Learn about shingles and how you can protect yourself from this viral infection with the shingles vaccine.
The first thing Mike noticed was a strange sensation on the back of his head. It almost felt like his scalp—on the left side of his head—was buzzing. He wondered if it was just a touch of dry scalp.
Then it began to itch—a lot.
“It was a weird sensation, and I was so puzzled that I considered possible allergies and I even washed the bedding the next day,” he explained.
Then came the bumps.
His wife could see raised bumps near the base of his skull, on the left side of his head.
They weren’t red, but they were visible.
By the next day they had turned red. “And that’s when the shooting pain started,” said Mike. “It was like a hot needle stabbing through the skin, but from the inside out. Definitely one of the worst pains I have experienced.”
Not only that, but the bumps began to spread, up the back of his skull and outward, towards the left side of his face.
He decided he needed to see a doctor to figure out what was going on. So, he headed to the urgent care where the doctor diagnosed it immediately. He had shingles.
Also known as herpes zoster—shingles is a viral infection. It’s caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Anyone who has had chickenpox can get shingles. That’s because even after you’ve recovered from chickenpox, the virus remains in your body. It lies dormant in your nervous system, which includes your nerves, as well as your brain and spinal cord. It’s not active, but it may reactivate at some point in the future as shingles.
A chickenpox vaccine became available in the United States in 1995. But before that, there was no vaccine, and each year about 4 million people would get chickenpox. That means many adults in the United States have had chickenpox. In fact, almost every adult born before 1980 has had it, according to the Centers for Disease Control and Prevention. As a result, most older adults are at risk of shingles. And nearly one in 3 adults will get shingles.
That’s what happened to Mike. He had chickenpox when he was around 3 years old. And almost 50 years later—when he was 52—he experienced shingles.
What are the symptoms of shingles?
The shingles rash is the most common and easy-to-spot symptom. The rash is made up of fluid-filled blisters. These blisters break open and scab over, often in a week or two. They tend to appear on only one side of your body, often near your torso. But they can appear anywhere on your body, including your face. Symptoms tend to last for a few weeks, and may also include:
- Pain or sensitivity
- A feeling of burning, tingling, or numbness
- Itching
- Fever
- Headache
Are there potential complications?
While some cases are mild, that’s not always the case, unfortunately.
Some people have nerve pain that lingers, even after the rash has cleared up. This is known as postherpetic neuralgia (PHN). It is the most common complication. PHN can last for months—or even years. And the pain can be excruciating.
If the shingles rash appears on your face, it can affect your eyes. It might affect your cornea, causing scarring, infections, and other damage. Or it might affect your retina or your optic nerve, causing infections and inflammation. In either case, it can damage your vision or potentially lead to vision loss.
The shingles rash can also affect the facial nerve close to one of your ears. This is known as Ramsay Hunt syndrome. It can lead to hearing loss and facial paralysis on the side of your face that’s affected. Ramsay Hunt syndrome is not common, but you may have seen headlines about it recently. That’s because pop star Justin Bieber announced that he was diagnosed with it in June 2022.
Shingles can also, in rare cases, lead to pneumonia and brain inflammation.
And in very rare cases, it can even cause death.
Who is at risk of shingles?
As mentioned, if you had chickenpox in the past, you may be at risk of shingles.What causes the chickenpox virus to reactivate and cause shingles is not clear. But it seems that it has something to do with your immune system. The most common risk factors include:
- Age: As you get older, your immune system gets weaker. If you’re over the age of 50, you have a higher risk of shingles.
- Certain diseases: HIV/AIDS and other diseases that attack your immune system can raise your risk of shingles.
- Chemotherapy and radiation: These cancer treatments can hamper your immune system and make you more susceptible to shingles.
- Certain medicines: Steroids and other drugs that suppress your immune system can increase your risk of shingles.
Learn more about your immune system and steps you can take to keep it in fighting shape.
Is there a shingles vaccine?
