More than 90 percent of American adults have had chickenpox, which means they could develop shingles. The frequency and severity of shingles increases with age, according to the American Pain Foundation (APF), which sponsored the new survey.
Of the estimated 1 million cases of shingles diagnosed each year in the United States, 40 percent to 50 percent occur in people aged 60 and older.
The survey included 1,465 older people, including 401 who said they'd had shingles in the past. Among the 1,064 respondents who did not report having had shingles:
- 85 percent (905 people) said they'd heard of shingles, but only 8 percent said they knew a lot about the disease.
- 53 percent of the 905 respondents who reported having heard of shingles weren't sure about the risk factors for shingles. Only a few correctly identified having had chickenpox (14 percent) or age (3 percent) as risk factors.
- 60 percent of the 905 people who said they'd heard of shingles said they weren't aware that shingles can lead to chronic pain in some people. This pain can last for months or even years after the rash phase of the disease.
Among the 401 people who reported having had shingles:
- 88 percent reported having a rash or blisters during their shingles episode.
- Many reported that they experienced severe (35 percent), very severe (11 percent), or intolerable (6 percent) pain during the first weeks of having shingles.
In an effort to improve public awareness about shingles, the APF has launched a national health education program, "Spotlight on Shingles." It recommends that older Americans who've had chickenpox talk to their doctor or another health-care provider about their risk for shingles.
What is Shingles?
Shingles is a disease that affects nerves and causes pain and blisters in adults. It is caused by the same varicella-zoster virus that causes chickenpox. After you recover from chickenpox, the virus does not leave your body, but continues to live in some nerve cells. For reasons that aren’t totally understood, the virus can become active instead of remaining inactive. When it’s activated, it produces shingles.
Just like chickenpox, people with shingles will feel sick and have a rash on their body or face. The major difference is that chickenpox is a childhood illness, while shingles targets older people. Most adults live with the virus in their body and never get shingles. But about one in five people who have had chickenpox will get shingles later in life—usually after the age of 50.
When the activated virus travels along the path of a nerve to the surface of the skin, a rash will appear. It usually shows up as a band on one side of the face or body. The word “shingles” comes from the Latin word for belt or girdle because often the rash is shaped like a belt.
Who Is at Risk?
Anyone with the varicella-zoster virus in their body can be at risk for getting shingles. Right now there is no way of knowing who will get the disease. But, there are things that make you more likely to get shingles.
- Advanced age. The risk of getting shingles increases as you age. People have a hard time fighting off infections as they get older. The chance of getting shingles becomes much higher by age 70.
- Trouble fighting infections. Your immune system is the part of your body that fights off infections. Age can affect your immune system. So can an HIV infection, cancer, cancer drugs, radiation treatments, or organ transplant. Even stress or a cold can weaken your immune system for a short time and put you at risk for shingles.
What Are the Symptoms of Shingles?
Most people have some of the following symptoms.
- Burning, tingling, or numbness of the skin
- Feeling sick—chills, fever, upset stomach, or headache
- Fluid-filled blisters
- Skin that is sensitive to touch
- Mild itching to strong pain
Shingles follows a pattern. A few days after the tingling or burning feeling on the skin, a red rash will come out on your body, face, or neck. In a few days, the rash will turn into fluid-filled blisters. The blisters dry up and crust over within several days. The rash usually happens on one side of the body. Most cases of shingles last from 3 to 5 weeks.
Do You Need A Doctor?
George, age 67, had a red rash on his face and felt sick. His wife urged him to see a doctor, but he told her, “It’s just a rash. I’ll be all right in a few days.” His wife insisted that he go to the doctor. The doctor told George that he had shingles and ordered some medicine for him.
It’s important to go to your doctor no later than 3 days after the rash starts. The doctor needs to see the rash to confirm what you have and make a treatment plan. Although there is no cure for shingles, early treatment with drugs that fight the virus can help. Shingles can often be treated at home. Patients with shingles rarely need to stay in a hospital.
How Is Shingles Treated?
For people with severe symptoms, there are many medications your doctor can prescribe to treat shingles. These include medicines that:
- Fight the virus—antiviral drugs
- Lessen pain and shorten the time you’re sick—steroids
- Help with pain relief—antidepressants and anticonvulsants
- Reduce pain—analgesics
When started within 72 hours of getting the rash, these medicines help shorten the length of the infection and lower the risk of other problems.
