If you've had chickenpox you're at risk of a painful condition called shingles — here's why
- Shingles is caused by the reactivation of the chickenpox virus.
- If you have had chickenpox, you are susceptible to shingles.
- The reactivation of this virus is caused by a weakened immune system, which is why shingles is more common in older adults.
- This article was medically reviewed by Scott Kaiser, MD, geriatrician, and Director of Geriatric Cognitive Health for Pacific Neuroscience Institute at Providence Saint John's Health Center in Santa Monica, California.
Shingles, also known as herpes zoster, is a viral infection that usually results in rashes or blisters that most typically develop in a linear pattern on one side of your body.
The infection is common and about 1 in 3 people get shingles in their lifetime. It's caused by the same virus that causes chickenpox, so if you've had chickenpox, you're at risk to develop shingles.
Here's what you need to know about the causes of shingles, as well as how to treat and prevent it.
Symptoms of shingles
A rash with blisters is the main visible symptom of shingles. The typical rash appears on one side of the body in a narrow band-like distribution and is most common along the torso.
Some other symptoms of shingles include:
- Pain or burning
- A tingling sensation that might feel like pins and needles
- Numbness
- Itching
- Red rash made up of blisters
Causes of shingles
If you had chickenpox when you were younger, your body was exposed to the varicella-zoster virus. Even after your chickenpox has healed, the virus remains in your body for the rest of your life. That's why you usually can't get chickenpox twice.
The virus lives in an inactive state in the dorsal root ganglion, which is a cluster of neurons that carry sensory information to the spinal cord, says Caroline Nelson, MD, a dermatologist at Yale Medicine. In this inactive state, the virus is harmless. Only once your immune system weakens to the point where it can no longer keep it under control does the virus reactivate causing shingles.
When the varicella-zoster virus reactivates, it travels down the nerve fibers that go from the dorsal root ganglia to the surface of the skin. As the virus multiplies, you typically develop the rash that is the telltale sign of shingles.
Risk factors for shingles
Everyone who has had chickenpox has the varicella zoster virus in their body, putting them at risk for developing shingles. While there is no way of knowing who will or will not get shingles, certain factors that impair the immune system but people at greater risk. Some of these factors are:
- Aging: The risk of shingles increases with age. Before your 80s, your risk of getting shingles is about 20-30%. However, that risk jumps up to 50% when you're 85 or older, says Nelson. While shingles can impact people of all ages, in fact, about half of all shingles cases occur in people 60 years of age and older.
- Suppressed immune system: You are more likely to get shingles if you are immunocompromised. Some conditions that can result in a weakened immune system are HIV/AIDS, cancer, or even having an organ transplant, since that usually involves taking immunosuppressive medications.
- Stress: Nelson says that there may be a link between stress and a shingles outbreak. In a 2014 review published in Innovations in Clinical Neuroscience, researchers determined that it's common to see a stressful life event precede a shingles outbreak, however, other general health factors play a role here, as well.
Treatment of shingles
The main treatment for shingles is antiviral medications. The most common antiviral meds for shingles are:
- Acyclovir
- Valacyclovir
- Famciclovir
If you think you have shingles, do not hesitate to get treatment. These medications will help reduce the severity and the duration of your shingles if you take them early. "Time matters. Antivirals are most effective when started within 72 hours of the appearance of skin lesions," says Nelson.
"[Antivirals] can accelerate lesion crusting and crust resolution by one to two days, reduce duration of viral shedding, reduce duration of acute pain, and perhaps most importantly reduce the duration of post-herpetic neuralgia," says Nelson.
Post-herpetic neuralgia is a complication that can result in the pain, itching, and numbness from shingles to last three or more months after the shingles infection.
Aside from getting the virus itself under control, you can also relieve the discomfort of your symptoms by:
- Taking over the counter pain relievers that are NSAIDs like ibuprofen or naproxen.
- Taking prescription nerve pain medication. Nelson says gabapentin is most commonly used to treat the acute pain, and nortriptyline are used for pain that may linger if you are dealing with post-herpetic neuralgia. Prescription painkillers may be prescribed in severe cases, but are not the first line of defense, Nelson says.
- Having oatmeal baths to relieve the itch.
- Using an anti-itch lotion like calamine lotion.
Prevention of shingles
Nelson calls vaccines the cornerstone of prevention for shingles. Even if you had chickenpox as a child, you can, and should, still get vaccinated for shingles.
The FDA approved a vaccine called Shingrix in 2017. According to the CDC, two doses of Shingrix was 97% effective for people aged 50-69 years old, and 91% effective in those 70 years and older.
Nelson recommends the vaccine for people who:
- Are 50+ years old.
- Have had prior episodes of shingles (since you can get shingles more than once).
- Received an older shingles vaccine called Zostavax, since Shringrix is more effective.
- Aren't sure if they've had chickenpox in the past. It's better to be safe than sorry, and the CDC estimates that in 99% of Americans over 40 have had chickenpox, even if they don't remember it.
Additionally, you can try to keep stress levels under control so that you can reduce that risk factor, as well as maintain a healthy lifestyle to have a stronger immune system.
The bottom line
If you think you may have shingles, see your doctor as soon as possible so you can receive treatment and feel some relief from the discomfort. Also, be sure to avoid others, especially those who have not had chickenpox, the chickenpox vaccine, or those who are immunocompromised.
While you can't directly transmit shingles to somebody, you can infect them with chickenpox through open blisters. However, once the rash is crusted over, you aren't infectious anymore.