Shingles in the Elderly

Shingles is a dangerous, but preventable, skin condition which is most common in the elderly. In this guide, we will go through what shingles is, what its symptoms are, how to treat it, what to do to prevent its spread, and how to support yourself as a caregiver.

What are Shingles?

According to the United States Centers for Disease Control and Prevention website, shingles is “a painful rash that develops on one side of the face or body.” It is a skin condition whose blisters take up to 10 days to scab and four weeks to clear, but whose secondary effects can last for several years.

 What causes shingles?

Shingles is caused by a common virus called the varicella-zoster virus, which is the same virus which causes chickenpox. Shingles only occurs in people who have already had chickenpox, even if it was when they were very young. Once the virus is reactivated, shingles occurs.

Varicella-zoster is a common virus which most adults will get at some point in their lives, its initial form being commonly known as chickenpox. That being said, in a majority of cases the virus will stay inactive after getting chickenpox. However, an average of one out of three adults will suffer from the development of active shingles in their lifetime. The risk increases the older you become.

Symptoms of Shingles

Because shingles is caused by a virus, there are certain virus-like symptoms which are associated with the development of shingles. It is important to be aware of all of the possible symptoms which may be caused by shingles, especially for elderly people. According to the American Academy of Dermatology Association (AAD), these symptoms include:

●     Burning or tingling on skin

●     Fluid-filled blisters

●     Painful rash

●     Fever

●     Muscle aching

●     Pain in stomach

●     Nausea

●     Vomiting

●     Chills

●     Skin sensitive to touch

This list is not exhaustive of all the symptoms which can emerge due to shingles. If you believe you may be suffering from shingles, make sure to contact your doctor immediately to avoid any further, potentially dangerous, side effects due to the condition.

Complications of Shingles

Most symptoms of shingles are temporary. However, some have a lasting effect. Here are some common complications associated with shingles.

Nerve Pain

According to the CDC, the most common long-lasting side effect of shingles is nerve pain, or postherpetic neuralgia (PHN). PHN emerges where the shingles rash occurs, and may emerge up to several months after the rash has cleared. In some cases, PHN causes pain which is “so severe and debilitating that it interferes with daily life.”

Just as the chances of developing shingles increase with age, so do the chances of getting PHN as a result of the skin condition. In most cases, PHN occurs in people who are over 40 years old. According to the CDC, about 10-18% of people who develop shingles will get PHN.

Other Side Effects

The CDC also offers a list of side effects which, although less common than PHN, may occur due to shingles. These include:

●     Blindness

●     Pneumonia

●     Hearing problems

●     Brain inflammation (encephalitis)

●     Death

Of course, these are unlikely and extreme side effects to shingles. That being said, it is important to keep them in mind, and to contact your medical professional immediately if you start to see signs of shingles emerging. 

How Long Does Shingles Last?

Shingles usually last between two and six weeks. The actual rash tends to be painful between seven to ten days before scabbing up. It can take up to four weeks to clear up. That being said,

Are Shingles Contagious?

If you are wondering if shingles can be passed on to another person, the answer is that while shingles cannot be passed on, the varicella-zoster virus can. According to the Mayo Clinic official website, shingles can only be passed to another person “who isn’t immune to chickenpox.” This means that if someone who has not yet had chickenpox becomes infected with the virus, they will get chickenpox, not shingles.

That being said, once someone gets chickenpox, they are prone to developing shingles later if the virus reactivates. Both chickenpox and shingles can be very dangerous, and so it is crucial to know how to avoid risking contaminating others if you are contagious. In the following section, we will go over the best ways to avoid spreading the virus.

How to Stop the Spread of the Shingles Virus

The varicella-zoster virus can be very dangerous whether in its chickenpox or shingles form. To prevent others from getting varicella-zoster, and limiting its spread, it is important to follow certain crucial cautionary steps. The virus is contagious through the shingles' open sores, so all physical contact must be avoided until the blisters have fully scabbed over. To protect others if you have shingles, there are several measures to take. These include:

• Covering the rash
• Avoid touching the rash
• Frequent hand washing
• Get vaccinated 

By following these measures, the risk of spreading the virus is limited.

