shingles: dr. jia hu on causes, symptoms and how to treat

one of the complications of shingles is facial paralysis, says dr. jia hu, former calgary medical officer of health, like what singer justin bieber experienced last year.

by karen hawthorne

published apr 05, 2023

last updated apr 10, 2023

4 minute read

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4 minute read

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if you think you have shingles, see a doctor asap

shingles is a reactivation of chickenpox that causes nerve pain and a painful rash. getty

shingles is a viral infection that causes an itchy, painful rash that looks like a strip of blisters around one side of your body or face. it originates from the varicella-zoster virus, which is the same virus that causes chickenpox. once you’ve had chickenpox as a kid, the virus stays dormant in your body and can resurface many years later as shingles. while unpleasant, it’s not life-threatening; however, one serious complication is postherpetic neuralgia where the shingles pain stays with you after the blisters have cleared and can interfere with daily activities.

as many as one in three people will develop shingles in their lifetime, and those age 50 and older make up more than two-thirds of all cases, according to health canada. your immune system naturally weakens with age, making you more susceptible to the infection.

healthing spoke with dr. jia hu, the former calgary medical officer of health and member of cleveland clinic canada’s medical director program. he’s also the ceo and founder of 19 to zero, a not-for-profit coalition of professionals working to improve public health, including promoting vaccine uptake, and chronic disease management and prevention.

what is shingles?

dr. hu.: shingles is basically a reactivation of chickenpox and, you know, almost everybody has had chickenpox at some point in their lives, putting people at risk of shingles. what it generally causes more so in older adults is a really painful rash and sometimes complications like a long-lasting nerve pain — which is really nasty to get.

what are the signs of shingles?

dr. h.: classically speaking, shingles will give you a rash along a line on your torso. but sometimes on some parts of your body, before the rash starts you may get a painful sensation or a tingling sensation. that will become more intense as the rash develops. generally, it’s a very painful rash. there are complications of shingles, one of which is postherpetic neuralgia, where even after the rash is gone, the pain can last. that can be debilitating and it can last for years. there are also more unusual complications. singer justin bieber, for example, had a complication of shingles linked to infection of some of the nerves on his face — so there are a lot of things it can do. but no manifestation of it is particularly nice.

how do people develop shingles? what are the risk factors?

dr. h.: basically everybody who’s had chickenpox is at risk of shingles. in terms of how somebody develops it, the risk factors include older age, so people who are over 50 are much more likely to get it. you also see some people in their 30s getting it or younger, like justin bieber. it tends to occur in people who are older. also, people who are immunocompromised are likely to get shingles, so that’s another situation where if your immune system is weak, it’s easier for that virus to reactivate.

not getting shingles vaccine is a risk factor

there is a vaccine you can get to prevent it, so not getting the vaccine is a risk factor. it’s recommended for people over 50 or people who are under 50 with certain immunocompromising conditions. the vaccine we currently use is called shingrix, which is a recombinant vaccine that is highly effective — it’s more than 95 per cent protective against shingles and some of the associated complications. it’s a two-dose series that you take once and you don’t need a booster. it lasts a very long time and very strongly protective. we’ve had the vaccine in canada for at least six years, so i certainly expect that the prevalence of shingles will go down as more people are vaccinated.

dr. jia hu is the former calgary medical officer of health, member of cleveland clinic canada’s medical director program, and the ceo and founder of 19 to zero, a not-for-profit coalition of professionals working to improve public health. supplied

are there lifestyle choices that can help prevent shingles?

dr. h.: there isn’t anything specific, but it’s much like not smoking makes you less likely to get lung cancer. generally, the healthier you are, the stronger your immune system is and probably the less likely you are to get it. that includes things like regular good diet and regular exercise. but the fact of the matter is that it can happen in healthy adults as well.

how is shingles treated?

dr. h.: the rash commonly lasts for a few weeks. it’s treated with different medications that treat the nerve pain associated with shingles. we do try to avoid opioids to treat it, but really a lot of the treatment for shingles is pain control through direct antivirals [to shorten the duration] and drugs that treat neuropathic pain — or nerve pain.

generally speaking, with shingles, we’re treating the symptoms associated with it. if you don’t treat it, it might last longer and then you’ll have more pain.

what’s one piece of advice for someone with shingles?

dr. h.: i would say that if you think you have shingles, see your family doctor as soon as possible because earlier treatment will lead to a shorter course of the infection. the earlier you start treating it, the faster it will be over.

for more information on shingles, visit the canadian skin patient alliance.

karen hawthorne is a toronto-based writer.

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karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

shingles: dr. jia hu on causes, symptoms and how to treat