Yes—there is a vaccine that is very effective at preventing shingles. It’s called Shingrix. It comes in the form of a shot that you get in your upper arm. You receive 2 doses—the second dose 2 to 6 months after the first.
Experts recommend that you get the Shingrix vaccine at the age of 50. But you may be able to receive the vaccine earlier if you have a weakened immune system.
An older vaccine—known as Zostavax—was phased out in the United States in 2020.
Getting the shingles vaccine is the best way to prevent shingles. And if you do still get shingles, being vaccinated makes it much more likely that it will only be a mild case.
You’re also more likely to avoid complications like PHN.
You’re able to get vaccinated with Shingrix even if you:
- Are older than 50
- Have already had shingles
- Got the Zostavax vaccine, or
- Had the chickenpox vaccine
Private insurance plans cover the shingles vaccine as a type of preventive care. Just be sure to go to an in-network provider. The shingles vaccine is also covered by most Medicare prescription drug plans (Medicare Part D). But check your coverage to be sure. You may have to pay a small out-of-pocket fee. The full cost of the vaccine, without coverage, is around $200.
Are there treatments?
If you think you have shingles, see your doctor right away. It is especially vital that you do so if you notice the shingles rash near your face. In most cases, your doctor can diagnose you based solely on your symptoms. If it turns out you do have shingles, your doctor will advise you on treatment options.
There are treatments that can help you manage any symptoms and heal more quickly. These won’t cure the infection. But they can make you more comfortable and reduce your risk of complications.
Antiviral drugs are the main form of treatment. These work best if you take them right away. They require a prescription from your doctor.
Other treatments your doctor might recommend include:
- Pain relievers, including topical pain relievers
- Steroids, to reduce inflammation
- Antihistamines, to reduce itching
Is it contagious?
Yes. If you have shingles, you are contagious. The fluid in the blisters contains the varicella-zoster virus. If someone who has never had chickenpox were to come into contact with that fluid, they could catch the virus and get chickenpox. Not shingles—but chickenpox. (However, once they’ve had chickenpox, they would also be at risk of getting shingles.)
In order to guard against spreading the virus, you just need to keep any blisters covered. Still, if you have shingles, it’s best to avoid contact with people who have not had chickenpox or who have not had the chickenpox vaccine. It’s also best to avoid contact with anyone with a weakened immune system, as well as babies and pregnant women.
As soon as the blisters have scabbed over, you are no longer contagious.
Talk with your doctor about the shingles vaccine
Mike’s case is a cautionary tale. Though he was eligible to receive the vaccine when he turned 50, he hadn’t gotten around to it. He thought he had time, “… but I sure was wrong about that,” he said.
Thankfully, though, he caught it early. Because he went to urgent care shortly after noticing symptoms, he was able to start treatment quickly. His doctor prescribed an antiviral that he took for 7 days. Though his rash had been spreading toward his face, it didn’t really advance past his hairline. His vision wasn’t affected, nor was his facial nerve.
Still, he admits, “the pain was awful.” He got acupuncture treatments to manage the pain, and he found those helpful.
After about 3 weeks, the infection subsided. And he hasn’t experienced any lingering nerve pain, luckily.
“I definitely recommend getting the vaccine,” Mike said. “If I could do it all over again, I would have asked my doctor for the shot.”
If you haven’t already been vaccinated, ask your doctor about the shingles vaccine. Your doctor can tell you more about the shingles virus, answer any questions you might have, and vaccinate you, if you decide that’s the right choice for you.
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This information is not intended to take the place of regular medical care or advice. Please check with your doctor before using this information or beginning any self-care program. Mike is not a member of the Silver&Fit Program. Images used for this article do not depict Mike nor any members of the Silver&Fit Program. Shingrix is a registered trademark of GlaxoSmithKline Biologicals, S.A. Zostava is a registered trademark of Merck Sharpe & Dohme Corp.
References
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This article was written by Nora Byrne, edited by Jason Nielsen, and clinically reviewed by Jossue Ortiz, DC.
