What to Know About Shingles

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What to Know About Shingles

Vaccines have been on everyone’s minds lately, thanks to the COVID-19 pandemic, as well as the flu season. However, there are other vaccines that are also important to consider, especially if you have diabetes. One of these vaccines is the shingles vaccine. If you’re not quite sure what shingles is, or why it’s important to protect yourself against this painful condition, read on!

What is shingles?

Shingles, also known as herpes zoster, is a viral infection of the nerves that causes a painful rash and blisters on the skin. Shingles is caused by the same virus that causes chickenpox. If you’ve had chickenpox, the virus stays, inactive, in the body. If the virus is reactivated, it can appear as shingles. Pain from shingles, called postherpetic neuralgia, can persist even after the rash or blisters are gone.

What are the symptoms of shingles?

The CDC (Centers for Disease Control and Prevention) states that “people often have pain, itching, or tingling in the area where it (shingles) will develop. This may happen several days before the rash appears.” Shingles pain can range from being mild to severe.

Shingles usually occurs on either the right or left side of the body; it can also occur on one side of the face, and can even affect the eye, potentially leading to vision loss. The shingles rash consists of a stripe of blisters that scab over about seven to 10 days after they appear.

Other shingles symptoms include:

  • Fever
  • Headache
  • Chills
  • Upset stomach

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How do you get shingles?

The varicella zoster virus causes shingles, and this is the same virus that causes chickenpox. If you’ve had chickenpox, you are at risk of getting shingles. Most people who get shingles only have one episode in their lifetime, but it’s possible to have shingles more than once. (Of note, you can’t “catch” shingles from someone who has it; however, if you’ve never had chickenpox or received the chickenpox vaccine, you can get chickenpox from someone who has shingles). The CDC estimates that about one out of every three people in the United States will have shingles during their lifetime.

Shingles can be transmissible if you a) have never had chickenpox or the chickenpox vaccine) and b) if you come in contact with the fluid from shingles blisters. If you or someone close to you has shingles, make sure to cover the rash, avoid scratching the rash, wash hands often, and limit contact with pregnant women, newborn infants, or people with a weakened immune system.

What are the long-term complications of shingles?

Most cases of shingles last three to five weeks. But about one in 10 people who have had shingles develop ongoing nerve pain in the area of the rash called postherpetic neuralgia (PHN). PHN is more likely to occur in older people. PHN can greatly interfere with activities of daily living, and may even cause depression, anxiety, sleeplessness, and weight loss.

If shingles affects the eye, blindness may occur. Less often, shingles may cause pneumonia, hearing problems, balance problems, brain inflammation, or death. Also, if you have diabetes, a shingles infection (like any infection) can raise blood sugar levels and make it more difficult to manage blood sugars, too.

Are you at risk of getting shingles?

If you’ve had chickenpox, you’re at risk of getting shingles. It’s not entirely clear what “activates” the virus and causes shingles, but researchers believe the following factors increase your risk:

  • Older age: Shingles risk increases as you get older.
  • Weakened immune system: The immune system tends to weaken as you get older, and conditions such as cancer and cancer treatment, HIV, too much sun, and organ transplant drugs can also affect your immune system. Stress and the common cold put you at risk, too.

Having diabetes can also increase your risk of shingles as well as PHN, according to a study published in the journal Diabetes Therapy in 2018. And, if PHN does occur, it tends to be more severe and persistent.

How do you know if you have shingles?

If you have any of the above symptoms, see your doctor right away. Shingles can be diagnosed based on your symptoms and by looking at the rash (if you have one). Your doctor might also take a tissue scraping from the rash or swab some fluid from the blisters to send to the lab for testing.

How is shingles treated?

There is no cure for shingles, but antiviral medicines (acyclovir, valacyclovir, and famciclovir) can shorten the length and severity of the illness. It’s best to take antiviral medicine as soon as possible after the rash appears.

Besides antiviral medicine, your doctor may prescribe other medicines to help manage pain. These medicines include:

  • NSAIDS (non-steroidal anti-inflammatory drugs), such as ibuprofen, naproxen, and acetaminophen
  • Capsaicin patches
  • Lidocaine cream, gel, spray, or patches
  • Opioids, such as oxycodone or hydrocodone/acetaminophen
  • Steroids, such as prednisone
  • Anticonvulsants, such as gabapentin
  • Tricyclic antidepressants, such as amitriptyline

Home remedies can make you feel more comfortable, too:

  • Wear soft, loose-fitting clothing
  • Take oatmeal baths
  • Use calamine lotion
  • Apply a cool washcloth to the rash and to help dry the blisters
  • Get plenty of rest
  • Eat healthy foods
  • Try to limit stress

Can shingles be prevented?

Shingles and its complications can be prevented with a vaccine. The CDC recommends that healthy adults 50 years and older get two doses of the Shingrix (recombinant zoster vaccine), separated by two to six months. “Two doses of Shingrix is more than 90% effective at preventing shingles and PHN,” says the CDC. You can get the shingles vaccine if you’ve already had shingles or if you don’t remember having had chickenpox in the past.

Some people shouldn’t get the vaccine — these include people who have had an allergic reaction to Shingrix, have tested negative to the varicella zoster virus (in that case, they should get the chickenpox vaccine), currently have shingles, or who are pregnant or breastfeeding. Also, people who are sick or who have a fever shouldn’t get the shingles vaccine.

For more information about vaccines recommend for older adults (including shingles and the COVID-19 vaccines), visit the National Institute on Aging.

Want to learn more about shingles? Read “Shingles Symptoms, Treatment, and Prevention.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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