Along with ranking as one of the most misunderstood maladies targeting baby boomers, shingles is also high on the list for being unforgettable.
“Patients describe it as an intense burning, or even electrical shocks,” says internal medicine physician Dr. Sasikumar Katamreddy. “At its peak, it can be so painful they can’t tolerate clothing against their skin.”
Herpes zoster, or shingles, is caused by the same virus that gives us chickenpox. Chickenpox is the acute phase of the virus, which usually affects children and adolescents. The virus then lies dormant in the nerve tissue near your spinal cord and brain, and may reactivate years later as shingles. Nearly one in every three people will develop shingles in his or her lifetime, and even though it’s widely considered a disease of the over-60 crowd, this represents only half of the total reported cases.
“Anyone who has had chickenpox can develop shingles, even children, however your risk increases with age,” Katamreddy says.
A weakened immune system is an open invitation for the reactivation of the virus. Cancer and HIV lead to immune deficiencies, and those who take steroids are at higher risk. Stress can also trigger shingles.
The name does not refer to the texture of the rash associated with the virus, but is derived from the Latin and French words for belt or girdle, describing the girdle-like skin eruptions that commonly appear on the torso. The period just before the rash appears is known as the pre-eruptive phase, which involves tingling, itchiness, burning, tenderness or pain across a single band of skin on one side of the body. However, this phase can also be sneaky and difficult to identify.
When 64-year-old Allen Cornell visited his doctor about a deep, throbbing pain in his lower left abdomen, he was sent for a CT scan, which showed nothing abnormal. Two days later, he broke out in the fluid-filled, pimply rash characteristic of shingles — precisely where his abdominal pain had been.
“An internal pre-eruptive phase like this makes an early diagnosis challenging, if not impossible,” Katamreddy says.
As with most diseases, the sooner you begin treatment, the better, but this is especially true with shingles. Even a mild case can last several weeks, and although there is no cure, antiviral medication can speed healing and reduce the risk of complications. It’s most effective when started within three days of the rash appearing, and over-the-counter pain medication and cold compresses on the blisters can help ease the discomfort.
Fortunately, most people who develop shingles typically have it only once in their lifetime, but some experience it a second or even a third time. Cornell had it once before in his 20s, so he was surprised to have another episode 40 years later.
“I thought it was a ‘one and done’ kind of thing,” he says.
The best offense against shingles is a strong defense, and Dr. Katamreddy strongly recommends the shingles vaccine for anyone age 60 and older, even if you’ve already had an episode. The vaccine doesn’t guarantee you won’t get shingles, but it will lessen its duration and severity while reducing the risk of serious complications.
“There is no good reason not to get the vaccine,” Katamreddy says. “It needs to become part of our adult precautionary vaccine regimen, along with flu and pneumonia.”
