Shingles is a very common disease that affects one in three Americans in his or her lifetime, according to the National Institutes of Health. Although it isn’t curable, it is treatable.

The disease is caused by a reactivation of the chickenpox virus (the varicella virus).

“The virus travels to the nerves and then lives in the nerves,” said Dr. Stephen Schleicher, a dermatologist associated with the Lehigh Valley Health Network with offices in Gilbert, Sugarloaf and Bethlehem. All of a sudden, it decides to come out.”

It usually occurs in both men and women over the age of 60. As people get older, they tend to be more immune compromised or have multiple medical conditions.

“The older you are the greater the chance you are of getting shingles,” Schleicher said. “Of course, it can certainly happen in pediatric patients and teenagers. Sometimes we see it in patients who are younger and are immunosuppressed. Sometimes they’re not and they just get it.”

Only people who have had chickenpox can get shingles, but it is not known if people who were vaccinated for chickenpox can also get shingles. The vaccine became available in 1995, so the people who received it as a child are just not old enough to get shingles.

“The hope is that people who were vaccinated will either not get shingles or if they do get shingles, they will have a milder case,” Schleicher said. “Nobody really knows for sure how it’s going to play out. The hope is that they will be somewhat protected at a later date.”

What are the signs of shingles?

Shingles is not contagious. It is basically a blistering disorder. It usually starts off looking like a red patch, like poison ivy, and then develops blisters.

“People complain of tingling or burning before they get the blisters,” Schleicher said.

It usually isn’t itchy like chickenpox, but some people do complain of itchiness. The main problem is that it hurts.

“The pain can last for quite some time,” Schleicher said.

When the virus comes out through nerves on the chest, some people think they were having a heart attack, and some doctors do diagnose it as one, he said.

“Two days later when the blisters come up, well, then everybody knows you didn’t have a heart attack. You had shingles,” Schleicher said.

It is important to see a doctor as soon as possible, because starting therapy on an antiviral medication is the best way to prevent severe pain. A steroid is also given sometimes to reduce inflammation. The severe pain can be incapacitating.

“The whole thing with shingles is it does go away on its own, but the problem with shingles is that about 10% or 12% of people will be left with severe pain that can last for months. We call that postherpetic neuralgia,” Schleicher said. “That can be a real game changer, life changer. People are in severe pain for quite some time.”

Shingles usually occurs on the trunk of the body, either the front or the back, but it can also occur on the scalp, occasionally on the legs, and sometimes the face.

“The problem is that if it occurs by the eye, it can be a very serious condition. If there’s any chance of shingles being by the eye, sometimes the tip of the nose, you definitely want to get in to see a doctor right away. That’s very important,” Schleicher said.

The blisters will develop a crust over them and within two weeks, most of it will be gone. Shortly after that, the blisters will heal without a trace, he said. Severe cases can leave some discoloration of the skin.

Shingles is not contagious, but someone who has never had chickenpox can get chickenpox from someone with shingles. Schleicher said it’s very rare, but it can happen.

Protecting yourself

The shingles vaccine is recommended for people over 50 years old, anyone with a family history of shingles, or people who have had it more than once.

“If you’ve had shingles before, you can get it again, so you definitely you want to get the vaccine,” he said.

The newest vaccine on the market is called Shingrix, and it is a two-dose vaccine. It is better than the original one-dose vaccine Zostavax.

Schleicher encourages people who had the original vaccine to go back and get the new one as well. The shots are given anywhere from two to six months apart, he said.

In addition to getting the shingles vaccine, Schleicher recommended getting the flu vaccine and the COVID-19 vaccine, just not all at the same time.

“It’s really important for everyone to get the COVID vaccine. That’s the number one thing you should get. After that, you want to get your flu vaccine, because it’s flu season. After that, if you haven’t had a shingles vaccine and you’re above 50, certainly if you’re above 60, it would be a good idea to get the shingles vaccine,” he said. “By and large, if you get the COVID vaccine, you want to wait two weeks before getting another vaccine.”