Shingles Symptoms & Prevention

If you had those tell-tale blisters and rash of chickenpox as a child, you face a significant risk for eventually developing shingles, as the rashes and blisters accompanying shingles are caused by the same virus that causes chickenpox.

Shingles is a severely painful, blistering skin rash that in rare cases can cause life-threatening complications.

Learn how more about shingles, including how common shingles is, the early symptoms of shingles, potential complications of shingles, what to do if you have possible shingles symptoms, and how you can prevent shingles if you had chickenpox earlier in life.

What Is Shingles?

A shingles infection is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. Anyone who has had chickenpox has VZV present in their body. Once a person contracts that virus — as nearly every American born before 1980 has — it remains dormant in the body, hiding out in the nerves. 

“We have all had chicken pox at some point in our life and sometimes maybe we don't remember it, it could have been a milder version,” said Narayan Prabhakar, MD, a board-certified family medicine doctor practicing at Franciscan Physician Network in Dyer.

While the virus usually lies dormant, if it reactivates, then a case of shingles results.

“Shingles is basically the chicken pox virus getting reactivated,” Dr. Prabhakar said. “It can happen at any age really, but it's usually seen as you get older, or if you have any sort of immune conditions, any conditions that lower your immune response, immune system, then you may be more prone to get shingles.”

How Common Is Shingles?

Shingles is an extremely common condition. About one-third of Americans will develop shingles in their lifetime, according to the U.S. Centers for Disease Control and Prevention. Your risk of developing shingles increases as you age.

More than a million cases of shingles are diagnosed in the United States every year, according to the American Academy of Dermatology.

What Are Risk Factors For Shingles?

“More than 50% of shingles cases occur in those above the age of 60,” said Rajarajeswari Majety, MD, a Franciscan Health physician specializing in internal medicine and geriatric medicine in Crown Point. “Age is a major risk factor in developing shingles.”

“If you're going through stress, in your body, or some reason your immune system is lowered, that would also increase your chance of getting shingles,” Dr. Prabhakar added.

What Triggers A Shingles Outbreak?

Generally, your immune system keeps the varicella-zoster virus in check. But when a person's immune function weakens or is compromised — due to age, illness or medications, for instance — the varicella zoster virus can reactivate, causing shingles. As people age, their immune system naturally becomes less robust – leading to the rise in shingles cases as people get older.

Research has suggested a link between stress and shingles since periods of high stress can also compromise the body’s immune system. 

“We know that anything that can weaken your immune system could then cause the virus that was lying dormant to resurface and reactivate – and therefore an association could be drawn between emotional or physical stress and a shingles outbreak,” Dr. Majety said.  

What Are Symptoms Of Shingles?

The most common symptom of shingles is a painful skin rash consisting of fluid-filled blisters. Patients infected with shingles develop a painful red rash – sometimes with pronounced, fluid-filled blisters – that affects only one side of the body or one side of the face. That rash usually clears up in a few weeks.

“Usually you get a rash, but in some cases you may get the pain or discomfort or itching in the area before the rash even occurs,” Dr. Prabhakar said. “Sometimes that could cause confusion, you don't know what's going on.

“It's usually one sided. You may get this discomfort, irritation of your skin. You could also get some kind of flu like kind of symptoms as well, potentially. And then a few days later, you get a rash in that area.”

What Does A Shingles Rash Look Like?

“They kind of look like blisters that could be in groups, scattered on one side, following along what we call a dermatomal pattern. The most common sites are along the chest wall area, but you can really get it on any part of the body. You can get on your face as well, which is quite often. Usually it's on the trunk of the body.

“It's usually only on one side of the body. If it's on both sides of the body, it crosses the midline then it's not shingles.”

What Are Other Signs Of Shingles?

• A severe burning or tingling sensation with the rash, to the point that the person who has shingles cannot bear to have anything touch the affected area, even clothing.
• Headaches
• Fatigue
• Fevers
• Chills.

Most shingles outbreaks last for three to five weeks, but the pain in the area could last much longer. It is possible to develop shingles again, even after you’ve had it once.

What Should I Do If I Have Early Symptoms Of Shingles?

If you feel you could be developing a case of shingles, don’t put off visiting your physician. Your doctor can prescribe antiviral medications to reduce the severity of shingles – and decrease the likelihood that you could develop long-term complications.

“We can assess for shingles complications like zoster ophthalmicus, determine if you are a patient who could be at higher risk for complications from shingles, and educate you on what to expect in the course of this condition,” Dr. Majety said.

Even people who are tolerating their shingles pain well should see a physician at the first sign of the rash. Your doctor will conduct a physical exam to rule out complications associated with the shingles virus.

“I always recommend patients come in early and discuss whether available antivirals are right for them, since these medications are more effective the earlier you start taking them after the initial presentation of the shingles rash,” Dr. Majety said.

Is There A Shingles Vaccine?

You can help prevent shingles can be done in part by having a shingles vaccine (zoster recombinant vaccine). The  shingles vaccine is recommended for adults 50 and older and for younger people and up who have a weakened immune system.

“The best way to prevent shingles is to emphasize vaccination,” Dr. Majety said.

The CDC recommends the shingles vaccine for all healthy adults ages 50 and older. Even those who have had shingles before can get the vaccine to reduce their chances of getting shingles again.

The current FDA-approved shingles vaccine, Shingrix, is a recombinant vaccine given in two doses – ideally between two and six months apart.

Shingrix was first administered in 2017, so patients who received a shingles vaccine before then likely received Zostavax, a single-shot vaccine that is no longer prescribed in the U.S.

“Zostavax was phased out because it was not as effective as Shingrix,” Dr. Majety said. “Shingrix can decrease the prevalence of shingles by approximately 90%. And it can decrease the incidence of postherpetic neuralgia by also about 90%.”

Patients over age 50 who previously received the Zostavax vaccine should consider taking the new Shingrix vaccine to decrease their risk of developing shingles.

“If you have taken the old vaccine, we still want to offer you the recombinant shingles vaccine that we have right now,” Dr. Majety said.

If you have never had chickenpox and had not been vaccinated for chickenpox, the CDC recommends two doses of chickenpox vaccine for children, adolescents, and adults to prevent the spread of the varicella-zoster virus and to reduce symptoms of chickenpox if you were infected.

Are There Side Effects To The Shingles Vaccine?

“Side effects are pretty much like most of these other vaccines, like the flu shot or COVID shot," Dr Prabhakar said. "You get some flu-like symptoms, your arm's going be a little sore for a few days, maybe you may get a low grade fever, but that's about it. It's pretty self-limited, and then you're fine. Or you may not even get any symptoms.

“You can get some bigger complications with shingles too, like the pain is the biggest issue which can linger for weeks. I've seen sometimes people have had to take off work for like a few weeks because the pain was pretty debilitating. So why deal with that, you know, when this vaccine is 90 percent effective?”

Is Shingles Contagious?

While chickenpox can be spread by direct contact with or respiratory secretions from another person who is infected, you cannot give shingles directly to someone else.

However, if your rash has fluid-filled vesicles and has not yet crusted over, then contact with the fluid from your blisters could spread the varicella-zoster virus to those around you, making them susceptible to developing chickenpox if they are unvaccinated or have not previously had chickenpox. They can then still get shingles later in life.

As a result, healthcare providers recommend that patients with an active shingles outbreak take steps to avoid contact with young babies or others in their family who may be immunocompromised.

By understanding the risks and taking preventative measures, you can significantly reduce your chances of experiencing the discomfort and complications associated with shingles. Remember, prevention is key. Consult with your healthcare provider to determine if the shingles vaccine is right for you.