How do You Get Shingles? Understanding symptoms, prevention and treatment

Doctor inspecting man's shingles.jpg

You’ve most likely heard of shingles, as well as the rash and pain that comes with the virus. But, how do you get shingles? Should you be worried? Physician and medical director, Megan Romine, DO, at UnityPoint Health explains who is most at risk, plus what to know about treatment and prevention. 

How Do You Get Shingles?

Shingles, also known as herpes zoster or zoster, is caused by the varicella-zoster virus, which also causes chickenpox. Only people who have had chickenpox can get shingles.

“After you get chickenpox, the virus stays in your body,” Dr. Romine says. “It can then return as shingles at any time. As we age, our body’s defense against the dormant virus weakens. Because of this, shingles is more likely to appear as you age and is most common after age 50.”

Dr. Romine says currently about 30 percent of people will get shingles at some point in their lifetime. It’s also more common in adults with a weakened immune system. But, if you never had chickenpox and you had the chickenpox vaccine, Dr. Romine says it would be unlikely you’d get shingles, since you were immunized against the virus.

“Shingles itself isn’t contagious, but you can spread the varicella-zoster virus. This could cause chickenpox in those who have not had chickenpox or the chickenpox vaccine,” Dr. Romine says.

Shingles Signs and Symptoms

Shingles presents as a rash, first as red bumps and then blisters. The bumps and blisters appear as a group and normally in a single area on one side of the body. This pattern occurs because shingles spreads along nerve pathways, or “dermatomes,” on the body. The shingles rash usually starts crusting over in seven to 10 days, before completely going away within two to four weeks.

“The rash most commonly affects the abdomen or arms, but it can appear anywhere on the body. If shingles is on the face near the nose or eye, it can cause infection of the eye itself, which is a serious infection that can lead to blindness,” Dr. Romine says.

Pain is also a main concern with shingles, and it can begin even before the rash. Shingles pain is caused by irritation of the nerve root and is often described as a “burning” feeling. Unfortunately, Dr. Romine says about 10-15 percent of people will develop postherpetic neuralgia, which is characterized by long-term pain even after the rash goes away.

“Spreading the virus is rare and only usually happens by direct contact with the active rash.  You can prevent spreading the virus by keeping the rash covered, if possible, and washing your hands frequently.  Those in most danger of catching the virus are pregnant women who have not had chickenpox or the vaccine, premature babies and people with a weakened immune system,” Dr. Romine says.

Shingles can also lead to a few more dangerous complications, including:

  • Blindness. As previously mentioned, shingles near the eye can cause blindness, if not treated properly.
  • Ramsey Hunt syndrome. This occurs when the shingles virus affects the nerves near the ear. Symptoms include ear pain with blisters in the ear and paralysis on the affected side of the face.
  • Meningitis and encephalitis. Rarely, the shingles virus can affect the central nervous system, causing meningitis and encephalitis (infection around the brain).

Shingles Treatment

Shingles can be treated with prescription antiviral medications to help limit the severity of the virus and speed recovery time. Antivirals work best when started in the first three days of infection. 

“Usually, shingles pain can be managed with over-the-counter medications, such as acetaminophen.  Prescription pain medications, specifically pain medications targeted at nerve pain, may be needed if the related pain is severe,” Dr. Romine says.

Shingles Prevention and Vaccination

“There is a single-dose shingles vaccine we’ve been using since 2006 to reduce the risk of shingles. In 2017, the FDA approved a new shingles vaccine, called Shingrix. Shingrix is a two-dose vaccine recommended for adults 50 and over.  It’s significantly more effective than the prior shingles vaccine.  Your doctor will likely recommend you get the new vaccine, even if you already had the previous vaccine,” Dr. Romine says.

According to the Centers for Disease Control and Prevention (CDC), adults 50 years and older should get two doses of the shingles vaccine to prevent shingles and shingles-related complications. Adults 19 years and older who have weakened immune systems should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.

Talk to your doctor about what vaccinations you may need, or check your vaccine history in your MyUnityPoint patient portal.