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Shingles in the Elderly: Symptoms, Prevention and Recovery

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Shingles in the Elderly: Symptoms, Prevention and Recovery
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Shingles in the Elderly: Symptoms, Prevention and Recovery

November 30, 2020

Do you remember getting chickenpox as a kid? You may remember a few weeks of red spots, itching, calamine lotion and time off from school. While having chickenpox as a child helps provide lifelong immunity to the disease, the virus can live on and can come back to haunt adults in the form of shingles. Shingles primarily affects adults over 50 and can be especially dangerous after age 65. Shingles can’t be cured, but it can be treated and prevented. 

an elderly man with glasses

What Is Shingles

Shingles is related to childhood chickenpox and caused by the same virus, the varicella-zoster virus (VZV). After you recover from chickenpox, the virus continues to live in some of your nerve cells. It stays dormant, so you don’t know it’s there. Most adults living with the virus in their bodies never get shingles. Unfortunately, for one in three adults, the virus can reactivate and affect the nerves. For most adults, the normal course of shingles follows this pattern:

  • The first stage starts with pain, numbness or itching.
  • Symptoms usually last about two to four weeks. 
  • Usually a small part of one side of the body or face is affected. 
  • After the first two weeks, a red rash and fluid-filled blisters may appear. 
  • Seven to 10 days later, the blisters begin to dry up and form a crust. 
  • The rash will then slowly disappear.

For many adults, shingles will be painful and uncomfortable, but they should see relief after a month and suffer little to no long-term effects. 

Shingles Symptoms in Seniors 

Unfortunately, for seniors and others with weakened immune systems, shingles can be more complicated. Seniors with shingles are likely to suffer from common symptoms like:

They may also have more severe symptoms like:

  • Fever
  • Headache
  • Sensitivity to light
  • Chills
  • Upset stomach

While an adult’s chances of suffering from shingles increases with age, the elderly are especially susceptible. Reasons for this include: 

  • They are likely to have a weaker immune system. 
  • The chickenpox vaccine wasn’t available until 1995, so they were more likely to be exposed to chickenpox as children. 
  • They may also be at risk if they’re taking drugs to support chemotherapy or after an organ transplant.

Long-Term Effects of Shingles in the Elderly 

How serious is shingles in the elderly? While most seniors with shingles will only suffer for a few weeks, some may face long-term complications. The most common complication is called postherpetic neuralgia (PHN). This is long-term nerve pain that continues in the areas where the shingles rash occurred long after the rash is gone. According to the Centers for Disease Control and Prevention (CDC), about 10 to 18 percent of people with shingles will also experience PHN, and the risk increases with age.

Nerve pain can continue for months or even years after an episode of shingles, and recovery from shingles in the elderly can take time. The pain can be so severe and debilitating that a doctor may need to prescribe medication to manage discomfort. On rare occasions, shingles can lead to other complications, including:

  • Pneumonia
  • Hearing problems
  • Balance issues
  • Blindness 
  • Brain inflammation (encephalitis)

How to Prevent and Treat Shingles in the Elderly 

If someone you love is suffering from shingles, there is no cure, but there is treatment. Oral antiviral medications such as acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex) can decrease the severity of the symptoms, but only if they are started within 72 hours of the appearance of the rash. Steroids, anticonvulsants and other pain management medications can also help mitigate symptoms, but they should only be used under a doctor’s supervision.

The best way to prevent shingles in the elderly is not to get it in the first place. Healthy adults over age 50 are strongly encouraged to get vaccinated against shingles. The vaccine called Shingrix (recombinant zoster vaccine) provides strong protection against shingles and PHN and is given in two doses separated by two to six months. Some studies show that the vaccine may reduce shingles by 50 to 75 percent.

A little prevention can go a long way. If you feel that you may be at risk for shingles, talk to your caregiver or doctor about getting vaccinated.

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