Taking pains to prevent it is well worth it, experts say
Published on Tuesday, April 1, 2025
By: Gary Pettus, gpettus@umc.edu
Chickenpox is the nightmare that keeps on giving.
If you’ve had it, there’s a good chance it’s still stalking you, living inactively in a nerve route that can pop again in another malevolent form called shingles.
About 1 in 3 people in the U.S. will develop shingles in their life at least once, and the best way to prevent that from happening to you is to get a vaccine, say experts at the University of Mississippi Medical Center.
Otherwise, you risk catching an extremely painful condition – triggered by stress, a weakened immune system or certain medications that may suppress your immune system, especially by the time you’re in your late middle-age.
“Chickenpox, which is caused by the varicella-zoster virus, can stay in the body for many years and then reactivate,” said Dr. Stephen Helms, UMMC professor of dermatology.
“That becomes more common as we get older because our immune system tends to wane. It shows up as shingles; it affects the sensory neurons [nerve cells], which is why people experience pain.”
In fact, pain is the first sign of shingles, said Dr. Tobe Momah, UMMC associate professor of family medicine.
“On a scale of 1 to 10, some people rate the pain as a 12,” he said.
“Following the onset of pain, after one to three days or so, you will break out in a rash or blisters that will develop into anything from mild to severe pain. If you’re Caucasian, it will be a reddish rash. For African Americans, it shows up in spots as darker skin with reddish edges.
“If the pain, rash and itching stay in a dermatome – that is, on one side of the body, or one side of the face – it’s likely shingles.”
The small blisters can clump together and then may crust; and the rash can last for two to four weeks, even for people who are generally healthy, Helms said.
But pain can last much longer.
“A potential complication of shingles that we see most often is called postherpetic neuralgia,” Helms said.
“The pain would persist on that side of the body or face where it started. It can last for years and impair your quality of life.
“It can also affect the eyes and the ears.”
Shingles can lead to blindness if the rash reaches the eyelids and it’s not treated in time, Momah said.
“It can also lead to Ramsay Hunt syndrome – which can include severe pain in the ear; it could damage your hearing, long-term.”
In rare cases, about 1 in 30,000 to 50,000, it can develop into encephalitis, Helms said.
If you suspect that you have shingles, it’s important to see your doctor right away. Particularly to avoid postherpetic neuralgia, you need to start taking anti-viral and pain medication within about five days of a shingles outbreak, Momah said.
Shingles is not necessarily one and done. Especially for people 50 or older, it can recur in times of stress or in those who have weakened or compromised immune systems – for people who are on dialysis or who have HIV or cancer, among other conditions.
Certain medications can also predispose you to a shingles episode, Helms said. Those include cancer treatments, as well as biologic meds for such conditions as arthritis, psoriasis and eczema.
“Any of that can open up the door to another shingles episode,” Momah said. “So, please always get the shingles vaccine, even if you’ve already had shingles or the chickenpox vaccine.”
For those who have had shingles, the vaccine can prevent future outbreaks, reports the Centers for Disease Control and Prevention.
Most insurance plans will cover the cost of the Shingrix vaccine, but usually only for patients 50 or older. “Otherwise, you can pay for it out-of-pocket,” Momah said.
The CDC also recommends the vaccine for adults 19 and older who have weakened immune systems.
The cost of Shingrix can vary, but a variety of sources estimate it at around $200 per dose – and it requires two shots, six months apart. “Make sure the rash has disappeared before getting vaccinated,” Momah said.
“There was a previous vaccine, no longer available in the U.S., but it was not effective for more than 10 years,” he said. “But two shots of Shingrix will keep you immune, hopefully, for the rest of your life.”
The vaccine is very effective in preventing nerve pain, Helms said. “Statistics say it’s more than 91 percent for people between 50 and 70, and almost 89 percent for those 70 and older.”
But people who are immunocompromised and want the vaccine should first discuss it with their doctor, Helms said.
Chickenpox/shingles is treacherous in at least one other way. You cannot develop shingles from someone who has shingles; however, since it is the chickenpox virus, someone who has never had chickenpox or the vaccine may develop chickenpox from someone who has shingles.
“It’s spread through contact with the skin usually,” Helms said. “Pregnant women really want to avoid someone with shingles, because the chickenpox virus could be transmitted to the baby.”
Avoid letting the affected area come in contact with anyone else, Momah said. “Don’t share towels or anything else that your skin touches.”
If there is a bright side to shingles, it’s this: Once the blisters have crusted, it – that is, the chickenpox virus – you can no longer spread it to someone else.
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A variety of specialists are able to treat patients for shingles. Those include specialists in dermatology, internal medicine, family medicine, neurology and infectious diseases. If the rash is threatening to reach the eyes, you should see an ophthalmologist. For hearing-related risks, see a specialist in otolaryngology.
To find a specialist at UMMC, start here or call 888-815-2005.
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