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The only way to reduce the risk of developing shingles (herpes zoster) and the long-term pain that can follow shingles is to get vaccinated. You are at risk of shingles if you have had chickenpox. Shingles is caused by a reactivation of the chickenpox virus (called varicella zoster) in a person's body.
The vaccine for shingles (Zostavax®) is licensed for use in people 60 years old and older to prevent shingles. The older a person is, the more severe the effects of shingles typically are—all adults 60 years old or older should get the shingles vaccine.
The shingles vaccine is specifically designed to protect people against shingles and will not protect people against other forms of herpes viruses, such as genital herpes. Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease. The shingles vaccine is not recommended to treat active shingles or post-herpetic neuralgia (pain after the rash is gone) once it develops.
Your risk for getting shingles begins to rise around age 50. Anyone 60 years of age or older should get the shingles vaccine, regardless of whether they recall having had chickenpox or not. Studies show that more than 99 percent of Americans ages 40 and older have had chickenpox, even if they don’t remember getting the disease.
It is safe to be around infants and young children, pregnant women, or people with weakened immune systems after you get the shingles vaccine. There is no documentation of a person getting chickenpox from someone who has received the shingles vaccine (which contains varicella zoster virus).
Some people who get the shingles vaccine will develop a chickenpox-like rash near the place where they were vaccinated. As a precaution, this rash should be covered until it disappears.
The most common complication of shingles is a condition called postherpetic neuralgia (PHN). People with PHN have severe pain in the areas where they had the shingles rash, even after the rash clears up.
The pain from PHN may be severe and debilitating, but it usually resolves in a few weeks or months in most patients. PHN can, however, persists for many years in some persons.
PHN occurs rarely among people under 40 years of age but can occur in up to half (and possibly more) of untreated people who are 60 years of age and older.
Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant (inactive) state. For reasons that are not fully known, the virus can reactivate years later, causing shingles. Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease.
Shingles usually starts as a painful rash on one side of the face or body. The rash forms blisters that typically scab over in seven to ten days and clears up within two to four weeks.
Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from one to five days before the rash appears.
Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash. Shingles can affect the eye and cause loss of vision.
Other symptoms of shingles can include:
Shingles may lead to serious complications involving the eye. Very rarely, shingles can also lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death.
Almost one out of every three people in the United States will develop shingles, also known as zoster or herpes zoster. There are an estimated one million cases each year in this country. Anyone who has recovered from chickenpox may develop shingles; even children can get shingles. However, the risk of disease increases as a person gets older.
About half of all shingles cases occur among men and women age 60 years and older.
People who have medical conditions that keep their immune systems from working properly, such as certain cancers, including leukemia and lymphoma, and human immunodeficiency virus (HIV), and people who receive immunosuppressive drugs, such as steroids and drugs given after organ transplantation are also at greater risk of getting shingles.
People who develop shingles typically have only one episode in their lifetime. In rare cases, however, a person can have a second or even a third episode.