Chicken pox once was considered a childhood rite of passage, yet few of us expect to experience a second eruption of the same virus. But this itchy and painful condition, known as shingles, strikes one in three adults during their lifetime.
Its hallmark is a rash that appears as a band or a patch of raised dots, usually on one side of the body. The rash eventually develops into red, fluid-filled, round, painful blisters that dry out within a few days or weeks.
Why it happens
The varicella zoster virus (VZV), responsible for both diseases, doesn’t leave the body when chicken pox resolves. Instead, it settles quietly into nerve cells near the spinal cord for a potential reappearance. This can happen when our immune systems are compromised.
The greatest risk factor is age, says Cleveland Clinic anesthesiology and pain management specialistBenjamin Abraham, MD, who treats patients at Elyria Family Health Center and Marymount Hospital. “As we age, our immune system doesn’t work as well,” he says, adding that the risk is especially high in those age 70 and older.
Dr. Abraham says the virus can be reactivated in times of stress. This can also happen when a person’s immune system is repressed, which can occur in those with cancer, HIV, or in those who have had an organ transplant.
What you can do
Because it’s a virus, there is no cure for shingles. However, most sufferers can weather the illness relatively comfortably, Dr. Abraham says. Much depends on how severe a person’s symptoms are and how early the diagnosis is made.
“Prompt diagnosis and treatment of shingles is important,” says Dr. Abraham. “Studies have shown that when the rash is treated with prescription antivirus medications within 48-72 hours, the symptoms don’t last as long and complication rates go down,” he adds.
How to address pain and itching
Most people with shingles recover completely and can resume their normal routine after a few weeks. But some shingles sufferers develop a chronic pain condition, sometimes accompanied by persistent itching, that long outlasts the initial outbreak — or that crops up weeks or months later. This condition is called postherpetic neuralgia (PHN).
Fortunately, relief is available. Dr. Abraham recommends seeing a doctor at the first sign of PHN to keep it from worsening.
- Antiviral medications, which may cut the duration of the PHN
- Anticonvulsant drugs, which decrease the abnormal firing of nerve cells and can break the “pain cycle”
- Epidural steroid injections to reduce inflammation in the painful area
- Topical anesthetics, such as lidocaine or capsaicin cream
If you have concerns that you have shingles, see your doctor as soon as you can. The earlier the diagnosis, the sooner treatment can begin.
–Chronic Conditions Team, health.clevelandclinic.org