Shingles and Shingles Vaccine
Shingles is a painful rash that occurs as you age. One in two people who live to age 85 willget shingles. It all starts with the chicken pox virus that you had as a child. You neverreally get rid of the virus, but it lives dormant in the nerves of the spine. Your immunesystem is able to keep the virus confined to the nerves and you have no idea that it isthere. As you age, your immune system weakens and the virus can escape, causing apainful rash along the path of the nerve.
Shingles is usually on one side of the body and is rash characterized by blisters, pain, anditching. The rash sometimes is preceded by several days of pain without a rash or canoccur just as blisters with minimal pain. The most common sites of involvement are thechest, face or arms, but it can occur anywhere on the body. The rash usually continues toerupt for three to five days and usually dries up without treatment in 10 days. The blisterscontain chickenpox virus, so exposure to infants and pregnant women does risktransmission of the virus (chicken pox).
The ideal treatment is a medicine named valacyclovir which is given for one week. Themedicine will shorten the duration of the rash and reduce the likelihood of chronic painafter the rash (post herpetic neuralgia). It is ideal to get the medicine within 48hours ofthe initial breakout, but we still treat even further out. Sometimes we use steroids as it canhelp speed pain relief.
The biggest problem with shingles is post herpetic neuralgia or chronic pain in the area ofthe rash. This pain has been called “the Devil’s Grip” in medical literature because of itsseverity. The rash will resolve and people are left with pain that can be debilitating in thearea of the rash. This pain can last weeks to years and there is no way to know who willget it. We do treat the pain with many different formulations of pain medicines which canhelp.
The shingles vaccine (Zostavax) has been around since 2006, and can reduce the likelihoodof shingles. It is approved for ages 50 and older and currently is a onetime vaccine. Theefficacy of the vaccine is greater the younger you are when you take it with a 70%efficacy if given in the fifth decade. The efficacy declines the older you are when you getthe vaccine, but the ability of the vaccine to reduce postherpetic neuralgia remains near67% no matter how old you are when you get it. If you have had shingles we still
recommend the vaccine. If you have recently had the shingles it is felt that you can waitthree years before needing the vaccine as the exposure to the virus will stimulate yourimmune system like the vaccine.
The vaccine is a live attenuated virus. This means that people with certain cancers, onsteroids, (or other immune suppression), or certain drugs for rheumatologic disease cannottake the shot. You also should not take the shot if you are allergic to gelatin or neomycin. There is a rumor that you cannot be exposed to young children after the vaccine, but thisis totally false. The chance of transmission of the virus can only occur if you develop therash. This is highly unlikely, but if you were to develop the rash then you would need toavoid pregnant women and young children until it resolved.
As you can see shingles is common especially as you get older but we do have a vaccinethat can help reduce the likelihood of a person getting it. If you think you have it, do notwait and call me right away because the key to a quick recovery is early treatment.
The Shingles rash usually starts as redness or discoloring of the skin and then developsinto fluid-filled blisters which generally take 2-4 weeks to heal.
The Shingles rash usually starts as redness or discoloring of the skin and then developsinto fluid-filled blisters which generally take 2-4 weeks to heal.
Over half of Shingles rash outbreaks occur on the torso and usually on only one side of thebody. This is a typical example.
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Shingles and Shingles Vaccine
recommend the vaccine. If you have recently had the shingles it is felt that you can waitthree years before needing the vaccine as the exposure to the virus will stimulate yourimmune system like the vaccine.