What Should Seniors Know About Shingles and Postherpetic Neuralgia?
Shingles is a painful condition caused by reactivation of the chickenpox virus that remains dormant in the body for decades. Seniors face higher risk of shingles and its most debilitating complication, postherpetic neuralgia. Understanding shingles helps seniors take steps to prevent this painful condition.
Understanding Shingles
After chickenpox resolves, the varicella-zoster virus remains dormant in nerve cells. Years or decades later, the virus can reactivate, causing shingles. The reactivated virus travels along nerves to the skin, causing a painful, blistering rash typically appearing in a band on one side of the body.
About one in three people who had chickenpox will develop shingles during their lifetime. Risk increases significantly with age as immune function declines. By age 85, half of adults will have experienced shingles.
Symptoms
Shingles typically begins with pain, burning, tingling, or itching in a localized area. This pain may precede the rash by several days, sometimes leading to misdiagnosis before the rash appears. The pain can be severe even before visible signs develop.
A rash of fluid-filled blisters develops, usually in a stripe pattern on one side of the torso, though it can appear anywhere including the face. The rash crusts over in seven to ten days and clears within two to four weeks. The affected area may remain sensitive long after the rash heals.
Additional symptoms may include fever, headache, fatigue, and sensitivity to light. Shingles involving the eye requires urgent ophthalmologic evaluation to prevent vision damage.
Postherpetic Neuralgia
Postherpetic neuralgia is chronic pain persisting after the shingles rash heals. This complication affects about 10 to 18 percent of shingles patients, with risk increasing significantly with age. Those over 60 face substantially higher PHN risk.
PHN pain is often severe and debilitating, described as burning, stabbing, or electric shock-like. Even light touch to the affected area can cause intense pain. PHN can persist for months or years, significantly impacting quality of life.
Treatment
Antiviral medications including acyclovir, valacyclovir, and famciclovir shorten shingles duration and reduce complication risk when started within 72 hours of rash onset. Early treatment is important, so seek medical attention promptly when shingles is suspected.
Pain management during acute shingles may require prescription pain medications. Calamine lotion and cool compresses soothe skin symptoms. Keeping the rash clean and covered prevents secondary infection.
PHN treatment includes topical lidocaine, capsaicin cream, certain antidepressants, anticonvulsants like gabapentin, and sometimes opioids. Finding effective treatment often requires trying multiple approaches.
Prevention Through Vaccination
The shingles vaccine Shingrix is highly effective at preventing shingles and PHN. The CDC recommends Shingrix for adults 50 and older, given as two doses two to six months apart. The vaccine is recommended even for those who previously had shingles or received the older Zostavax vaccine.
Shingrix is over 90 percent effective at preventing shingles and PHN. Protection remains strong for at least seven years. Side effects include arm soreness and temporary flu-like symptoms.
Getting Shingles Prevention
All Seniors Foundation strongly encourages shingles vaccination for eligible seniors. Preventing shingles prevents significant suffering. Contact us if you have questions about shingles vaccination or need help accessing the vaccine.
