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How to prevent the pain of shingles

This adult form of chicken pox affects more than 1 million people age 60 and up each year

Published: July 2012

Childhood chicken pox has a way of making a comeback—in almost one out of three adults who have had it—in the form of shingles, a painful rash and illness. The varicella zoster virus that causes the disease does not disappear after recovery from chicken pox but lies dormant in the nerve roots of the spine. Medical science does not know what causes the virus to be reactivated, but doctors are seeing more patients with this condition. 

Shingles, also called herpes zoster, should not be confused with the sexually transmitted herpes simplex virus that causes genital herpes or the very common herpes labialis blisters that recur around the lips and mouth.

Shingles may begin with tingling and itching and surface as a painful rash of small blisters or vesicles on one side of the face, body, or legs. The most common and dreaded complication is persistent and recurrent pain in the nerve and muscles of the affected area, a condition known as post-herpetic neuralgia, which can occur for weeks to months after the rash dries up and disappears. The symptoms can be quite debilitating, especially in the elderly, and require chronic pain management.

The majority of the more than 1 million annual cases of shingles occur in people age 60 and up, but it can also appear at any age, especially in people with immune-deficient conditions, HIV, and certain cancers (such as leukemia and lymphoma), and among steroid users and organ transplant recipients.

Fortunately there are both preventative and treatment options for shingles. A single-dose vaccine, Zostavax, was approved by the Food and Drug Administration for people over age 60 in 2006. In March 2011 the FDA also approved the vaccine for people over 50. Vaccination prevents shingles in the majority of recipients and greatly reduces the risk of post-herpetic neuralgia in others. Pregnant woman, people with immune-deficient conditions and certain cancers, and those allergic to neomycin, gelatin, or other vaccine components should not get the vaccine.

People who get shingles are treated first with a prescription anti-viral oral medication, which, especially at the onset of the rash, can help speed healing and reduce complications. For patients suffering with post-herpetic neuralgia, there are several effective medications and pain-management strategies that can assist in recovery.  

It’s important to recognize the signs and symptoms of the uncomfortable rash and see your doctor immediately so that early treatment can improve your outcome. If you are over 60, consider the vaccine option, and find out from your doctor whether you are eligible to receive it.

Editor's Note: Joseph L. Mosquera, M.D., a medical adviser to Consumer Reports, is a board-certified physician trained in integrative medicine.
   

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