Shingles Symptoms, Treatment and Prevention

An estimated one million Americans develop shingles annually. In fact, one-third of the population will suffer from shingles at some point during their lifetime. Shingles is a painful rash caused by a virus called varicella-zoster (herpes zoster) — the same virus that causes chickenpox. If you have had chickenpox, the virus will “hide” inside the body making you at risk for getting shingles. The shingles virus can be transmitted from person to person if direct contact is made with the fluid from the rash. It is important to note that the virus that causes chickenpox and shingles is not the same herpes virus that causes cold sores and genital herpes.

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Shingles and diabetes

Research has shown that chronic conditions such as diabetes are associated with an increased risk of acquiring shingles. Scientists suggest that shingles is more severe in people with diabetes. After the infection, you would be more likely to have worsening of blood glucose control, need for medical follow-up, additional medication, as well as risk of hospitalization may be increased for up to six months after the infection was noted. Shingles may occur at any age; however, it is much more common in older adults who are also are more likely to have a severe infection. Being an older adult with diabetes increases both the risk of getting the infection and serious infection.

Symptoms

Shingles symptoms usually start on one side of the body with feelings of burning or tingling nerve pain which can range from mild to intense. After several days, numbness or itching along with a rash of fluid-filled blisters (that look similar to chickenpox) result. A common location for shingles to appear is along the nerve path from one side of the upper body wrapping around the waistline. Headache, fever, chills, nausea and body aches may also be present. Shingles is commonly diagnosed by your health-care provider based on the appearance of the painful skin rash.

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Facts about shingles

Key Facts from the Centers for Disease Control and Prevention:

• Shingles and chickenpox are caused by the same virus called varicella zoster virus.
• An estimated 1 million people get shingles each year in the United States.
• Anyone who has had chickenpox can get shingles, and you can get shingles at any age.
• Your risk of getting shingles and having more severe pain increases as you get older.
• The shingles vaccine, called Shingrix, is recommended for people age 50 and older to protect against shingles and the long-term pain that it can cause.
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Treatment

Treatment with antiviral medications such as acyclovir (brand names Zovirax and Sitavig), valcyclovir (Valtrex), or famciclovir (Famvir) can help reduce the severity and duration of a shingles attack if initiated promptly (within 72 hours). These medications may also help reduce nerve pain called postherpetic neuralgia that is often experienced after an attack of shingles. Other medicines used to treat nerve pain may include steroids, antidepressants, anticonvulsants and topical creams or ointments. Analgesics, such as acetaminophen (Tylenol) may also be recommended for headache and generalized pain.

Prevention

Vaccines to prevent shingles approved by the Food and Drug Administration for adults age 50 and older are Shingrix and Zostavax. Shingrix reduces the chance of getting shingles by ~90% and is given as two injections between two and six months apart. The Centers for Disease Control and Prevention (CDC) recommends that all adults aged 50 or older receive Shingrix. The Shingrix vaccine is preferred by the CDC over the one-time Zostavax vaccine that lowers risk of shingles by 50–60%. Shingrix is also recommended for adults with chronic medical conditions such as diabetes. If you had shingles in the past, Shingrix can prevent future outbreaks. Data suggest that Shingrix reduced the expected number of later cases of shingles by about 50% in older adults. If you acquire shingles following the appropriate immunization, the severity of infection and associated complications are significantly lower. Receiving the shingles vaccine is for prevention of the outbreak, not treatment.

So if you have diabetes, consider the Shingrix vaccine. Talk with your diabetes care team and/or your pharmacist about your risk for shingles and any side effects the vaccine may have. Above all, take action to prevent this painful disorder.

Want to learn more about shingles and diabetes? Read “Shingles Vaccine and Blood Sugar Control: Diabetes Questions & Answers.”

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