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When Late Night host David Letterman returned to television in early April 2003 after a month-long absence, he talked about his painful bout with shingles. “I was beyond crazy.”

Letterman had shingles in his eye, “a particularly severe form that affects the nerves in the face,” explains infectious disease specialist Luis Ostrosky-Zeichner, M.D., assistant professor of medicine at The University of Texas Medical School at Houston.

Chicken pox to blame
At age 55 at the time and in a stressful profession like television, Letterman was a prime candidate for the common neurological disorder that targets people over 50 who had chickenpox in childhood. The same virus that causes chickenpox “somehow stays dormant in your body, especially in the nerves, and many, many years later you have stress and it pops back up – it reactivates,” says Ostrosky-Zeichner.

The older you get….
Letterman confessed that he knew nothing about shingles before he got it, even though close to a million cases are diagnosed each year.

But while the majority of those affected are in their 50s or older, younger people can also get the disease, particularly if their immune systems can’t fight off the virus. That includes HIV and chemotherapy patients and others undergoing medical treatments that affect the immune system.

Signs and symptoms
In older people, stress is what usually triggers a shingles attack. But before blisters appear, the disease is often mistaken for other conditions.

“Until the rash shows up, sometimes all you feel is the pain,” says Asra Ali, M.D., clinician and assistant professor of dermatology at the UT Medical School at Houston “When the virus is traveling along a nerve route in the chest area, sometimes people think they’re having a heart attack. If the abdominal area is affected people may think they have appendicitis or gallstones.”

Any nerve in your body can be affected by shingles. The most common is the area at the waist, but it can also appear on the back, chest, head, face and lower part of the spine or neck.

The first sign is often “severe pain in the affected area, pain that doesn’t go away with Tylenol or Advil,” says Ostrosky-Zeichner. Even the slightest touch hurts, including contact with the sheets on your bed. Then small red spots or blisters appear. In two to four weeks the blisters heal, but the pain may last a month or more.

Soothing your inner-child
The key to treating shingles is starting antiviral drugs immediately, within 24 to 72 hours after the rash appears. Early treatment with antiviral drugs can reduce the risk of Postherpetic Neuralgia (PHN), severe pain in the affected area that persists for months and