A family friend was with a pal when she noticed something had formed on her arm and leg that looked like a rash. “I didn’t know what it was,” she recalls. Fortunately, she had the presence of mind to go to the doctor’s office and get it checked out. Even the nurse told her she had never seen anything like it. But the doctor knew what it was: shingles. “It’s supposed to be so terrible,” recalls my friend, “and it is.”
The breakout spread further — on her arms and legs, as well as her face. It lasted about six weeks. Thankfully, she didn’t experience what can often manifest: debilitating pain. She also told me of a friend whose daughter had had it, and as she was being taken to a health center, she practically had to jump out of the car because it was so uncomfortable.
If we hear anything at all about shingles in our community, we hear it through the grapevine or via a loved one’s awful experience. What we don’t hear often enough is how simple it can be to protect ourselves from the frequently debilitating condition.
What is shingles?
Shingles is a viral infection caused by the varicella zoster virus, the same virus that causes chickenpox. Once you get chickenpox, which I had as a child, the virus enters the nervous system and remains in the body, lying dormant in nerve cells. Years later the virus may erupt again, and this second eruption is called shingles. According to the Centers for Disease Control and Prevention (CDC), 1 out of 3 people in the U.S. will develop shingles. Like in that shingles commercial, I couldn’t get the shot fast enough.
Not everyone who has had chickenpox will develop shingles. It’s more likely to occur in older adults (50 years and older), although rates have been increasing among younger adults. Also at risk are people with weakened immune systems. Adults 50-plus who have had COVID-19 are also more likely to experience a shingles outbreak.
Get vaccinated. According to the Centers for Disease Control and Prevention, in efforts to help prevent an outbreak of shingles, the Shingrix vaccine is recommended for people age 50 and older whether they’ve had shingles or not. It’s also available to people age 19 and older with weakened immune systems. The vaccine is given in two doses with two to six months between doses. How long protection lasts seems to be debatable, but according to the CDC, immunity is strong for at least the first seven years after vaccination. It doesn’t guarantee you won’t get shingles, but if you do get it, the vaccine will likely lessen the severity and lower the risk of postherpetic neuralgia. If you received the Zostavax vaccine (recently discontinued in the U.S.), as I did, you still need to get two doses of Shingrix. If you can, get the shot in the nondominant arm, because there can be soreness. That was the only side effect I had, but according to the CDC, there can be headache, fever and muscle pain that will resolve in one to three days. You might want to schedule the shots for a Friday and have the weekend to rest. The vaccine is available at some doctors’ offices and many pharmacies. Most private insurance covers it in full or partial for people 50 and older. Shingrix is covered by Medicare Part D and most Medicare Advantage plans, but original Medicare (which is composed of Medicare Part A and Part B only) does not cover the vaccine.
According to Cleveland Clinic, you can also help keep shingles at bay by maintaining a healthy weight and eating a well-balanced diet with plenty of vitamins and nutrients. In addition, B vitamins help maintain a healthy nervous system, according to a study published in the scientific journal CNS Neuroscience & Therapeutics. In a separate study published in the journal Immunotherapy Advances, researchers propose that vitamin D supplements may also offer some protection.
Cleveland Clinic also recommends other healthy lifestyles choices like getting physical and mental exercise, reducing stress, getting seven to nine hours of sleep at night and avoiding unhealthy activities such as smoking.
What are the symptoms?
Early symptoms can be similar to other viral infections, such as fever, headaches, light sensitivity, fatigue and malaise. A noticeable symptom is localized pain in one area of the body. The pain can range from mild to intense, with burning or tingling, itching, stinging and/or sensitivity to touch. A few days after the pain begins, a red rash appears. The rash can be harder to recognize on Black or brown skin, and the small bumps in the affected area might be mistaken for eczema or dermatitis. The area will look discolored, typically purplish, dark pink or dark brown.
Over a period of three to five days, fluid-filled sacs called vesicles, resembling blisters, will form in the affected area of the body, often in a bandlike pattern on the torso, neck or face. You should see your primary care physician as soon as possible, especially if the rash occurs near an eye, because, untreated, it could lead to permanent eye damage. Next, the vesicles break open and crust over. After this happens, it takes from two to four weeks for the area to heal.
Is shingles contagious?
According to the CDC, you can pass the virus on to anyone who is not immune to chickenpox (who hasn’t had chickenpox or the chickenpox vaccine). This is usually through direct contact with the open sores of the shingles rash. (The person will develop chickenpox, not shingles.)
“To treat shingles, dermatologists usually prescribe an oral antiviral called valacyclovir,” says Heather Woolery-Lloyd, M.D., a dermatologist who has treated shingles in Black women. “For best results, treatment should start as early as possible.”
Starting an antiviral (acyclovir, valacyclovir, famciclovir) within 72 hours of the first sign of a shingles rash may shorten shingles and prevent complications, such as postherpetic neuralgia, a common complication that can last for months or years after blisters have cleared.
To help lessen the uncomfortable effects of the rash:
- Apply a cool compress to the area to soothe pain and itching.
- Try over-the-counter medications for pain.
- Use anti-itch products like calamine lotion.
- Resist the urge to scratch, because this can lead to bacterial infections and pigment changes.
“It can take several weeks for the blisters to crust over and heal completely. In darker skin types, after the skin is healed, there may be hyperpigmentation,” Dr. Woolery-Lloyd adds. “This usually resolves but can take months. Dermatologists can prescribe topical fade creams to help speed up this improvement if needed.”