually resolves, Dr. Mrugala says.

About one in three Americans will develop shingles in their lifetime, according to the Centers for Disease Control & Prevention. An estimated one million people get shingles every year.

So if you’ve ever had chickenpox or care for parents or grandparents who are at risk of shingles, it’s important to be aware of the symptoms, treatment and consider vaccination. (Yes, there is a way to prevent that horrible rash!)

Related Article: Even with vaccine, parents should still be aware of symptoms of chickenpox

Here are five things you should know about shingles:

Who’s at risk of getting shingles?

As mentioned, anyone previously infected with the chickenpox virus can get shingles. This includes nearly everyone born before routine chickenpox immunization was started in 1995, Dr. Mrugala says. Even children can get shingles. However, your risk of shingles increases as you get older.

What causes shingles?

When a person is first infected with chickenpox, the varicella-zoster virus causes the classic whole-body rash that we are familiar with, Dr. Mrugala explains. After the immune system develops a sufficient response to the virus and suppresses it, the immune system drives concentrations of the virus down in the body to a point where it no longer causes the outward signs of chickenpox, mostly rash and fever.

“However, the viral particles are not completely eliminated. They remain in the body and take refuge inside our nerve cells,” Dr. Mrugala says. “They remain there for the rest of our lives and for the most part do not cause any trouble – that is until circumstances arise when our immune system becomes less active, whether during a stressful event or during an unrelated illness.”

When that does occur, the virus can reemerge and cause a blistering rash on the skin along the nerve where it was residing. Along with painful nerve irritation, that is diagnosed as shingles.  

What are the symptoms of shingles?

Shingles typically start as numbness and tingling along a band-like area of the skin anywhere on the body, usually on one side, Dr. Mrugala says. The tingling progresses and soon small blisters develop on the skin. These blisters typically last for one to two weeks, but even after they resolve, the nerve irritation unfortunately may persist and turn into a chronic condition called postherpetic neuralgia. This condition can cause persistent pain for years after resolution of the initial rash.

The risk of postherpetic neuralgia resulting from shingles increases with age and primarily affects people older than 60.

How do you treat shingles?

If symptoms are recognized early and a diagnosis is promptly made, antiviral medications can shorten the duration of the illness and decrease the likelihood of developing postherpetic neuralgia, Dr. Mrugala says. Your physician may also recommend creams or locations to ease itching, steroids or antidepressants or anticonvulsants for nerve pain.

However, there is no true cure for shingles or postherpetic neuralgia, Dr. Mrugala says.

Can shingles be prevented?

So you had chickenpox as a kid and don’t want to deal with that irritating, itchy rash again, let alone put yourself at risk of postherpetic neuralgia. There’s good news in the form of vaccination.

The recombinant zoster vaccine is recommended to prevent shingles in adults 50 and older. There are two current immunizations available for prevention of the shingles virus.

The first vaccine was approved in 2006 and is called Zostavax. This vaccine is made of a live weakened version of the varicella-zoster virus and provides a 50 to 60 percent reduction of the risk of developing shingles, Dr. Mrugala says.

More recently, a newer vaccine became available called Shingrix, which uses slightly different technology and is able to reduce the risk of shingles by 97 percent in patients who complete the two-dose series.

“Shingrix has become the standard of care in preventing shingles in patients today,” Dr. Mrugala says.

If you were vaccinated with Zostavax before Shingrix was available, Dr. Mrugala recommends talking to your doctor about now getting the Shingrix vaccine for more comprehensive protection.

And, he strongly encourages all qualified adults to get the shingles vaccine.

“The reason I feel so strongly is the long-term effects of a shingles infection can be devastating and include hospitalizations for bacterial infections of the rash, blindness – in cases where the rash involves facial nerves – and lifelong pain, which in some patients can be debilitating and very difficult to treat.”

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