Shingles is a viral infection that results in a painful rash, typically presenting as a stripe of blisters on one side of the body. It stems from the Varicella-Zoster Virus (VZV), the same virus causing chickenpox. After chickenpox, VZV remains in the body.
The Likelihood of Recurrence
Shingles can recur. While most people only have it once, recurrence is possible because the Varicella-Zoster Virus remains in the body. Approximately 1.2% to 9.6% of individuals who have had shingles may experience another episode. This rate can be higher, reaching up to 18%, in people with weakened immune systems. Subsequent episodes may vary in severity or location.
The Dormant Virus Explained
The dormant nature of the Varicella-Zoster Virus explains shingles recurrence. After chickenpox, VZV retreats and establishes a latent state within nerve cells, residing in sensory ganglia near the spinal cord. The virus remains inactive, often for decades, without causing symptoms.
Various triggers can cause this latent virus to reactivate. When reactivated, VZV travels along nerve pathways to the skin. This journey manifests as the painful rash and blisters, typically appearing in the dermatome (area of skin supplied by a single nerve) associated with the affected nerve. This explains why shingles often presents as a localized rash on one side of the body.
Factors Influencing Reactivation
Several factors can increase the risk of shingles recurrence. Age is a factor, with older individuals, particularly those over 50, facing a higher risk due to the natural weakening of the immune system with aging.
Weakened immune systems also contribute to reactivation risk. Conditions such as HIV/AIDS, cancer, and organ transplants can suppress the immune system. Certain medications, including chemotherapy, corticosteroids, and other immunosuppressants, can increase VZV reactivation. Chronic physical or emotional stress is another trigger, as it can weaken immune function. Lastly, having had a previous shingles episode is a prerequisite for recurrence, and a severe initial outbreak or one complicated by postherpetic neuralgia might indicate a higher risk for future episodes.
Proactive Measures to Prevent Recurrence
Taking proactive steps can help reduce the risk of shingles recurrence. Vaccination is considered the most effective measure, with the shingles vaccine (Shingrix) being highly recommended for adults. This vaccine is over 90% effective in preventing shingles in adults aged 50 and older, and it can significantly reduce the chances of recurrence even if a person has already had shingles. The vaccine works by boosting the body’s immune response against the Varicella-Zoster Virus, strengthening its ability to keep the virus dormant.
Supporting overall immune system health through lifestyle choices is also beneficial. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins provides the necessary nutrients for robust immune function. Regular physical activity, aiming for at least 30 minutes most days of the week, can also invigorate the immune system. Adequate sleep, typically 7-9 hours per night, is important for immune system rejuvenation.
Managing stress effectively can mitigate its potential role as a trigger for recurrence. Techniques such as meditation, deep breathing exercises, and engaging in relaxing activities can help control stress levels. While not a preventative measure for recurrence itself, prompt antiviral treatment during an active shingles outbreak is important. Starting antiviral medications within 72 hours of rash onset can reduce the severity and duration of the episode, and potentially minimize nerve damage that could contribute to future issues like postherpetic neuralgia.