Q: Several people in my family have had shingles recently, and some have had it more than once in less than a year. I thought this was a rare complication of having had chicken pox as a child. What's going on?
-Stephen D., Des Moines, Iowa
Recently, a large group of naturopathic physicians was polled, and many noted that in the past 5 or so years, they have seen a significant increase in shingles cases. This has certainly been true for my practice as well.
Shingles (herpes zoster) is a reappearance of a past infection from the varicella virus. Most commonly known as chicken pox, "wild type" varicella is a generally mild disease that most everyone over age 30 in the U.S. remembers having as a child.
There is no question that shingles, a painful blistering disease, affects people who had chicken pox earlier in life. The virus infects the nervous system and becomes "latent," which means it never completely goes away. The virus is then reactivated in the form of shingles. Certain things are thought to trigger shingles, including stress, intense sunlight, and toxins such as prescription and/or recreational drug use. An episode typically lasts 7-10 days, but it can take several weeks for the skin to look normal again.
How Effective Is the Vaccine?
Unfortunately, there is not enough data at this point to assess whether the chicken pox vaccine, which became available in 1995, is consistently associated with milder cases of chicken pox and fewer occurrences of shingles later in life. Here's what we do know: One dose of the vaccine has been shown to be 85 percent effective at preventing any form of varicella and almost 100 percent effective against severe varicella (e.g., shingles). Current evidence shows that the vaccine retains its effectiveness for 10-20 years.
While it would be best to avoid getting shingles in the first place, neither avoiding the "wild type" disease nor the vaccine seems to be a good strategy. This is because getting chicken pox for the first time as an adult is absolutely miserable; the disease is usually not as debilitating in children, and once you've had it, you have lifelong immunity against it.
And that's the issue with the vaccine. We don't know if it confers lifelong immunity. In general, vaccines need to be boostered throughout life, but there is little information about boostering the chicken pox vaccine in adults. When the "wild type" virus was more prevalent, many adults got automatically boostered by being in the proximity of kids with childhood chicken pox. In fact, one theory as to why we're seeing more shingles now is that this boostering effect is diminishing as more parents choose to vaccinate their children.
There is not enough data at this point to assess whether the chicken pox vaccine is associated with fewer occurrences of shingles later in life.
There are several naturopathic approaches to shingles. In terms of prevention, do your best to manage stress. This generally involves having a little fun every day, as well as drinking enough water, getting enough sleep, having meaningful relationships, and finding some "me" time on a regular basis. And if you live in a low-sun climate and are planning a trip to somewhere sunny, make sure to use sunscreen and avoid sudden, intense sun exposure.
Many naturopathic therapies are very effective for viral infections. Some of my favorites include high-dose vitamin A (50,000 IUs daily for 5 days, but no longer); zinc (50 mg daily for 1-2 weeks); and buffered vitamin C. If the lesions are persistent, or the problem develops into postherpetic neuralgia (PHN), intravenous vitamin C can lead to rapid improvement of lesions.
Subcutaneous B12 injections (near the blisters) are another naturopathic therapy that has been successful for shingles, particularly when the virus is stress-induced.
Honey, applied topically, has significant antiviral properties and is worth trying. [Editor's note: For best results, use Manuka honey, available at health food stores.]
There are many herbs that are both antiviral and analgesic, including St John's wort, ashwagandha, and oats. Tinctures can be found in health food stores and can be applied to the skin (mix with castor oil first). Cover the oil-tincture mix with a cloth, and then with a heating pad set on medium. This often provides relief after a few applications.
Herbal antivirals can also be taken internally. A blend I like combines licorice, osha, ligusticum, and astragalus.
Helpful Homeopathic remedies
The major homeopathic remedy for shingles is Rhus toxicodendron (poison ivy). The zoster blisters actually look like a bad case of poison ivy. Rhus tox. is more likely the right remedy for a younger person, who finds relief from some form of movement.
If the patient is very chilly with restless anxiety, exhaustion, and a worsening of symptoms after midnight, then Arsenicum album is likely to help. For a rash that is described as feeling like a burn, Cantharis (Spanish fly) might be a good choice. Another remedy that might be very useful is Iris versicolor (blueflag), which seems to be most applicable to rashes that manifest on the right side of the body. Antimonium tartaricum is known to help resolve chicken pox lesions and may accelerate resolution of herpes zoster.
Use 1 tiny tablet (12X and 30C potency) every 4 waking hours for a few days. If symptoms fail to improve within a few days, consult a licensed homeopath.