Shingles and Side Effects: What to Know

If you know someone who has had shingles, you know what we’re about to say: You do not want to get shingles. The ugly, blistery, painful rash can last for weeks. And you do not want to experience excruciating nerve pain that can persist for months or even years after the rash clears.  

“Shingles can be way more dangerous and life-changing than people think,” says Priscilla Agyemang, MD, a primary care doctor and an assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. “I have a patient who has ongoing pain months after her rash cleared. Shingles can be really, really debilitating.” 

And if you, like more than 99% of Americans born on or before 1980, have had chickenpox, then you are at risk.  

Agyemang talked to us about the virus behind shingles and what happens if it hits.  

What is shingles? 

Shingles is a painful rash of blisters that usually develops on one side or part of the body, often the face or torso. The rash is intense: clusters of fluid-filled blisters that eventually crust over and heal. The blisters typically scab over in seven to 10 days and clear within two to four weeks.  

The rash can be accompanied by itching, tingling, or burning sensations. For some people, the pain can last for months or years after the rash. This pain, called postherpetic neuralgia, is the most common complication of shingles.  

What causes shingles? 

Shingles is caused by a reactivation of the chickenpox virus. After the chickenpox virus infects someone, the virus stays dormant in the nerves within the body. At any time later in life, the virus can reactivate and cause shingles.  

Who gets shingles? 

Shingles can occur in anyone who has had the chickenpox virus, but the risk of getting shingles increases as you get older because the immune system wanes with age. The CDC estimates one out of every three people in the United States will get shingles in their lifetime. There are one million cases every year. 

We also know stress—mental or physical—can trigger shingles. If you are sick or take medications that weaken your immune system, if a loved one died, or if your work or home life is very stressful, these could be contributing factors.  

Why does shingles appear in different body parts in different people?  

It’s based on where the virus is hiding in your body. It’s not something we can predict. Maybe it's hiding in your cervical nerve, so you’ll get the rash on your neck. For somebody else, it could be hiding in a nerve in the abdomen, and that's where it will reactivate. 

What happens after you get shingles? 

The most uncomfortable complication of shingles is postherpetic neuralgia, persistent nerve pain that continues after the rash has healed. This pain can be severe and debilitating, lasting for weeks, months, and even years. 

Shingles can also lead to other nerve complications, such as: 

• Heightened sensitivity or numbness in the affected area 
• Itching even after the rash disappears 
• Vision or hearing problems 
• Problems with the central nervous system 

Shingles blisters can also become infected with bacteria, leading to additional symptoms such as increased pain, redness, swelling, and abnormal discharge. If these are present, prompt medical attention is vital to prevent the infection from causing serious damage to the skin or spreading throughout the body. 

Can you prevent shingles?  

You may not be able to prevent shingles completely, but you can reduce your risk. There are two steps you can take:

• Get vaccinated: This is the most effective way to prevent or reduce the severity and duration of shingles. Vaccination also reduces the chance that you get shingles by 90%. The shingles vaccine, Shingrix, is a two-dose vaccine, given 2 to 6 months apart. It is recommended for adults aged 50 years and older, is readily available, and lasts a long time.  
• Maintain a healthy immune system: A strong immune system can help prevent infection, including reactivation of the virus. 

Does the chickenpox vaccine prevent shingles? 

It is possible to get shingles even if you’ve been vaccinated with the chickenpox vaccine because it contains a weakened, live virus. This weakened virus can go dormant in a nerve and, in some instances, reactivate to cause shingles later in life.  

Why should everyone eligible get the shingles vaccine? 

Shingles can be severe. It can be debilitating, with painful, long-term consequences.  

As a society, we tend to focus more on death than discomfort, even if it’s debilitating or long-term. People do die from shingles, but it’s very rare, only about 100 people per year. However, the severe rash and pain are not rare.