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What Patients Need to Know About the Shingles and the Shingles Vaccine

How are shingles and chicken pox related? Do you need the shingles vaccine?

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Updated July 17, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

The shingles rash can be very painful, lasting for many weeks, or more.

The shingles rash can be very painful, lasting for many weeks, or more.

Wikimedia, through Creative Commons

If you had chicken pox (varicella) as a child, then you are at risk for contracting shingles as an adult.

Yes - that seems backward. And most of us think, incorrectly, that it's the other way around, that you can only get shingles if you didn't have chicken pox. Since most of us over the age of 20 had chicken pox as children, that means that most people reading this article are at risk of developing shingles.

What Is Shingles?

Shingles is a virus. Its Latin name is herpes zoster (not the same as genital herpes or the mouth sores we also call herpes). It is a painful inflammation of the nerves and a painful, red, inflamed rash on one's skin. Its symptoms may include the rash, plus fever, headache, chills and sometimes stomach upset.

The rash itself is the very telltale sign that makes diagnosis fairly easy. It usually starts on one side of the body or the face as a tingling, itching or pain for a few days before the actual rash appears. Once the rash appears, it will be quite painful. Shingles will last for 2 to 4 weeks, or even longer - even for years. It can spread to the eyes, and it can cause a loss of vision. Eventually the rash will scab over.

Shingles will develop in someone who had chicken pox as a child because the virus that causes chicken pox, called vericella zoster, never really disappears from one's body. It lies dormant until something triggers its reappearance as shingles.

Shingles can be developed more than once in a lifetime.

Who Will Get Shingles? How Contagious Is It?

Most shingles patients are over the age of 60, although younger people, even children, can develop it. Almost one-third of adults suffer with it at some point in their lives, which adds up to about a million Americans developing shingles each year.

There seem to be a handful of triggers for the appearance of shingles. Patients with immune deficiencies caused by diseases such as HIV or cancer will be more at risk of developing shingles than others. Patients who take steroids or other immunosupressants are at higher risk, including those who have had an organ transplant. Stress is known as a trigger, too. But some patients develop shingles without ever knowing what caused it to flare up.

Shingles can be contagious, but not in the ways we see other diseases being contagious.

Shingles is not spread from one person to another as shingles if that other person had chicken pox in the past.

The virus that causes shingles can be spread to another person through direct contact with the rash if the other person never had chicken pox or the chicken pox vaccine. But that person will develop chicken pox, and not shingles. An example would be a grandparent who develops shingles, then exposes her unvaccinated grandchild, who then develops chicken pox.

Shingles is not contagious once it has scabbed over.

What Is the Treatment for Shingles?

There are some antiviral drugs available to lessen the pain and relieve the other symptoms associated with shingles. If you think you may have shingles, contact your doctor right away since the sooner you begin taking the medicine, the easier it may be to weather the disease.

The best treatment is prevention - the shingles vaccine.

Prevent Shingles With the Shingles Vaccine

The vaccine for shingles, called Zostavax (zoster vaccine live), was approved in 2006 for people over the age of 60, and in 2011 for people age 50 to 59. Results reported during the FDA approval process show that vaccination cuts the risk of acquiring shingles by 70%.

There are some patients for whom the shingles vaccine is contraindicated. If you are allergic to gelatin or the antibiotic neomycin, the vaccine should be avoided. As always, discuss options with your doctor.

Some pharmacies are now offering the shingles vaccine, over the counter, making the shingles vaccine as convenient as the flu vaccine. Do check with your primary care physician before you choose to be vaccinated at the pharmacy.

Be advised that not all insurances cover the cost of the shingles vaccine. Double check with your insurance company before you get the vaccine. But remember, that even if your insurance doesn't cover the cost, it may be less expensive to be vaccinated than it will be for all the doctor visits, drugs and lost work time you may accrue should you develop shingles.

Learn more about shingles from other About.com Guides:

• Find a series of shingles photos from Guide to Dermatology

• Learn more about treating shingles pain from the Guide to Pediatrics

• Learn more about alternative natural remedies from the Guide to Alternative Medicine

Sources:

Vaccine for the Prevention of Shingles from the AAFP Shingles information from the CDC
Information about Zostavax from the FDA

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