Chicken pox is a common concern for children, but the virus behind this disease does not disappear along with its characteristic red spots. Instead, the varicella zoster virus can reactivate later in life as a painful rash called shingles. 

“The virus sits in the nerve cells, so once the shingles are activated from this chicken pox virus, the nerve cells become inflamed,” says Dr. Anatoli Freiman, Dermatologist and Medical Director of the Toronto Dermatology Centre. “That’s why it’s extremely, sometimes excruciatingly painful.”

Approximately nine out of ten adults in Canada have had chicken pox and are therefore at risk for developing shingles. In Canada, an estimated 130,000 new cases are diagnosed each year, according to the Public Health Agency of Canada.  

“For the person who thinks ‘oh it’s not going to happen to me’, it is happening more and more so it’s important to learn about it and be proactive,” says Kathryn Andrews-Clay, Executive Director of the Canadian Skin Patient Alliance.

A real pain

“The older you are, the more likely you are to get it,” says Freiman. He adds that certain medications or conditions, such as those that impact the immune system, can also put patients at risk for shingles. 

Once the virus activates, patients experience severe pain and develop a red, blistering rash, often in a strip along one side of the body. The discomfort can be so extreme that patients are unable to work, sleep or complete routine tasks. 

 “Life will change if you get shingles,” says Andrews-Clay. “It will have an impact on your day-to-day.”

For most people, shingles can be successfully treated within a few weeks but for one in five patients, the pain will remain long after the lesions have cleared. The lasting, debilitating discomfort is due to a complication called post-herpetic neuralgia (PHN) and it can affect a patient’s quality of life for years. 

Given the potential consequences of shingles, Freiman says, “If we can prevent that, it is quite important.”

Being proactive vs. reactive

An estimated three in ten Canadians will develop shingles in their lifetime, but there is now a vaccine that can reduce the risk. 

“Life will change if you get shingles. It will have an impact on your day-to-day.”

“People need to be aware of shingles, it can be a fairly common condition,” says Freiman. “Especially after the age of 60, they should speak to their physician about the shingles vaccine.” 

The vaccine has been available in Canada since 2008 and has been shown to reduce the risk of developing shingles by 70 percent for patients 50 to 59, and 51 percent for those over 60. Once vaccinated, if a patient does get shingles, it is typically less severe and there is a 65 percent less chance that the patient will develop PHN.  

Freiman says that the vaccine’s benefits are three-fold. “Number one, we can prevent a lot more cases. Number two, the cases that will occur, hopefully will be milder. Three, the complications of shingles that we unfortunately do see, will not be as common and also will be milder,” he says. 

The vaccine is approved for anyone over the age of 50 and the National Advisory Committee on Immunization specifically recommends it for patients over the age of 60 – for whom there is a much greater chance of the virus reactivating. 

For those at-risk for developing shingles, Freiman says it’s important to talk to a physician about the vaccine sooner rather than later to help prevent the disease and its complications. 

“I think we’re lucky to have an opportunity to prevent something that’s fairly common and can have potentially devastating consequences,” he says. “An ounce of prevention is worth a pound of cure.”