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Shingles: Myths and facts– Ogden Clinic provided source, Standard-Examiner Health & Wellness 6/27/2015

OGDEN - It’s inevitable. The longer you live, the more at risk you are to contract shingles.

But you don’t have to suffer with the painful virus. Here are some of the myths surrounding shingles, followed by the facts, laid out by Dr. Bradley Neuenschwander, a dermatologist at Tanner Clinic, and Chase Bailey, a family nurse practitioner at the Ogden Clinic.

First of all, what are shingles? Shingles is a viral infection that affects the nerve roots of dermatomes in the body, Bailey said. The other name for shingles is varicella-zoster and it is a remnant of the same varicella virus that causes chickenpox.

“In most people, the virus is suppressed after resolution of chickenpox but remains dormant in the nerve root for many years,” Bailey said. “When the immune system is challenged to a degree in which that suppression is unable to be maintained, shingles may develop.”

Shingles also occur following immunosuppression such as in cancer patients or patients taking steroids, Bailey said. Typically shingles begins with a stage called a prodrome in which a nerve like pain is felt in the area in which the rash will develop.

Now, on to the myths:

Myth: You can only get shingles once.

“Developing shingles does not result in immunity, meaning you can still have another attack in the future,” said Neuenschwander. “Some individuals may experience two to three episodes during their life.”

Myth: Shingles is not contagious.

“Shingles is contagious during a period of time in which the vesicular or blister-like lesions are open and weeping,” Bailey said. “During this period of time, patients should stay home and avoid contact with others, as it may spread the virus.”

Neuenschwander said the development of shingles is a reactivation of the chickenpox virus that may be caused by stress, fever, trauma or immunosuppression. The rash you typically see with shingles is made up of blisters. If a susceptible person comes into direct contact with the blister fluid they can become infected with the varicella (chickenpox) virus.

“So, you cannot cause someone to have shingles directly, meaning if you have shingles and I touch your shingles rash, I won’t get shingles, but I can get chickenpox, which could eventually lead to me developing shingles in the future,” he said.

Neuenschwander said roughly 90 percent of people will experience pain, itching or tenderness about four to five days before the rash appears. In addition, Bailey said shingles typically beings with a sensation in the area in which the rash will develop.

Myth: Singles only appears on your torso.

Singles can occur anywhere on the body, including the face, arms, legs, torso and back, Bailey said. Shingles can also appear on the scalp, eyes and ears, Neuenschwander said.

Myth: Shingles goes away after a few days.

Frequently, the rash does resolve within a few weeks; however, the lingering effects on the nerve root may be longstanding, Bailey said. A phenomenon called post-herpetic neuralgia can persist for years, or a lifespan.

Neuenschwander said although the rash of shingles will usually resolve over a few weeks it is best to treat shingles in an effort to minimize complications. Sometimes it can stay longer than expected and be extremely painful and result in scarring, or if it is on the face can permanently affect vision. With advancing age, the risk of developing post-herpetic neuralgia increases greatly. This is described as pain that persists 30 days after the rash has resolved and it can last for months or even years and be quite debilitating. The best time to treat shingles is within the first 48 to 72 hours if possible. This usually consists of taking pills multiple times a day for seven to 10 days.

Myth: You have to just let it run its course.

“No, nor should you allow it to remain untreated if you recognize what the symptoms are,” Bailey said. “Antiviral medications such as a valacyclovir coupled with medication such as prednisone will decrease the severity of the outbreak and prevent post-herpetic neuralgia.”

Myth: You can’t prevent shingles.

“There is no sure-fire way to prevent shingles, but there is a vaccine, Zostavax, that can minimize the risk of developing shingles,” Neuenschwander said. “One study showed that it can reduce overall risk of developing shingles by about 50 percent. It is a one-time vaccine that can be given after the age of 50. However, the CDC recommends getting it after 60 years of age because the protection wanes after five years and efficacy after that is unclear.”