By
Newswise — If you still can see those small round and slightly indented scars from your childhood bout with chickenpox, they might be a good reminder to consult with your primary care provider and schedule a vaccine for shingles.
“Shingles is caused by the varicella-zoster virus. It’s the same virus that causes chickenpox,” said Dr. Eugene Fellin, a family medicine physician at Penn State Health Medical Group – Fleetwood. “For most of us who grew up before the 1990s, when children began being immunized against chickenpox, we’ve been exposed to the virus and are at risk for shingles.”
The virus lies dormant in the nervous system, for many years sometimes, and then reemerges as shingles, which causes a painful string of rashes, typically on the face or around the side of the torso, Fellin said.
A burning rash
“It’s like a poison ivy rash that won’t go away,” Fellin described.
Shingles can happen at any age, but it most typically affects people with stress, compromised immunity and those over 50.
“It can occur in patches, but along that same nerve root. A lot of times, people feel some tingling or a burning sensation prior to the rash actually breaking out,” Fellin said. “When we’re looking for the rash, it will be in a string on the torso because the nerves wrap around the torso. You get a line around you, from the back to the front.”
The rash usually breaks down in little clusters of blisters with red bases that will be present for several days. Then they’ll rupture, form a crust, scab over and go away, he noted.
“The other issue we worry about is if it breaks out on the face and involves the eye because this can lead to blindness,” Fellin said. “Shingles around the eye is considered dangerous, and an instant referral to an ophthalmologist is always recommended.”
Effects can linger
Antiviral medications such as Valacyclovir can be prescribed for patients who develop shingles, but they’re time-sensitive and need to be taken within 36 hours of the onset of the rash because they work by slowing the spread of the virus, Fellin said.
While symptoms go away after three to five weeks, pain can sometimes return in the form of postherpetic neuralgia, he said. This long-term nerve pain occurs where the shingles rash appeared and can last for months or even years after the rash fades. Older adults are more likely to develop postherpetic neuralgia and have longer lasting and more severe pain.
Who should get the shingles shot?
Fellin supports the guidance from the Centers for Disease Control and Prevention and recommends the Shingrix vaccine. It’s given in two doses, with the second given two to six months after the first. People who had shingles can still benefit from the vaccine, but sometimes patients can get the virus again, although it’s often milder the second time around because of the added protection. Patients who get shingles can still receive the vaccine, which reduces the chances of another outbreak, he noted.
One of Fellin’s patients, Kathleen Ruscett of Wyomissing, developed a rash on her back about a year and half ago. It wasn’t sore, and she had no idea what it was, so she visited a dermatologist. It turned out to be a mild case of shingles.
“There was nothing he could do because it had already broken out,” she said, noting that she had chickenpox when she was 10. “The shingles went away after a couple of weeks. That’s when I decided to get the shot.”
The first dose “was nothing, just like getting a flu shot,” but the second one “knocked me out for about two days like I had the flu,” Ruscett said. Even with the vaccine, shingles returned about a month ago, but it was a mild, short-lived case and treated with an antiviral medication.
“Dr. Fellin knew what it was immediately,” she said. “I’m glad I had the vaccine because the symptoms when the shingles came back were mild. I’ve been encouraging friends and family to get the vaccine.”
Covered, accessible and worth it
Fellin said most family doctors and pharmacies stock the vaccine, which is covered by Medicare. The approximate retail price via GoodRx for the two shots is $300.
“Most insurance programs are covering it because it has been out long enough and shows a real benefit,” Fellin said. “There’s a lot of misinformation about vaccines circulating out there. My message is this: Don’t be afraid of this or any vaccine.”
