What you need to know about shingles

If you had chicken pox as a child, beware: The virus is still in you and ready to re-emerge as shingles.

Almost one out of three people will develop shingles during their lifetime, and while the risk of developing shingles increases after age 60, about 1 million people of all ages experience the painful, blistering skin rash each year, said Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University School of Medicine in Nashville.

“Shingles is very common. If you got chicken pox as a child, you get over the illness but the virus remains. It’s like a bear in hibernation. The virus hides in areas of nervous tissue,” Schaffner said.

What it is

Shingles is caused by the same pathogen as chicken pox, varicella zoster virus. The medical community doesn’t fully understand what causes the virus to pop up later in life.

It’s a misconception that shingles only affects older people – while it is most common after age 60 about half of cases are in people under 60. For people who reach 80, between one-third and one-half will develop shingles, Schaffner said.

One of the reasons shingles is more prevalent may be because of an aging population. As we age, our immune systems weaken and it becomes more difficult for our natural defenses to fight off the virus, Schaffner said. Additionally, people whose immune system is compromised – such as those fighting cancer or HIV, on certain medications or undergoing stress – are more likely to develop shingles.

Because the virus goes along the nerve, it appears only on one side of the body or the face as a blistering, red skin rash, Schaffner said. The name itself refers to the physical appearance being like a shingle on a roof, Schaffner said.

What it does

Depending on how severe the case, shingles can be excruciatingly painful and can last for about two to four weeks. It’s itchy, burning, even stabbing and can disrupt daily living activities such as dressing and bathing, Schaffner said.

Even worse, for some people the pain can last for years if the nerve that shingles followed suffers lasting damage. That’s called postherpetic neuralgia and can be so severe and debilitating that wind ruffling a shirt will bring pain, Schaffner said.

If the nerve damage is on the face it can lead to disfigurement and eye complications that can result in vision loss, Schaffner said.

Prevention

For most people, shingles is a one-time only event, but it is possible to have a second or third episode, Schaffner said. Shingles isn’t contagious, but a person with shingles can transmit the virus.

“Since the mid-1990s children have been vaccinated for chicken pox. The hope is that the comprehensive vaccination of children will largely eliminate shingles in the future,” Schaffner said.

A shingles 2.0 vaccine is in the works that may be licensed and available within the next two years, Schaffner said.

Possible pull quote

“Since the mid-1990s children have been vaccinated for chicken pox. The hope is that the comprehensive vaccination of children will largely eliminate shingles in the future.”

Dr. William Schaffner,

Vanderbilt University School of Medicine