Are You Young Enough For Shingles?

The painful zoster virus is affecting more age groups than vaccination guidelines suggest.

Shingles Symptoms

People 50 years of age and older should get immunized against shingles. One out of three people you know develop it, according to the CDC. Shingles is a manifestation of the zoster virus. It is often a painful skin rash of similar blisters on one median of the body, based on the particular dermatome affected.

Something as simple as a breeze blowing a T-shirt against your torso can increase neuropathic pain sensation. This may last for months or years after the rash goes away.

Though shingles transcends dermatology, neurology, immunology, and epidemiology, it can be treated by an internist or family practitioner. Intense pain is not limited to the area covered by blisters. You might feel itching and burning on one half of your body before blisters are visible or when eruptions cover a small area. If so, go to urgent care even before a rash develops. This can considerably reduce the course of disease and treatment.

Minimize the chance of transferring blisters to other people or your face and eyes. Avoid scratching or touching open sores. Wash hands that come in contact with them to keep from spreading the virus to other parts of the body.

Initial infection with the varicella-zoster virus, most often resulting from (childhood) chickenpox, lays dormant within the ganglia adjacent to the spinal cord. How the virus survives or subsequently re-activates, is not well understood. Open blisters can be contagious, causing chickenpox in those who have never had it before but will not trigger shingles. In the absence of oozing blisters, there is no risk of spreading the virus.

Shingles Treatment

Treatment aims to limit the severity of pain, shorten the duration of a shingles episode, and reduce complications. Any combination of analgesics, antivirals, steroids, opioids, and lotions may be prescribed. Though pain can be severe, overuse of pain relievers may damage digestive organs like the liver or kidneys. An antiviral is most effective in limiting shingles progression if taken early.

In the absence of oozing blisters, there is no risk of spreading the virus.

Natural remedies include vitamin C, zinc, baking soda compresses, and calamine lotion. This does not constitute a recommendation to avoid physicians. Scarring is likely to be evident after the scabs heal. Cocoa butter, aloe vera, or other natural skin lightening/healing treatments might help.

It is a good practice to ingest probiotics for several days after completing a course of any antibiotics. Antibiotics generally kill both good and bad bacteria. Your gut needs the latter. Yogurt can supply lactobacillus and may be fortified with a few other friendly bacteria.

Miso, sauerkraut, Kombucha, and Kefer are fermented products offering various probiotics. However, your digestive tract is estimated to thrive with 100 trillion bacteria. A good refrigerated probiotic supplement is generally more comprehensive.

Shingles Vaccinations

Through a media blitz, the CDC and a vaccine manufacturer promoted shingles vaccinations a few years ago. Promotion may continue in some areas to a lesser degree. Inoculations are offered at some pharmacy chains.

Zostavax^® (Merik & Co. zoster vaccine) has been used in the United States since 2006. This vaccine is currently recommended for adults 50 to 59. Interestingly, the vaccine decreases the chance of shingles by about half in those between the ages of 50 and 80 with a significant drop at 60.

Shingrix^® provides stronger protection against shingles than previous vaccines and is usually prescribed for people 60 years of age and older. Both vaccines aim to minimize the effects of neuropathic pain, not prevent the dormant virus from reactivating. Shingrix, given in two shots, is more than 90% effective at preventing shingles and long-term nerve pain.

Skin rash, joint pain, flu-like symptoms, headaches and fatigue are some potential side effects reported by some patients following the Shingrix vaccine. These reactions pale in comparison to the burning pain of shingles.

⚠️ Cutaneous complications common post-transplant

As use of lung transplant becomes more common, pulmonologists should be aware of post-transplant dermatologic complications. The most common are HSV-1, HSV-2, varicella zoster, HHV-6, and KSHV. Zoster (shingles) rates in transplant recipients are between 3 and 25 percent and are more common in older recipients of thoracic transplants receiving mycophenolate-containing immunosuppressive regimens. —Cleveland Clinic

People in their 30s and 40s have been affected by shingles. About half of all cases occur in people under the age of 60. So it should not be considered a disease that only affects the elderly. During their lifetime 30% of Americans will develop herpes zoster, which translates into an estimated 1 million cases each year in the United States.

How To Pay For Shingles Vaccine

There are several ways to pay for your shingles vaccine:

Medicare

Medicare Part D plans cover the shingles vaccine, but there may be a cost to you depending on your plan. There may be a copay for the vaccine, or you may need to pay in full and then get reimbursed for a certain amount.

Medicare Part B does not cover the shingles vaccine.

Medicaid

Medicaid may or may not cover the vaccine. Contact your insurer to find out.

Private health insurance

Most private health insurance plans cover the vaccine for people 60 years of age or older. Some plans cover the vaccine for people 50 through 59 years of age.

Vaccine assistance programs

Some pharmaceutical companies provide vaccines to eligible adults who cannot afford them. See more information on the patient assistance program that includes Zostavax^® (shingles vaccine).

Shingles Recurrence

It is possible to develop shingles more than once. What can be done after the three- to six-week ordeal has passed? A vaccination is still advised and may be administered at an appropriate time determined by the patient and treating physician.

Although some people will develop shingles despite vaccination, the vaccine may reduce the severity and duration of it. Stay healthier by taking proactive, rather than reactive, measures.

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Are You Too Young For Shingles?

Shingles Symptoms

Shingles Treatment

Shingles Vaccinations

⚠️ Cutaneous complications common post-transplant