Take Action Quickly when Symptoms of Shingles Appear
Mar 30, 2019 10:50AM
● By Kathleen Ganster
Shingles never crossed Jane Siford Mallinder’s mind when she started experiencing pain on her right side.
“Because I’d had many kidney infections in the past, I thought, “Here we go again with another kidney infection,” she said.
Another reason shingles may not have occurred to her was that she’d gotten the shingles vaccine a few years before. But soon it was clear that the pain could be something other than a kidney infection.
“On the way to an urgent care the pain became more severe, so we went to the ER instead. It wasn’t until the next day that I was diagnosed with shingles. The pain by then was unbearable—I suffered for at least 24 hours,” the Cranberry resident said. Siford Mallinder was hospitalized for three days.
While the severity of her case may have been more than most who suffer from shingles have to deal with, the odds are fairly high that you or someone you know will experience the disease. According to the Centers for Disease Control and Prevention, there are an estimated 1 million cases of shingles a year in the U.S., and nearly one out of every three people will develop the disease.
So what exactly is it?
“Shingles is a localized reactivation of the chickenpox virus in the sensory nerves of the skin,” explained Dr. Joseph English III, professor of dermatology at the University of Pittsburgh and medical director of teledermatology, UPMC North Hills Dermatology. “It can affect anyone at any time after the initial chickenpox infection and more commonly occurs in those over the age of 60. This is the time when our natural immunity to the virus decreases. It can also appear during stressful medical or psychological conditions.”
While those over 60 may be likely to develop shingles, younger people are not immune—anyone who has had chickenpox can get shingles. The symptoms of the disease manifest in various ways.
“Shingles may initially present as pain on one side of the body followed by red blotchy patches on the skin that will then develop into blisters but may cause significant itch,” Dr. English said.
Many, like Siford Mallinder, will experience pain on one of their flanks. “The rash began at the naval on my right side, continued around my waist and ended at the back bone,” she said.
Quick action can be key to a faster recovery and avoiding a hospital stint. “Anyone who develops localized pain with or without the initial rash leads most physicians to consider this disease in the differential diagnosis,” said Dr. English. “But if you are over age 60, on systemic immunosuppression or have multiple illnesses, any pain of this nature needs to be brought to the attention of your health care provider.”
The rash usually turns into fluid-filled blisters that can be extremely painful. The blisters will dry out and crust over in several days. For those diagnosed, there are medications that can help ease the pain and length of recovery.
“Your healthcare provider will start an oral antiviral agent such as valacyclovir for a 10-day course. Be sure to take the full prescribed course of medication. If the acute pain is severe, you may also be given pain medication such as nonsteroidal anti-inflammatory, narcotic or neuropathy medications,” said Dr. English.
While Siford Mallinder’s vaccination didn’t prevent a case of the shingles, there is a newer vaccine, Shingrix, which Dr. English recommends for everyone over 60. Unfortunately, there has been a shortage of the new vaccine, causing long wait times.
Anyone suffering from shingles may be contagious to people who have never had chickenpox or the chickenpox vaccination. And unfortunately, those who have had shingles can have them more than once.
“Though most people do not, you can get shingles again. It is recommended that even if you’ve had shingles, you still get the vaccine once you turn 60,” said Dr. English.
Perhaps the worst outcome of shingles can be long-term pain. “Every day I am reminded of that episode by an itching sensation at my waist line on the right side of my body,” said Siford Mallinder.
“Since the virus spreads through your skin’s sensory nerves, there may be continued burning pain or significant itch after the rash and blisters of shingles disappears,” explained Dr. English. “This is a condition known as post-herpetic neuralgia and is due to nerve damage from the reactivation of the virus. It can be severe and become a chronic pain syndrome.”
That is another reason why immediate medical attention is imperative, according to Dr. English. “This is more likely to occur in patients who develop shingles when they are older and fail to seek medical treatment when the pain and rash from shingles first appears.”
For more information, visit https://www.cdc.gov/shingles/about/overview.html.