- Jessica Craig
Herpes Zoster: Understanding and Preventing Shingles
By Jessica Craig
What is shingles?
Shingles, also called herpes zoster, is a disease that produces a painful skin rash. It is caused by the varicella-zoster virus, which is the same virus that causes chickenpox in children. After recovery from the symptoms of chickenpox, the virus continues to live in certain nerve cells. For most adults, the virus is dormant and never triggers shingles. But, for about one-third of adults, the virus will become active again and lead to shingles.
Typically, shingles develop on one side of the body or face in a small area. The most common place for shingles to occur is in a band on one side of the waistline. Most people with shingles have one or more of the following symptoms:
Burning or shooting pain
Tingling, itching, numbness of the skin
Chills, fever, headache, or upset stomach.
For certain individuals, the symptoms of shingles are mild; only a sight itching sensation. For others, shingles can cause severe anguish that can be felt by the softest touch or breeze. Blisters caused by shingles near or in the eye can result in permanent eye damage or blindness. Hearing loss, paralysis of the face or, very seldom, inflammation of the brain can also take place.
How long does shingles last? How is it treated?
If you think you might have shingles, talk to your doctor as soon as possible.
Most cases of shingles last three to five weeks. The earliest sign is frequently burning or tingling pain; sometimes symptoms consist of numbness or itching on one side of the body. Within one to five days after the tingling or burning feeling on the skin occurs, a red rash will emerge. A few days later the rash will turn into fluid-filled blisters. Within seven to 10 days after that, the blisters dry up and crust over. Then, a couple of weeks later, the scabs clear up.
After the shingles rash goes away, some people may be left with a continuing pain called postherpetic neuralgia, or PHN. The pain is felt in the area where the rash has occurred. As one ages, the onslaught of shingles means the greater the chances of developing PHN, which can bring about depression, anxiety, sleeplessness and weight loss. Some people with PHN find it hard to go about their daily activities, such as dressing, cooking and eating. Generally, PHN will lessen over time.
There is no cure for shingles. Once a rash appears, it is important to see a doctor no later than three days after it appears. Most cases can be diagnosed from a visual examination. However, early treatment with antiviral medications can speed healing and reduce the risk of complications.
How to prevent shingles
A shingles vaccination is the only way to protect against shingles and PHN.
The CDC advises that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix. This recombinant zoster vaccine, with the doses separated by two to six months, helps prevent shingles and complications caused by the disease. The vaccine's double dose provides a proven defense against shingles and PHN; more than 90 percent effective in stopping shingles and PHN.
There is no maximum age for receiving the vaccine Shingrix. Its defense against shingles stays above the 85 percent-effective mark for at least the first four years after vaccination. If one has had shingles previously, the vaccine can still help to prevent future episodes.
There is no specific length of time an individual must wait after contracting shingles to receive vaccination, but, generally, one should make sure the shingles rash has disappeared before doing so. Shingrix has been 97 percent effective in preventing shingles among adults 50 to 69 years of age, and 91 percent effective among adults 70 years and older. Relative to PHN, in adults 50 to 69 years old who got two doses, the vaccine was 91 percent effective in prevention, and 89 percent effective among adults 70 years and older.
There are approximately one million cases of herpes zoster in the U.S. annually. Since the risk of suffering from shingles and PHN increases as one ages, it is important to ensure strong protection against the diseases.
 NIH National Institute on Aging. (2021). Shingles. Retrieved from https://www.nia.nih.gov/health/shingles#what.
 National Center for Immunization and Respiratory Diseases. (2018) Shingles Vaccination. Vaccines and preventable diseases. Retrieved from https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html.
 Maltz, F., and B. Fidler. (2019). Shingrix: A New Herpes Zoster Vaccine. P & T : a peer-reviewed journal for formulary management, 44 (7), 406–433.