Who is most at risk?

It is especially important to avoid contact with people at-risk of catching chickenpox including those who have not received the chickenpox vaccine, the elderly, people with weak immune systems, pregnant people, and newborn babies.

There are also other circumstances which may make people at risk compared to others. These include undergoing cancer treatment such as radiation or chemo, certain medications such as prolonged use of steroids, and have immune-deficiency diseases such as HIV.

Treatment for Shingles

In this section of the guide, we will consider different treatment methods available for shingles patients. This includes antiviral medication, pain medication, and mindful meditation.

Antiviral medication

According to the CDC, there are several different antiviral medicines to treat shingles. These medicines may help alleviate some of the symptoms and shorten the duration of the skin condition. These include:

●     Acylovir

●     Valacyclovir

●     Famciclovir

These antiviral medications are reportedly “most effective if you start taking them as soon as possible after the rash appears.” It is important that you consult your medical professional about your shingles before receiving or taking any treatment.

Pain Medication

Pain medicine may help alleviate the pain caused by shingles. There are different options including prescribed or over-the-counter medication. Other kinds of pain alleviators may include:

●     Wet compresses

●     Calamine lotion

●     Colloidal oatmeal bath

Again, remember to speak with your doctor before using any kind of pain medication to ease the pain caused from shingles.

Mindful Meditation

While meditation is commonly known for its anxiety and stress relieving benefits, a growing amount of studies have suggested that the benefits of mindful meditation extend to chronic pain alleviation. There are many free, online resources available to help begin and learn about the mindful meditation practice which can be done in the comfort of your home.

How to Prevent Shingles

Although there are several ways to limit the spread of shingles once someone is infected, the best way to reduce the risk of getting shingles is by getting the shingles vaccine. In this section, we will look at who should get vaccinated, when, and what it consists of.

Getting Vaccinated for Shingles

Anyone over the age of 50 should get the shingles vaccine. The CDC recommends the Shingrix vaccine which it calls “the best way to help protect yourself against shingles.” The Shingrix vaccine protects both from the emergence of shingles as well as the long-term nerve pain which can be a result of shingles.

The vaccine comes in 2 doses. The vaccine can be done at your doctor’s office or in some pharmacies. Many health insurances cover the costs of the Shingrix vaccine. The second dose must be done anywhere between two and six months after the first dose.

Shingrix is, according to the CDC, “90% effective at preventing shingles and long-term nerve pain.” There are possible side effects to the vaccine, most of them mild side effects which have little-to-no impact on daily life tasks. The possible side effects include:

●     Sore arm

●     Redness or swelling around area of shot

●     Fatigue

●     Nausea

●     Muscle pain

●     Headache

●     Stomach pain

●     Fever

●     Shivers

The side effects tend to go away after no more than three days. Just under 17% of people who received the vaccine were unable to perform certain tasks such as “yardwork or swimming.” As the CDC notes, it is important to remember that “the pain from shingles can last a lifetime, and these side effects should only last a few days.”

Conclusion

Shingles is a potentially dangerous skin condition which is common among the elderly. Many people who have had chickenpox in their early lives do not remember it, and so do not realize the risk they have of getting shingles. The consequences of shingles can be long lasting and devastating, so it is important to get vaccinated, and if one becomes contagious, to immediately seek treatment and avoid physical contact with others.

As a caregiver, the first step to care for someone with shingles is to learn about the disease and its effects on those who suffer from it. That way, you will best be able to adapt to your patient’s needs, and notice any strange and potentially dangerous developments which may arise as a result of the skin condition. If you notice any, ask your patient to let their medical professional know.

Remember, your job as a caregiver is to support your patient, but it is equally important for you to support yourself. Don’t let your work put your mental and physical wellbeing at risk. As you begin your caregiving journey, make sure to set up a routine to give yourself time and space during the week to rest and recover from the difficulties you may face. Don’t forget to reach out to caregiver support resources whenever you may need them.