Wallet in back pocket

Source: Pond5

It was the beginning of a Labor Day weekend when Al felt a strange sensation on his right buttock, just underneath his back pocket where he carried his wallet. It was kind of sore and kind of itchy.

Although it wasn’t easy to do, he took a look and saw a red area. He figured his skin was irritated from rubbing against the corner of his wallet.

The red area got larger and the painful itch became more intense. Al hated to bother his doctor on a holiday weekend, so he waited three days to call for an appointment.

One glance and his doctor knew immediately that he had shingles.

What is shingles?

Shingles is a painful skin rash that is caused by the varicella-zoster virus — the same virus that causes chickenpox.

Shingles rash

Source: CDC/Joe Miller

What are the signs and symptoms?

The rash on just one side of Al’s body is typical of shingles. Usually, it will look like a stripe of blisters that wraps around one side of the trunk from back to front. Sometimes it appears near one eye or on one side of the neck or face.

The Mayo Clinic list these symptoms:

  • Pain, burning, numbness or tingling
  • Sensitivity to touch
  • A red rash that begins a few days after the pain
  • Fluid-filled blisters that break open and crust over
  • Itching

Some people also have:

  • Fever
  • Headache
  • Light sensitivity
  • Fatigue

Who gets shingles?

If you’ve ever had chickenpox, you’re at risk of developing shingles. That’s because the virus can lie dormant in your nervous system for years.

It’s not know for sure what can reactivate the virus, but some people seem to be at greater risk than others.

People of all ages can get shingles, even children, but it’s more common in older people. About half of all cases occur in people 60 years old or older. That may be because with age, the immune system weakens.

Other people at increased risk include those who:

  • have weakened immune systems because of certain medical conditions, such as HIV or cancers like leukemia and lymphoma.
  • are on immunosuppressive drugs, such as steroids and drugs that are given after an organ transplant to prevent rejection.
  • are undergoing radiation or chemotherapy treatments.

Is shingles contagious?

Shingles is not contagious, but you can pass on the varicella-zoster virus to someone who has never had chickenpox. That person won’t get shingles but may get chickenpox. While it’s usually a mild disease in children, chickenpox is often more severe in adults.

The virus can be transmitted through direct contact with the fluid in the blisters that are part of the rash. Once the blisters are dry and crusted over, which usually takes about seven to 10 days, the person is no longer contagious.

To lower the risk of infecting someone else, the CDC recommends that you:

  • Keep the rash covered
  • Avoid touching or scratching the rash
  • Wash your hands often
  • Until the rash has crusted over, avoid contact with
    • pregnant women who’ve never had chickenpox or the chickenpox vaccine
    • premature or low birth weight infants
    • people with weakened immune systems

How is shingles treated?

The usual course of treatment is an antiviral medication.

Because shingles can be pretty painful, your doctor may also prescribe pain relieving medications.

Shingles isn’t curable, but treatment can lower the risk of complications. The sooner it is started, the better. Because Al waited, he needed to go into the hospital to receive the anti-viral medication intravenously.

Shingles usually lasts between two and six weeks. If you get it once, you’re not likely to get it again, although it is possible to get it two or three times.

Possible complications

  • Postherpetic neuralgia or lingering pain in the area of the shingles rash is the most common complication. Unfortunately, even with treatment, Al developed postherpetic neuralgia, which lasted for many years.
  • Vision loss if shingles is near an eye and causes an infection
  • Bacterial infection in the skin if the blisters aren’t properly treated.
  • Neurological problems, such as encephalitis, facial paralysis and hearing or balance problems.

Prevention in older people

The CDC recommends that people 60 and older get the shingles vaccine. It doesn’t guarantee you won’t get shingles, but it should lessen the length and severity of the disease and reduce the risk of postherpetic neuralgia.

For more information about the vaccine, visit the CDC website.

A lesson learned

If we can learn anything from Al’s experience, it’s that you should contact your doctor right away if you think you might have shingles. You should be especially cautious if:

  • you’re 70 or older because the risk of complications increases with age.
  • the pain and rash is near your eye.
  • you or someone in your family has a weakened immune system.
  • the rash is widespread and extremely painful.

This post was originally written for the Advantage Home Care Aging in Place blog, which I also write. Advantage Home Care provides services throughout Southern Maine to help elderly people live independently at home.