Prevent Shingles – A Vaccine
A new way to keep you from getting shingles has recently been approved by the Food and Drug Administration. You should ask your doctor if the new shingles vaccine is right for you. It is available for ages 60 and older.
Why Does the Pain Go On and On?
After the rash goes away, some people may be left with long lasting pain called post-herpetic neuralgia or PHN. The pain is felt in the same area where the rash had been. For some people, PHN is the longest lasting and worst part of shingles. The pain can make some people feel weak and unable to do things they usually enjoy. Those who have had PHN say the pain is sharp, throbbing, or stabbing. Their skin is so sensitive they can’t bear to wear even soft, light clothing. People who have PHN call it a pain that won’t go away.
The older you are when you get shingles, the greater your chance of developing PHN. This pain can last for weeks, months, or even years.
“I’ve had post-herpetic neuralgia for nine months,” said Pete, an 80-year-old man. “I’ve lost 20 pounds. I can’t find anything that helps with the pain.”
The PHN pain can cause depression, anxiety, sleeplessness, and weight loss. Some people with PHN find it hard to go about their daily activities like dressing, cooking, and eating. Talk to your doctor if you have any of these problems. There are medicines that may help. Usually PHN will get better over time.
What Are Other Complications?
In some cases, blisters can become infected. Scarring of the skin may result. Your doctor can prescribe an antibiotic treatment. Keep the area clean, and try not to scratch!
There are other problems to watch for. If blisters occur near or in the eye, lasting eye damage or blindness may result. This can be very serious. See an eye doctor right away.
Other problems may include hearing loss or a brief paralysis of the face. In a small number of cases, swelling of the brain (encephalitis) can occur. It’s very important to go to the doctor as soon as possible— especially if you have blisters on your face.
Can You Catch Shingles?
No, shingles is not contagious. You can’t catch shingles from someone who has it. But you can catch chickenpox from someone with shingles. So, if you’ve never had chickenpox, try to stay away from anyone who has shingles.
Flo, a 77-year-old woman notes, “My daughter stayed away when I had shingles. She’d never had chickenpox and didn’t want to risk catching it. Good thing my sister lived nearby and could help me during those first few weeks.”
Will Shingles Return?
Most people get shingles only once. But it is possible to have it more than once.
What Can You Do?
If you have shingles, here are some things that may make you feel better:
- Make sure you get enough rest, avoid stress as much as you can, and eat well-balanced meals.
- Simple exercises like stretching or walking can help. Check with your doctor first.
- Dip a washcloth in cool water and apply it to your blisters to ease the pain and help dry the blisters.
- Do things that take your mind off your pain. Watch TV, read interesting books, talk with friends, or work on a hobby you like.
- Try to relax. Stress can make the pain worse. Listen to music that helps you relax.
- Share your feelings about your pain with family and friends. Ask for their help.
Where Can I Get More Information?
For more information about shingles and pain management, you can call or write:
Food and Drug Administration
5600 Fishers Lane
Rockville, MD 20857
888-463-6332 (toll-free)
www.fda.gov
National Institute of Allergy and Infectious Diseases
6610 Rockledge Drive MSC 6612
Bethesda, MD 20892
301-496-5717
www.niaid.nih.gov
National Institute of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
1-800-352-9424
301-468-5981 (TTY)
www.ninds.nih.gov
American Chronic Pain Association
P.O. Box 850
Rocklin, CA 95677-0850
1-800-533-3231
www.theacpa.org
National Chronic Pain Outreach Association
P.O. Box 274
Millboro, VA 24460
540-862-9437
www.chronicpain.org
National Foundation for the Treatment of Pain
P.O. Box 70045
Houston, TX 77270-0045
713-862-9332
www.paincare.org
VZV Research Foundation
40 East 72nd Street
New York, NY 10021
1-800-472-8478
www.vzvfoundation.org
For more information on health and aging, contact:
National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
1-800-222-4225 (TTY)
To order publications online:
www.niapublications.org
Please visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly Web site from the National Institute on Aging and the National Library of Medicine. This Web site features popular health topics for older adults. It has large type, is simple to use, and has a “talking” function that reads text aloud.
National Institute on Aging
U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health
June 2004
Web page last updated:
August 18, 2006
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