Once the chickenpox has run its course, the varicella zoster virus retreats to nerve cells within the spinal cord where it may lie dormant for decades. Doctors aren’t sure what causes this virus to reactivate, but they note a link between patients with shingles virus and weakened immune systems (either through stress or old age). The virus travels along the nerve pathways to the skin’s surface, where it causes terrible pain accompanied by a band-like rash with oozing, burning skin lesions, all of which persists for about 3-4 weeks.

Doctors diagnose the shingles virus once the painful rash appears by looking at the way the spots are distributed. Most commonly, the shingles rash appears in a defined band on one side of the torso or face. This appears different from dermatitis and poison ivy. In fact, the word “shingles” itself derives from the Latin word “cingulum,” which means girdle or belt. A lab diagnosis can also confirm the viral nature of the telltale spots. Most people will receive an oral anti-viral and chronic pain medications from their doctors and go home to recover over the month without incident. However, some people experience rather severe complications.

The worst type of shingles virus complications usually occur when the band of lesions appear on the face. Usually, a single spot cluster appears on the tip of the nose, which is called “Hutchinson’s sign,” which means that the ophthalmic nerve has been attacked by the varicella zoster virus, which will soon be making its way toward the eye to potentially cause permanent blindness. “My husband was undergoing chemotherapy treatment for prostate cancer when he developed shingles in his right eye,” Julia Hershfield, of Kensington, Maryland describes. “The pain was so bad, that he lost all will to live. Shingles finished him.” People with severely weakened immune systems may have this painful rash spread to internal organs affecting the lungs, brain and central nervous system, which can even cause death.

Patients can protect themselves from shingles virus by getting vaccinated at age 60. For people who have already noticed the shingles symptoms, it is best to be vigilant and contact the doctor at once to prevent more serious complications. Although the virus itself can’t be cured, doctors can prescribe oral antiviral medications like Zovirax, Famvir or Valtrex that will fight the infection and protect nerve cells from serious damage. “Antiviral therapy may shorten the course of an episode of shingles,” says Therese A. Cvetkovich, M.D. “However, therapy must be started as early as possible after symptoms develop–within 48 hours–in order to have an effect.”

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As we get older and our immune systems weaken, the possibility of developing a hideous and painful rash, known as shingles, drastically increases. In fact, it’s estimated that adults who’ve had chickenpox in the past have a 1 in 10 chance of coming down with this disease. The portent is even worse for adults who haven’t had chickenpox, as they may develop severe reactions like brain swelling, hearing loss, blindness, facial paralysis and chronic pain disorders. The best way to prevent this painful malady is to get the shingles vaccine starting at age 60, which will reduce the risk by 50-60%.

The shingles vaccine, Zostavax, was licensed in 2006 and has been tested on more than 20,000 Americans so far. One dose administered by injection into the upper arm has been shown to reduce the risk of shingles by 50% and the risk of post-herpetic neuralgia (PHN) by 67%. The few people who developed shingles, regardless of the vaccine, generally suffered less pain and required less medication treatment than those who were not vaccinated. The vaccine is said to be extremely safe. The only serious risk associated with the vaccine is for people who are allergic to gelatin or the antibiotic neomycin. One in three patients reported redness, soreness or swelling at the injection site. One in seventy patients said they got a headache following their vaccination. People who develop a reaction to the vaccine do so within minutes or an hour of injection, and usually report a sudden fever, difficulty breathing, wheezing, weakness, hives, a quickened heartbeat, dizziness, paleness and throat swelling. If any of these serious symptoms occur, a doctor should be called immediately.

The Centers for Disease Control and Prevention recommends one dose of the shingles vaccine every 6 years for any adult age 60+, even if they’ve had the chickenpox virus before. It is a fallacy that having the virus once bolsters immunity, as people often relapse after years of dormancy. “People who have had chicken pox have at least a one in ten chance of developing shingles. The risk increases with age,” Dr. Jon Hallberg tells Minnesota Public Radio. “As we get older, our immune system is less capable of fending off things, or in the case of the varicella zoster virus, of keeping it in check,” he explains. Individuals who have the shingles virus should at least wait until the rash has cleared to be vaccinated. The vaccine is most effective when administered to people ages 60-69, but shows promise for those who are older as well.

Some patients wonder how they will pay for the shingles vaccine. All Medicare Part D plans cover the herpes zoster vaccine, whereas Medicare Part B plans do not. Private insurance carriers and Medicaid may or may not cover the vaccine, depending on your plan. There have been many reports of insurance companies refusing to cover the $200 vaccine. Dr. Jon Hallberg explains on Minnesota Public Radio: “I think insurance plans are simply thinking that, ‘Look, if it’s only 60 percent effective, this may not be worth us covering for all of our patients over the age of 60.’”

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