While much unknown about shingles, vaccines remain the best defense

Mar 30, 2014

Imagine getting a skin rash so painful that it compares to the intensity of pain associated with childbirth and kidney stones. The Center for Disease Control says that shingles can cause this kind of pain, and that one in three Americans will get it in their lifetime. Why exactly does shingles cause this kind of pain, and what is being done to prevent and treat it?

This week on Take Care, Dr. Pritish Tosh discusses the skin rash known as shingles. Dr. Tosh is assistant professor of medicine at the Mayo Clinic where he has collaborated with the Vaccine Research Group in basic science vaccine development. He’s a leading expert on emerging infections and preparedness activities related to them.

Click 'Read More' to hear our interview with Dr. Tosh.

Getting the virus that causes shingles can happen decades before shingles actually appear. The virus responsible for shingles is the varicella zoster virus, which also causes chickenpox in children. Once this virus enters the body, it stays there forever, residing mostly in nerves. While most people’s immune systems can hold it off from attacking the body after chickenpox occurs, some cannot.

“Over time, especially with older age and sometimes if people are taking medication to lower their immunity, the virus can sort of escape the immune system and erupt into shingles,” says Dr. Tosh.

Shingles often appears in the form of a blistering skin rash. This rash can appear anywhere, but usually only shows on one side of the body. While the rash generally disappears in a week, some report that an intense pain may linger.

The source of this pain, known as postherpetic neuralgia, comes from the nerves the virus affects. It can linger for weeks to months after the rash disappears, and has the potential to cause depression, anxiety and loss of appetite, and can interfere with a person’s daily routine.

While there is still much to discover about shingles, Dr. Tosh says the best form of prevention is to get a shingles vaccine.

“The vaccine has been able to reduce the amount of shingles by about 50 percent, but also, more importantly, reduce the postherpetic neuralgia by about two-thirds,” he says.

Because the risk of getting shingles increases with age, Dr. Tosh says that everyone over the age of 50 should get the shot, regardless of whether they have had chickenpox or not. Even people who never have had chickenpox can still be harboring the virus in their body. Maintaining good health (eating healthy, getting an annual flu shot, etc.) can also aide in prevention by keeping the immune system strong.

For those who get shingles, Dr. Tosh says there are antiviral and neurologic pain medications that are available to help treat both the infection and the pain that comes afterwards.

Shingles is contagious, and Dr. Tosh cautions that, “people who are at a high risk of developing infection from the virus itself, so pregnant women and people who are highly immunocompromised, they should stay away from people who have active shingle lesions.”