DEAR DR. GOTT: What is the treatment for shingles? I have had them for three months now. How long do I have to wait after an episode before I can get the vaccine?

DEAR READER: Shingles is a viral infection. It is actually a second infection caused by the chickenpox virus. Symptoms typically begin with pain, numbness or tingling on one side of the body. It most commonly occurs on one side of the chest, wrapping around to the back. The next most common area is the face, but it can present anywhere on the body, including the eyes, which can cause permanent damage if left untreated.

Usually, within two or three days, a red rash develops that slowly turns into fluid-filled blisters that break open, ooze, and crust over. Untreated, most cases will resolve within five or six weeks. Untreated shingles carry potentially serious complications depending on the location where they appear. The open sores should never be touched, as the fluid contains high levels of the virus that can be transferred easily to others. The disorder is highly contagious and can cause chickenpox in those who have never had it and shingles in those who have.

Other symptoms include fatigue, headache, fever and chills, itching and a general achy feeling. There are also atypical cases in which patients develop shingles pain without the typical rash and blistering.

Treating shingles can speed healing, reduce the risk of complications, and ease pain. The best results are achieved if antiviral medication is started within 72 hours of the first symptoms. For those in severe pain, narcotics, tricyclic antidepressants, anticonvulsants or numbing agents may be prescribed. Mild to moderate pain may be controlled with over-the-counter pain relievers such as ibuprofen and naproxen. Antihistamines may also help. Topical anti-itch creams may be helpful if there is an accompanying itch.

Stress can worsen the pain of shingles and should be avoided. Cool compresses or baths may ease symptoms. Relaxation techniques such as meditation, tai chi or deep breathing can reduce stress levels. Even something as simple as listening to soft music or reading in a quiet room can help.

Anyone concerned about having shingles or who develops pain or itching on one side of the body should see his or her physician as soon as possible. Those over the age of 60 should also consider receiving the shingles vaccine, which reduces the risk of developing this infection and may lessen symptoms, duration and intensity should an attack occur. It may also lower the risk of developing postherpetic neuralgia (continuing nerve pain after the shingles infection is over). The vaccine is not a treatment option. People with specific health concerns should not receive the vaccine, so speak with your physician regarding whether to have it.

How long you should wait depends on your situation. There is no specific time period, but it is generally recommended that the rash be gone before receiving the vaccine. If you are under 60, you may not be able to receive it because the vaccination has been tested only in people 60 and older.

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