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An unwelcome visitor from the past: Understanding shingles

Did you ever get chicken pox as a child? If so, you’re unfortunately a candidate for shingles. Shingles is a reactivation of chicken pox virus, and it’s quite common, affecting about one in three adults at some point in their life. We spoke with Lisa Felsman, MD, family medicine physician with Beacon Medical Group Bristol, to better understand shingles and what to do about it.

Dr. Lisa Felsman, family physician at Beacon Medical Group Bristol

Q: How does shingles compare to chicken pox?

Dr. Felsman: Once we’ve had chicken pox illness, that virus stays with us, and it is very opportunistic. In other words, it loves to kick us when we’re already down. It can also come back multiple times. Times when you have another illness or times of heightened stress are common scenarios where we see shingles.

Q: What are the symptoms of shingles?

Dr. Felsman: The most common symptoms are burning, tingling and crawling-type pain, sometimes with numbness, typically affecting one area of the body on one side. The pain often comes first, before a rash shows up.

When the rash shows up, it is usually blistery and red or pink. The rash gradually scabs over, generally over the course of several days to a couple of weeks. Shingles tends to follow the path of one nerve, so if you have a rash and pain all over your body, it is probably not shingles.

Q: How quickly after seeing symptoms should someone talk to their provider?

Dr. Felsman: As soon as possible! Antiviral medication is most effective when the situation is caught in the first 48 hours.

Q: Is shingles contagious?

Dr. Felsman: If you have shingles, it is possible to spread the chicken pox virus to unvaccinated children or to unvaccinated adults who have never had chicken pox. Keeping your hands washed can greatly reduce the chance of spreading the virus to susceptible people.

Most people already have some immunity, either from being vaccinated or from previously having chicken pox. Children usually get their first Varicella vaccination around 12 months old.

Q: Is shingles dangerous?

Dr. Felsman: Shingles can be dangerous in a patient who is immunocompromised. Although rare, it is possible to get severe infection affecting the brain in some cases. A significant mental status change with confusion or falls are possible.

When shingles affects the face, in about 15% of cases, it can lead to permanent vision loss in one of the eyes. It’s important to get in touch with your provider as soon as possible if you believe shingles is happening on your face, particularly near the eye, forehead or nose.

Q: When someone gets shingles, how long does it typically last?

Dr. Felsman: The rash usually resolves over several days to a few weeks. Be sure to keep the rash covered if possible, and avoiding picking or scratching it.

The pain from shingles can be variable. Some people don’t get much pain at all, and others get pain that’s quite intense and lasting. It could come on weeks ahead of the rash and in some cases can last months after the rash resolves.

Q: Can shingles be prevented?

Dr. Felsman: If you are 50 years of age or older, or if you are immunocompromised and 18 years or older, you may be a candidate for Shingrix, which is a two-part vaccine that is more than 90% effective at preventing shingles. Shingrix came out in 2017, and it was discovered pretty quickly that it was much more effective than the previous vaccine, Zostavax (which is no longer available).

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