What is shingles?

The varicella-zoster virus causes shingles. This is the same virus that causes chickenpox. After you’ve had chickenpox and your symptoms have gone away, the virus stays inactive in your nerve cells. The virus can reactivate later in life as shingles. People don’t know why this occurs. Shingles is also known as herpes zoster. Anyone who has had the chickenpox can later get shingles.

The name “shingles” comes from the Latin word for “girdle,” and refers to how the shingles rash often forms a girdle or belt, usually on one side of the torso. Shingles can also erupt on your:

  • arms
  • thighs
  • head
  • ear
  • eye

An estimated 1 million people in the United States have shingles every year. About 1 out of every 3 people in the United States will get shingles in their lifetime, and 68 percent of these cases occur in people 50 years and older. People who live to be 85 years old have a 50 percent chance of developing shingles.

You can also get shingles a second time. This is less common and known as shingles recurrence.

The first symptom of shingles is usually pain, tingling, or a burning sensation in the outbreak area. Within days, a grouping of red, fluid-filled blisters that may break open and then crust over occurs. Other symptoms include:

  • itching in the outbreak area
  • skin sensitivity in the outbreak area
  • fatigue and other flu-like symptoms
  • sensitivity to light
  • chills

Recurring shingles has the same symptoms, and often the outbreak occurs in the same place. In about 45 percent of cases, the shingles outbreak was in a different place.

Data about how often shingles recurs is limited. A 2011 study in Minnesota over seven years found that between 5.7 and 6.2 percent of shingles people got shingles a second time.

In general, the research suggests that your risk of getting shingles a second time is about the same as the risk you had of getting shingles the first time.

The amount of time between the first case of shingles and a recurrence has not been well-researched. In the study from 2011, the recurrence occurred from 96 days to 10 years after the initial shingles outbreak, but this study covered only a 12-year period.

People don’t know what causes recurring shingles, but certain factors increase your chances of getting shingles again.

People with weakened immune systems are more likely to get shingles again. One study determined that the rate of shingles recurrence was 12 percent among people with compromised immune systems. This is about 2.4 times higher than for those who didn’t have compromised immune systems.

You may have a compromised immune system if you:

  • are getting chemotherapy or radiation therapy
  • have organ transplants
  • have HIV or AIDS
  • are taking high doses of corticosteroids like prednisone

Additional risk factors include:

  • longer-lasting and more severe pain with the first case of shingles
  • pain for 30 days or more with the first case of shingles
  • being a woman
  • being over the age of 50

Having one or more blood relatives with shingles may also increase your risk of getting shingles.

The treatment for recurring shingles is the same as for shingles.

If you suspect that you have recurring shingles, see your doctor as soon as possible. Taking an antiviral drug like acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir) can reduce the severity of shingles and reduce how long it lasts.

Your doctor may also prescribe medications to lessen your pain and help you sleep. These include the following:

  • Skin patches with the painkiller lidocaine are available. You can wear them on the affected area for a specific length of time.
  • Skin patches that have 8 percent capsaicin, an extract of chili peppers, are available. Some people cannot tolerate the burning sensation, even though the skin is numb before the patch is put on.
  • Antiseizure drugs, such as gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica), reduce pain by reducing the nerve activity. They have side effects that may limit the amount of the drug that you can tolerate.
  • Antidepressants such as duloxetine (Cymbalta) and nortriptyline (Pamelor) can be useful, especially to relieve pain and allow you to sleep.
  • Opioid painkillers can relieve pain, but they have side effects, such as dizziness and confusion, and they can become addictive.

You can also take cool baths with colloidal oatmeal to ease the itching, or apply cold compresses to the affected area. Rest and stress reduction are also important.

Shingles usually clears up within two to six weeks.

In a small number of cases, the pain can remain once the rash has healed. This is called postherpetic neuralgia (PHN). Up to 2 percent of people who get shingles have PHN for five years or more. The risk increases with age.

Recurring shingles isn’t preventable. You can reduce your risk by getting the shingles vaccine, even after you’ve had shingles.

A large-scale study showed that people who had the shingles vaccine had 51 percent fewer cases of shingles. For people 50-59 years old, the shingles vaccine reduced the risk of shingles by 69.8 percent.

People who received the shingles vaccine generally had less severe cases of shingles. They also had 66 percent fewer occurrences of PHN.

Doctors recommend the shingles vaccine for people over 50 but not for those who have a weakened immune system.