Dr. Rx: Considering the shingles vaccine

July 9, 2015 by Cynthia McMullen

VCU School of Pharmacy faculty, alumni and students have provided the Dr. Rx column for Richmond’s Fifty Plus magazine since December 2009. We now share those columns on the SOP website, as well, for those who might not have seen the most recent issue.

Serving as Dr. Rx for July 2015 was Anne Masich, a fourth-year Pharm.D. student. She earned her bachelor of science degree in biology from Washington and Lee University. Her focus areas are pharmacotherapy and HIV.

Q: My friend was recently diagnosed with shingles. It sounds painful. What can I do to protect myself from getting shingles?

A: The herpes zoster virus, commonly known as shingles, is a flare-up of the same virus that causes the chickenpox. Once you have the chickenpox, the virus remains inactive in your body but can reactivate later in life. Common triggers include stress and having a weakened immune system.

Shingles usually appears on one side of the abdomen or back as a banded, red rash or fluid-filled blisters. You may experience mild or intense symptoms including itching, pain, numbness, fever, headache and fatigue. If left untreated, nerve pain, vision loss or skin infections may occur because of damaged nerve fibers.

The shingles rash cannot be passed from person to person. However, the virus can be spread through the blister fluid. This will affect only those people who have never had the chickenpox; but instead of developing shingles, they will have chickenpox.

The Centers for Disease Control recommends that anyone older than 60 who has had chickenpox receive a one-time shingles vaccination. The vaccine can be administered at your physician’s office or at a pharmacy, but you might need to bring a prescription with you.

The shingles vaccine does not guarantee you will not get shingles, but it reduces your risk by about 50 percent. Studies have shown that people who get the vaccine — and still get shingles — experience milder symptoms and fewer complications.

If you develop shingles, you should see your health care provider. Starting treatment early will reduce the duration and severity. The drug of choice for treating shingles is an antiviral medication that blocks the virus from replicating. In addition to drug therapy, nonpharmacologic options to help reduce itching include wet compresses, oatmeal baths and calamine lotion.

The rash and pain should subside within five weeks. Pain lasting longer than the rash is a nerve complication of shingles called postherpetic neuralgia. The risk of postherpetic neuralgia is associated with increasing age and the location of the rash, especially when it appears on the face. Medications used for postherpetic neuralgia help relieve the pain symptoms but are not curative options. Speak to your health care provider about prescription options for treating the pain.

To prevent spreading the virus to friends and family, avoid touching and scratching the rash, keep your hands washed and keep the rash covered until the blisters crust. Until the rash crusts, avoid contact with pregnant women who have never had the chickenpox, low birth-weight infants and people with compromised immune systems, such as those undergoing chemotherapy or organ transplantation or who are HIV positive.

In summary: Shingles is a flare-up of the chickenpox virus that usually occurs later in life. A vaccine is available to help prevent shingles. Remember to seek treatment as soon as you notice a rash to reduce the risk of developing complications.