If you had chickenpox in the past, there is a chance that you could develop shingles. Herpes zoster, or shingles, develops as the result of reactivation of the varicella-zoster virus (VZV) that causes chickenpox. After the chickenpox infection clears, the virus lies dormant in nerve cells. Then, later on in life, the virus can reactivate in the form of shingles. The exact cause of the reactivation is still unknown. The CDC estimates that approximately 30% of individuals in the U.S. will develop shingles in their lifetime. The likelihood of developing shingles increases with age, which can explain the CDC’s recommendation for adults 50 years and above to be vaccinated for shingles.
Someone with shingles can transmit VZV to an individual who has never had chickenpox. This can occur through direct contact with shingles’ skin lesions. The following steps are important to decrease the chances of spreading the virus:
- Cover the rash.
- Avoid direct contact or scratching the rash.
- Practice good hygiene such as hand washing.
- Avoid contact with pregnant women who have never had chickenpox, premature infants, and people with compromised immune systems such as cancer patients or those with HIV.
The shingles rash occurs along the skin in an area where a single group of nerve cells resides, or a dermatome. The rash appears on one side of the body and does not cross to the other side of the body. It mainly is present on the chest, abdomen, stomach, or face and can be quite painful. The rash can appear as red, fluid-filled bumps. Individuals will typically notice pain prior to the appearance of the rash. If the rash develops around the eye or nose, this indicates that the virus may be in the eye and could potentially cause blindness. This condition is known as herpes zoster ophthalmicus and requires prompt evaluation. Shingles treatment consists of antiviral medications as well as analgesics to help with the pain.
Pain may persist for weeks to years after diagnosis; when it does, it is known as postherpetic neuralgia. The risk of this complication increases with age. Postherpetic neuralgia and shingles can both be prevented with vaccination. Currently, there are two different shingles vaccines, one of which can be administered starting at 50 years of age and the other at age 60; your healthcare provider can review this important vaccination recommendation during wellness visits. It is important to be vaccinated for shingles, even if you do not recall ever having had chickenpox.