Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Shingles facts
- What is shingles? What causes shingles?
- What are shingles symptoms and signs? How long does shingles last?
- How long is shingles contagious?
- How is shingles diagnosed?
- What is the treatment for shingles? Should I visit my health care professional?
- What are the complications of shingles?
- What is postherpetic neuralgia?
- Can shingles be prevented with a vaccine?
- What are potential side effects of the shingles vaccine?
- Is shingles dangerous in pregnant women?
- Test Your IQ: Take the Shingles Quiz
- Pictures of Shingles - Slideshow
- Pictures of Shingles
- Shingles (Herpes Zoster) FAQs
- Find a local Dermatologist in your town
What is postherpetic neuralgia?
The most common complication of shingles is postherpetic neuralgia. This occurs when the nerve pain associated with shingles persists beyond one month, even after the rash is gone. It is a result of irritation of the nerves of sensation by the virus. The pain can be severe and debilitating. Postherpetic neuralgia occurs primarily in people over the age of 50 and affects 10%-15% of people with shingles. There is evidence that treating shingles with antiviral agents can reduce the duration and occurrence of postherpetic neuralgia.
The pain of postherpetic neuralgia can be reduced by a number of medications. Tricyclic antidepressant medications (amitriptyline [Elavil] and others), as well as antiseizure medications (gabapentin [Neurontin], carbamazepine [Tegretol], pregabalin [Lyrica]), have been used to relieve the pain associated with postherpetic neuralgia. In 2012, the FDA approved the use of gabapentin enacarbil (Horizant), previously used for the management of restless legs syndrome, for the treatment of postherpetic neuralgia. Capsaicin cream (Zostrix), a derivative of hot chili peppers, can be used topically on the area after all the blisters have healed, to reduce the pain. Lidocaine pain patches (Lidoderm) applied directly to the skin can also be helpful in relieving nerve pains by numbing the nerves with local lidocaine anesthetic. These options should be discussed with your health care professional.
Can shingles be prevented with a vaccine?
In May 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine for adult shingles. The vaccine known as Zostavax, is approved for use in adults ages 50 and over who have had chickenpox. The U.S. Centers for Disease Control and Prevention recommends the vaccine for people 60 years of age and over who have had chickenpox. It is a onetime injection (shot) that does not need to be repeated. The shingles vaccine contains a booster dose of the chickenpox vaccine usually given to children. Tests over an initial four-year period showed that the vaccine significantly reduced the incidence of shingles in these older adults. The single-dose vaccine was shown to be more than 60% effective in reducing shingles symptoms, and it reduced the incidence of postherpetic neuralgia (PHN, see above) by at least two-thirds. Studies are ongoing to evaluate the effectiveness of the vaccine over a longer term. Even if you have had shingles, you can still have the vaccine to help prevent future outbreaks.
There are certain contraindications to receiving the shingles vaccine. People with weakened immune systems due to immune-suppressing medications, cancer treatment, HIV disease, or organ transplants should not receive the shingles vaccine because it contains live, weakened viral particles. There is not enough information available from researchers to decide at this point whether Zostavax may be beneficial in people younger than 60 years of age. Pregnant women should not receive the shingles vaccine.
Learn more about: Zostavax
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