Treating Shingles

By Henry H. Balfour, Jr., M.D.

Shingles is a condition that initially causes pain, followed by a rash that blisters and eventually heals. While it is not life-threatening to people with normal immune systems, people living with shingles can be in constant pain that makes it difficult to complete simple daily tasks. The disease is caused by the same virus as chicken pox, the varicella-zoster virus. Despite being a member of the herpes family, shingles is in no way related to sexual activity.

People with shingles often first report pain, which is followed by skin infection and eventual rash that blisters and scabs, similar to a case of the chicken pox. This process usually evolves over a two- to three-week period. Once the blisters heal, the pain of a shingles attack also subsides.

The older you are, the more likely you are to get a case of the shingles. In fact, as people age, their risk steadily increases. Younger people who have compromised immune systems are also at risk. People who have not had chicken pox can get the virus from someone with a shingles outbreak and develop chicken pox, but you cannot "catch" shingles from contact with someone who has shingles.

Anyone who has had chicken pox can get shingles, since it is caused by a dormant or inactive form of the varicella-zoster virus that hides in a structure of nerves along the spine. The virus remains there until the time of a shingles attack. These attacks can be brought on by physical or emotional stress.

People with shingles who have moderate to severe pain should consult a health professional. Moderate pain is defined as pain that interferes with some daily activities. Severe pain means that most daily activities are impaired and sleep is disrupted. Two drugs given by mouth are equally effective against the virus and hasten the healing process if they are prescribed within three to four days after the rash has begun. They are valacyclovir and famciclovir. Patients should be given one of these antiviral drugs and should have their pain controlled with pain-relieving drugs, drugs that reduce inflammation, or other pain reduction measures, including surgery. Receiving an antiviral drug as soon as possible after the shingles rash erupts and having pain reduced as much as possible help to lessen the severity of potential complications.

The vaccine for shingles, first made generally available in 2006, is actually a "souped-up" version of the chicken pox vaccine, which is commonly given to children. The vaccine is currently approved by the FDA for use in patients over the age of 60. This vaccine has proved incredibly safe, and is usually recommended for patients who have not had a case of shingles, because people seldom get shingles more than once. Last year, the Centers for Disease Control recommended the vaccine be given to patients when they are 60. It is likely that this vaccine will benefit younger people as well, especially adults in their 50s.

Henry H. Balfour, Jr., M.D., is professor of Laboratory Medicine and Pathology, and Pediatrics at the University of Minnesota where he has led numerous clinical virology studies for more than 30 years. He is principal investigator of the University of Minnesota International Center for Antiviral Research and Epidemiology.

Health Talk & You is an educational service of the University of Minnesota. Advice presented here should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu/.