DEAR DR. GOTT: I am a 59-year-old female. I was told that I had never had chickenpox; however, I came down with shingles. I have been on prednisone and famciclovir for a week. The spot (about the size of a quarter) is drying up. How long can I expect pain? Should I be immunized again shingles? Can I get shingles without ever having had chickenpox? Some days I can tolerate the pain but at other times it’s very uncomfortable.
DEAR READER: Whomever told you that you never had chickenpox was incorrect. However, it is possible that you had a very mild case with few lesions that may have gone unnoticed. I can say this with certainty because shingles cannot occur without the varicella-zoster (also known has the herpes zoster) virus which can only be present after having had chickenpox. So to simplify, if you never had chickenpox, you could not be suffering from shingles now. This can be confirmed with a lab tested to check for antibiotics to the virus.
Pain is a normal (and often the first) symptom, because the viral culprit, after causing the initial chickenpox outbreak, migrates to the nerve cells and becomes dormant. Should reactivation occur, the nerve cells are on the front lines leading to pain, tingling, burning and/or numbness.
With appropriate treatment, shingles may last up to a few weeks. Should complications occur, such as postherpetic neuralgia, the pain/tingling may last indefinitely. Complications are more likely to occur in those who have severe outbreaks or in those who delay getting treatment.
As for immunization, I believe you should be. The vaccine is currently approved for those 50 and older. If your doctor feels you are an appropriate candidate, set up an appointment. Keep in mind that some insurance companies may not cover the cost so you will have to pay out-of-pocket.
Readers who are interested in learning more about pain can order my Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.