Why the risk of shingles increases with age
While anyone who has had chickenpox can develop shingles, the risk increases with age. The varicella-zoster virus (VZV) becomes dormant in nerve tissue after a person's initial chickenpox illness. Over time, the immune system naturally weakens, a process called immunosenescence. This decline makes it harder for an older adult's body to keep the dormant virus in check, allowing it to reactivate and cause shingles. Other factors that compromise the immune system, such as certain medications, chronic diseases, and stress, can also increase the risk.
Symptoms and signs of shingles in the elderly
Recognizing the signs of shingles early is crucial for timely treatment. Symptoms often begin before the visible rash appears.
Early symptoms before the rash
Early signs can include pain, burning, tingling, or sensitivity to touch on one side of the body. Some individuals may also experience itching, numbness, headache, fever, and chills.
Visible rash and blisters
A few days after the initial symptoms, a red rash typically emerges, which then develops into fluid-filled blisters that eventually break and crust over. The rash most commonly appears as a single stripe on one side of the torso, but can also affect the face or near an eye.
Potential complications for older adults
Seniors with shingles are at higher risk for serious and lasting complications. Prompt medical attention is key to managing these risks.
- Postherpetic Neuralgia (PHN): This is the most common complication, causing severe nerve pain that can last for months or years after the rash heals. The risk of PHN increases with age.
- Vision Loss: If shingles affects the eye, it can lead to painful infections and permanent vision damage.
- Other Neurological Issues: In some cases, shingles can lead to inflammation of the brain, facial paralysis, or problems with hearing and balance.
- Bacterial Skin Infections: The open blisters can become infected, leading to further issues.
Vaccination: The most effective prevention
Vaccination is the most effective way to prevent shingles and its severe complications. The CDC recommends the recombinant zoster vaccine, Shingrix, for healthy adults aged 50 and older.
Comparing Shingrix and Zostavax
| Feature | Shingrix (RZV) | Zostavax (ZVL) |
|---|---|---|
| Type | Recombinant (non-live) | Live-attenuated (discontinued in US 2020) |
| Efficacy (50-69) | 97% effective | 70% effective |
| Efficacy (70+) | 91% effective | 41% effective |
| Doses | 2 doses, 2–6 months apart | 1 dose |
| Max Age | No maximum age | Limited effectiveness in older age groups |
Even those who have previously had shingles or received the older Zostavax vaccine should get the Shingrix vaccine to help prevent future outbreaks.
Treatment options for shingles at 80
For someone at age 80 with shingles, prompt treatment is essential. Antiviral medications work best when started within 72 hours of the rash's appearance.
- Antiviral Medications: A doctor may prescribe medications like acyclovir, valacyclovir, or famciclovir.
- Pain Management: Over-the-counter or prescription pain medication can help manage discomfort.
- Home Remedies: Applying cool, wet compresses, taking colloidal oatmeal baths, and using calamine lotion can soothe the skin.
How to care for an 80-year-old with shingles
Caring for a senior with shingles involves preventing the virus's spread and providing emotional support.
- Preventing Contagion: The shingles virus can spread through the fluid in blisters to someone who has not had chickenpox or the chickenpox vaccine. Always keep the rash covered and practice good hand hygiene, especially around young children, pregnant women, and people with weakened immune systems.
- Support Immune Health: Encourage rest and stress reduction, as stress can weaken the immune system. Ensure the person has a balanced diet with lean proteins, vegetables, and whole grains to support their immune system.
- Monitor Symptoms: Closely watch the rash and the person's overall health. If the pain worsens, the rash spreads, or other symptoms appear, contact a healthcare provider immediately.
Conclusion: Prevention is key for seniors
An 80-year-old can get shingles, and the consequences can be severe due to age-related immune decline. Fortunately, the Shingrix vaccine offers a highly effective defense. By prioritizing vaccination and seeking prompt medical attention, seniors can significantly reduce their risk of developing shingles and debilitating complications like postherpetic neuralgia. Staying proactive is the best approach for healthy aging. For more information, consult the Centers for Disease Control and Prevention guidelines at https://www.cdc.gov/shingles/vaccines/index.html.
