Avoid the Pain of Shingles

Anyone who has recovered from chickenpox can develop shingles

Veteran in an exam room talking to a member of his primary care team The same virus that causes chickenpox causes shingles. Shingles is a painful recurrence of the original chickenpox infection. Yet not everyone who had chickenpox will develop shingles.

Some people have the virus hiding in their nerve tissue. If conditions are right, the virus "awakens." This may cause a few blisters on the skin or a big rash that is typically on one side of the body. The rash can occur on any part of the body. In healthy people, the rash usually goes away in 2 to 4 weeks, but the pain can last longer. Pain that lasts after the rash has cleared is called postherpetic neuralgia.

What are the risk factors for shingles?

Anyone who has had chickenpox can develop shingles. But your risk is greater if any of these are true:

  • You are age 50 or older.

  • You have an illness that weakens your immune system.

  • You have cancer, especially leukemia or lymphoma.

  • You take medicines that suppress your immune system, such as steroids or those given after an organ transplant.

Can shingles be prevented?

A vaccine reduces your risk of getting shingles. Half as many people get shingles after being vaccinated. Among those who are vaccinated and then develop shingles, only one third develop postherpetic neuralgia. If you're older when you're vaccinated and you get shingles, your outbreak will be less severe.

How do you know when shingles is coming on?

The early signs of shingles can easily be mistaken for another illness. You may be familiar with some of them: 

  • Burning or shooting pain in the skin 

  • A numb or tingling feeling 

  • Mild flu-like symptoms

  • A rash or cluster of blisters (seen later) 

For most people, shingles will disappear without major problems, but there is a chance you can develop postherpetic neuralgia.

What is the treatment for shingles?

Quick treatment with an antiviral drug decreases the severity and length of time of acute pain. Antivirals work best when taken 24 to 72 hours after the rash appears. Corticosteroids and pain relievers may provide pain control.

What causes postherpetic neuralgia?

After-shingles pain occurs because the virus that causes shingles damages specific nerves in your body underneath the skin. Severe pain can occur on or around the rash. It's often described as burning, aching, itching, or sharp. The pain can last for a long time, even months or years after the infection resolves.

Who is most likely to develop postherpetic neuralgia?

Your chances of developing after-shingles pain increase with age.

  • If you're over 50, you have a more than 50% chance of developing after-shingles pain.

  • If you're over 80, you have an 80% chance of developing after-shingles pain.

Others at higher risk include those who had felt pain before the rash appeared. Those who have had a severe rash within a few days of shingles infection are also at higher risk.

How serious is postherpetic neuralgia?

Postherpetic neuralgia may cause your skin to become sensitive to changes in temperature. You may find the feeling of clothing painful. Daily tasks such as bathing, dressing, and grooming may be unpleasant. Severe after-shingles pain can limit activities like shopping, cooking, traveling, and sports.

Is there a treatment for postherpetic neuralgia?

The good news is help is available. Effective treatment choices, including getting enough rest and taking medications, may relieve after-shingles pain. Each medication works differently and has its own benefits.

If you’re suffering from shingles or after-shingles pain, it’s important to schedule an appointment with your health care provider. Make sure to reach out to your doctor using Secure Messaging if you need to talk about managing the pain.

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Read More

Shingles (Herpes Zoster) Veterans Health Library

Shingles Vaccine: Should I Get It? (Mayo Clinic)

Vaccines and Immunization (VA Public Health)

Updated June 6, 2023