No time for shingles

Why bother with shingles?

Because 1 in 3 people will get shingles. I did.

It’s caused by the chicken pox virus. The first time you’re infected, you get a diffuse rash – that’s chicken pox (varicella). The virus then sleeps in nerve endings (no, it never leaves). With age, weakening immunity or idiopathy (medical term for "worst-luck-ever"), the virus wakes up and causes a localized rash – that’s shingles (herpes zoster).

Thus its fancy-pants name – varicella-zoster virus (VZV).

VZV belongs to the herpes family, closely related to cold sores and genital herpes, which also never leave and show up at inopportune times. (Now you see the family resemblance?)

With shingles, malaise and localized pain/tingling may precede the rash by days. The rash could be small blisters or oozy red patches. The pain (and other complications) that follow may last weeks to months. Rarely years.

VZV is highly contagious. Almost all U.S.-born adults over the age of 40 have had chicken pox. Since 1995, U.S. children would’ve been vaccinated.

Complications of shingles

  1. Rash: Usually worsens over days, resolves in weeks – may leave a scar – and is the least of your problems.
  2. Pain: VZV joyrides along the nerve to the skin, damaging it. About 1 in 5 suffers pain for longer than three months (post-herpetic neuralgia or PHN). The older, the higher the risk.
  3. Eyes: About 20% develop shingles in the eyes. If blisters envelop your eyes, run to your doctor. It’s a medical emergency. The incidence tripled in the U.S. from 2004 to 2016. Why? Experts have theories (they always do). Nobody knows for sure.
  4. Nerves: Depending on which nerves VZV attacks, and how badly, shingles causes many neurological complications, some stroke-like. It also increases the risk of actual strokes.
  5. Chicken pox: Shingles blisters can infect those who’ve never had chicken pox. Once scabbed, they’re no longer infectious. 


Given within the first few days, anti-viral drugs (and maybe steroids) might shorten the course.

The most effective treatment: shingles vaccine. We have two. The newest, Shingrix, available since 2017, given as two shots months apart, is 90% effective in preventing shingles. For the unfortunate few who still get shingles, it’s 90% effective in preventing PHN.

Vaccine coverage is variable ($280, covered in Medicare Part D). Check with your insurance first.

The new recommendation: With few exceptions, all adults 50 and older should be vaccinated against shingles.

I got shingles in my 40s. After a stressful few weeks at work.

An itchy, red patch appeared below my right shoulder blade. I thought “Hmm, contact dermatitis.” (In hindsight, how’d I get poison ivy in place I couldn’t even scratch?)

Once the pain started, it was obvious what I had.

And there was no stopping how creative the pain got: Dull, sharp, deep, achy … a light touch seared like somebody wiped a hot blade on my skin. There’s no sleeping.

Times like this make you reflect how good life was, before shingles. But if you, like me, are so done with these life-reflecting moments – get vaccinated.

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Volume 11, Issue 17, Posted 9:47 AM, 09.04.2019