Talk to Your Doctor About the
By Serena Yoon, MD
According to the Centers for
Disease Control (CDC), one in three people will experience shingles in their
lifetime and 70 percent of these people will be over age 50. If you are 50 or
older, you should talk with your doctor about receiving the shingles vaccine.
It has been safely in use for six years and is approved by the Federal Drug Administration
for individuals ages 50 and up.
What is shingles?
Shingles, also known as herpes
zoster, is a very painful rash that occurs in individuals who have had chickenpox
in their lifetime. The name is derived from the Latin word “cingulus”
or belt, due to the characteristic distribution of the rash. Following the infection, the chickenpox virus
(varicella zoster) remains latent in the body. As we
age, the immunity developed during the childhood bout of chickenpox declines
and we may no longer be able to suppress the virus. Shingles occurs when this
virus is reactivated. According to the CDC, 99.5 percent of adults in the
United States age 40 and over are at risk for h. zoster because they’ve had
What are the symptoms of shingles?
The hallmark of h. zoster is the
appearance of painful blistering lesions in the region of a single sensory
nerve (dermatome). Often, the involved dermatome is on the torso, creating a
belt-like distribution of the rash, hence the descriptive name, shingles. Sometimes
people have a prickling or burning sensation for several days to a week before
the rash actually appears on the skin. Once the rash appears it is
characterized by multiple blistery, red lesions, which start out as raised
fluid-filled bumps then progress to scabbed over
Chronic pain is the most common
h. zoster, which can be severe and
is frequently characterized as “burning”, “stabbing” and “stinging.” Typically,
the symptoms of shingles last from two to four weeks; however, for about one in
five people the pain becomes chronic and can continue long after the rash goes
away. This condition is called post-herpetic neuralgia (PHN) and can last for
months or years. There are no curative strategies for PHN, but there are some
medications available that can palliate some of the associated pain. The incidence
of PNN increases with age.
Why is shingles vaccination
Approximately 10-25 percent of
patients with shingles will develop ophthalmic zoster, which occurs in and
around the eye and can lead to permanent blindness. While rare, a shingles infection
can also lead to hearing loss, bacterial super-infection, scarring, and motor
nerve palsies. Post-herpetic neuralgia
can be quite severe and disabling, especially among the elderly.
Is the shingles vaccine safe and
The shingles vaccine was first
released in 2006 and since that time no serious problems have been identified
with it. This is the same vaccine we administer to children for chickenpox, but
in a stronger dose for adults. In clinical trials, the shingles vaccine reduced
the risk of shingles by approximately 50 percent. People who do get shingles
after being vaccinated typically experience milder symptoms and an abbreviated
course of the illness.
Is shingles contagious?
You cannot catch shingles from
another person. However, if you never had chickenpox as a child and were never
vaccinated for it, you could get chickenpox from someone with shingles if you
were directly exposed to the shingles rash. This is very uncommon.
If I suspect I have shingles, what
should I do?
Timing is important. If you think
you may have shingles, call your doctor immediately. There are antiviral
medications available that can attenuate the severity and duration of the
shingles experience; however, it is important to start these medications within
36 hours of the rash becoming apparent.
Shingles can be a life-changing
event but it is very preventable. Talk to your primary care physician about the
shingles vaccine if you are 50 or older.
Dr. Yoon is
board certified in internal medicine, a fellow of the American College of
Physicians and serves on the medical staff of Cayuga
Medical Center. She is in practice with Cayuga Medical Associates where she can
be reached at (607) 266-7500.