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Shingles in the Elderly

Shingles is the same chickenpox disease, It can occur in all age groups. However, you will have a higher chance of developing shingles if you age, as the older you become.

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Shingles in the Elderly

What is Shingles (Herpes zoster)?

Herpes zoster (commonly known as shingles) is a condition caused by the varicella-zoster virus (VZR). It is the same virus that caused chickenpox. It can occur in all age groups. However, you will have a higher chance of developing herpes zoster if you age, as older you become, you tend to have several complications from herpes zoster.   

After the chickenpox virus has been recovered, the virus will enter the nervous system and remain in the system for many years without showing any symptoms. If the body's immune system toward infections has been weakened, the virus can react, and herpes zoster will occur. Those who are at risk are senior adults or those who lack an adequate amount of sleep. It also affects those who suffer from an autoimmune disease such as SLE and those who are HIV-infected. Additionally, the risk groups are people who receive immunosuppressive drugs as their treatment options and those with underlying chronic conditions, for example, diabetes, heart disease, and kidney diseases.  

Symptoms

When a patient gets herpes zoster, they will begin to feel pain and a burning sensation. This means that even a slight clothing touch or skin touch can result in pain. Rashes will start to become visible after 2 to 3 days and evolve into a chickenpox blister-type rash. However, herpes zoster will not spread to the entire body the way chickenpox does. But it will appear as a strip or small area with a fluid-filled blister covering the infected area. Blisters will eventually dry and begin to crust into scabs. In some people, they may have symptoms of fever or flu-type symptoms.

Complications 

Complications of shingles can occur in anyone but are more likely to occur in senior adults and people with a weakened immune system.  

  • Post-herpetic neuralgia  This is a term used to describe the pain that lasts for more than three months. It is the most common complication of shingles. The pain typically affects the area of skin that was affected by the rash. It can be mild to severe and is often described as “burning.” Post-herpetic neuralgia affects 10-15 percent of people, with about half of those cases occurring in individuals older than 60.
  • Skin infection  The sores of the shingle can become infected with bacteria, which can delay healing. 
  • Eye complications  It occur in about 2 percent of cases when the rash affects the skin near the eyes. (Herpes zoster ophthalmic and damage to the retina) 
  • Ear complication  Herpes zoster optics or Ramsay Hunt Syndrome symptoms include weakness of facial muscle and ear pain.

Treatments 

Some of the treatment options for herpes zoster are as follows: 

  • Antiviral drugs – This helps relieve pain, inflammation, and symptoms of skin blisters 

Some other drugs that the doctor may prescribe are: 

  • Pain relief medicine 
  • Antihistamine drugs
  • Antibiotics  

Prevention 

Thailand now has a vaccine to prevent the development of herpes zoster for senior adults. The vaccine is recommended for senior adults age 60 or older. It will help decrease herpes zoster, and if the patient is infected, the vaccine can help reduce the severity of the symptoms. The vaccination is highly recommended before the age of 60 for those with chronic health diseases or who suffer from other conditions that result in a weakened immune system.

Published: 21 Feb 2021

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