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Shingles

older woman in a doctor's officeRuth, a 79-year-old woman, said her shingles caused so much pain she couldn't bear to put on her clothes or have the sheets touch her skin. Ruth was sick for several months. Her friend, Sarah, had it easier. Shingles made Sarah feel sick for a few days, and she had some discomfort. But she was back to her old self in a few weeks.

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 (VZV) that causes chickenpox in children. 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 in adults, it produces shingles.

Most adults live with the VZV virus in their body and never get shingles. About one in five people who have had chickenpox will get shingles later in life. With shingles, the blisters tend to be clustered in one specific area, rather than scattered all over the body like chickenpox.

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 because that's often the shape of the rash. Having shingles doesn't mean that you have any other underlying disease such as cancer.

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, too much sun, 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.

You Should See 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 that you have shingles and make a treatment plan. Although there is no cure for shingles, early treatment with drugs that fight the virus can help the blisters dry up faster and prevent the severe pain. Shingles can often be treated at home. Patients with shingles rarely need to stay in a hospital.

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 older you are when you get shingles, the greater your chance of developing PHN.

"I've had post-herpetic neuralgia for nine months," said Pete, an 80-year-old man. "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. Steroids may lessen the pain and shorten the time you're sick. Analgesics, antidepressants, and anticonvulsants may reduce the pain. Usually PHN will get better over time.

Prevent Shingles—A Vaccine

A vaccine that may keep you from getting shingles has been approved by the Food and Drug Administration. You should ask your doctor if the shingles vaccine is right for you. It is available for people age 60 and older.

What About Complications?

In some cases, the blisters caused by shingles can become infected. This may leave a scar. Your doctor can prescribe an antibiotic treatment. Keep the area clean and try not to scratch.

There are other problems to watch for. Blisters near or in the eye can cause lasting eye damage or blindness. Also, hearing loss, a brief paralysis of the face, or in a small number of cases, swelling of the brain (encephalitis) can occur. If you have blisters on your face, it's important to see the doctor as soon as you notice a rash.

Can You Catch Shingles?

No, shingles is not a contagious disease. 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 says, "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.

For More Information

Here are some helpful resources:

American Chronic Pain Association
P.O. Box 850
Rocklin, CA 95677
1-800-533-3231 (toll-free)
www.theacpa.org

Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
1-888-463-6332 (toll-free)
www.fda.gov

National Institute of Allergy and Infectious Diseases
5601 Fishers Lane, MSC 9806
Bethesda, MD 20892-9806
1-866-284-4107 (toll-free)
1-800-877-8339 (toll-free/TTY)
www.niaid.nih.gov

National Institute of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
1-800-352-9424 (toll-free)
1-301-468-5981 (TTY)
www.ninds.nih.gov

National Shingles Foundation
590 Madison Avenue
21st Floor
New York, NY 10022
1-800-472-8478 (toll-free)
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 (toll-free)
1-800-222-4225 (toll-free/TTY)
www.nia.nih.gov
www.nia.nih.gov/espanol

To sign up for regular email alerts about new publications and other information from the NIA, go to www.nia.nih.gov/health.

Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.

National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services

June 2009

Publication Date: June 2009
Page Last Updated: August 25, 2014