Shingles is a viral infection that causes a painful rash, and while it is commonly associated with older adults, it can affect anyone who has had chickenpox in the past. The infection is caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. After you recover from chickenpox, the virus lies dormant in your nerve cells and can reactivate later in life, leading to shingles.
In this article, we will discuss whether shingles is dangerous for adults, the complications that can arise, the risk factors, and the available treatments to help manage the condition.
What is Shingles?
Shingles, also known as herpes zoster, is a painful rash that usually appears as a band or strip on one side of the body. The rash consists of blisters that eventually scab over. It typically affects the torso but can also appear on the face, neck, or other areas of the body. The rash is often accompanied by pain, burning, itching, or tingling sensations in the affected area.
Shingles is caused by the varicella-zoster virus, the same virus responsible for chickenpox. After you recover from chickenpox, the virus does not leave your body but instead becomes dormant in nerve cells. In some cases, the virus can reactivate later in life and cause shingles.
How Does Shingles Affect Adults?
While shingles is more common in older adults, it can also affect younger adults, especially those with weakened immune systems. The infection begins with symptoms like pain, itching, or tingling in a specific area of the skin, followed by the appearance of a rash. The rash is typically confined to one side of the body, as the virus reactivates in a specific nerve ganglion.
Although the rash can be uncomfortable, it is the pain associated with shingles that makes it particularly dangerous. The pain can be severe and last for weeks or even months in some cases. This prolonged pain, known as postherpetic neuralgia (PHN), can significantly impact a person’s quality of life.
Can Shingles Be Dangerous?
Shingles is not usually life-threatening, but it can lead to serious complications, especially for adults with weakened immune systems or those over the age of 60. The main concern with shingles is its potential to cause long-term pain and other complications. Some of these complications can have lasting effects on a person’s health.
Postherpetic Neuralgia (PHN)
One of the most common complications of shingles is postherpetic neuralgia (PHN), a condition where the pain associated with the rash persists long after the rash has healed. PHN can be very severe and debilitating, often described as a burning, stabbing pain in the affected area. In some cases, the pain can last for months or even years, significantly affecting the person’s quality of life.
PHN is more common in older adults, and it is a major reason why shingles is considered dangerous for this age group. The older you are, the higher your risk of developing PHN. In fact, up to 20% of people who have had shingles will experience some form of PHN.
Vision Problems
Shingles can also affect the eyes, leading to a condition called ocular shingles. This happens when the virus reactivates in the ophthalmic branch of the trigeminal nerve, which affects the eyes and the surrounding areas of the face. Ocular shingles can cause eye pain, redness, swelling, and even vision loss in severe cases. This can be a serious complication, as it may result in permanent damage to the eyes.
If shingles affects the eyes, it is crucial to seek medical attention immediately to prevent long-term vision problems. Antiviral treatment can help to reduce the severity of the infection and lower the risk of complications.
Neurological Complications
In some cases, shingles can lead to more severe neurological complications. The virus can spread to the brain or spinal cord, causing conditions like encephalitis (inflammation of the brain), myelitis (inflammation of the spinal cord), or meningitis (inflammation of the membranes surrounding the brain and spinal cord). These conditions are rare but can be life-threatening.
Symptoms of neurological complications include headaches, confusion, seizures, or difficulty walking. These complications require immediate medical attention and can result in long-term damage or even death in some cases.
Bacterial Infections
The blisters caused by shingles can also become infected with bacteria, leading to a secondary bacterial infection. This can cause the area to become red, swollen, and filled with pus. In some cases, this infection can spread to other parts of the body, leading to more serious health problems.
Secondary infections can be particularly dangerous for adults with compromised immune systems or those who are elderly. These infections may require antibiotics and additional medical treatment to prevent further complications.
Risk Factors for Shingles in Adults
Several factors can increase the risk of developing shingles in adults. These include:
Age: The risk of shingles increases as you age, particularly after the age of 50. About half of people will develop shingles by the age of 85. Older adults are also more likely to experience severe symptoms and complications, such as PHN.
Weakened Immune System: Adults with weakened immune systems are more susceptible to shingles. This includes people who have conditions like HIV/AIDS, cancer, or autoimmune diseases, or those who are taking immunosuppressive medications (such as chemotherapy or steroids).
Stress: High levels of stress can trigger the reactivation of the varicella-zoster virus. Chronic stress can weaken the immune system, making it easier for the virus to reactivate and cause shingles.
Previous Chickenpox Infection: Anyone who has had chickenpox in the past is at risk for developing shingles later in life. The varicella-zoster virus remains dormant in the body after chickenpox and can reactivate when the immune system is weakened.
Is Shingles Contagious?
Shingles itself is not contagious, but the virus that causes shingles (the varicella-zoster virus) can be spread to people who have never had chickenpox or have not been vaccinated against it. This can lead to them developing chickenpox, not shingles. The virus is spread through direct contact with the fluid from the blisters of the rash.
It’s important to note that you cannot catch shingles from someone who has it, but you can catch chickenpox from someone with shingles if you have never had chickenpox or been vaccinated.
Treatment for Shingles
Although shingles is not curable, it can be managed effectively with antiviral medications. The goal of treatment is to reduce the severity of symptoms, shorten the duration of the illness, and prevent complications like PHN. Early treatment with antiviral drugs can help to reduce pain and speed up recovery.
Common antiviral medications used to treat shingles include:
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
These medications work by slowing down the replication of the varicella-zoster virus, which helps to control the spread of the infection. Antiviral medications are most effective when started within 72 hours of the appearance of the rash.
In addition to antiviral medications, pain relief is an important part of shingles treatment. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help manage mild pain. For more severe pain, doctors may prescribe stronger medications, such as opioids or nerve pain medications like gabapentin or pregabalin.
For people with PHN, additional treatments may be needed to manage the chronic pain. This may include antidepressants, anticonvulsants, or topical treatments like lidocaine patches.
Prevention of Shingles
The best way to prevent shingles is through vaccination. The shingles vaccine is recommended for adults over the age of 50, even if they have had shingles in the past. The vaccine reduces the risk of developing shingles and can also reduce the severity of the illness if it does occur.
The shingles vaccine is available in two forms:
Shingrix: This is the preferred vaccine for shingles prevention. It is a non-live vaccine and is administered in two doses, with the second dose given two to six months after the first.
Zostavax: This is a live vaccine, but it is no longer recommended as the preferred option due to its lower effectiveness compared to Shingrix.
Conclusion
Shingles can be dangerous for adults, particularly for those over the age of 50 or those with weakened immune systems. While it is rarely life-threatening, shingles can lead to serious complications, including long-term pain, vision problems, and neurological issues. The best way to protect yourself is to get vaccinated and seek medical attention promptly if you develop symptoms of shingles.
If you are concerned about your risk for shingles or have experienced shingles in the past, it is important to talk to your healthcare provider about preventive measures and treatment options. With the right care, shingles can be managed effectively, and complications can often be prevented.
Related topics
