Shingles is a viral infection caused by the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After a person recovers from chickenpox, the VZV does not leave the body but remains dormant within nerve tissue. Years later, the virus can reactivate, leading to an outbreak of shingles. While many people experience shingles only once, it is possible for the condition to return.
Likelihood of Shingles Returning
The possibility of shingles returning, known as recurrent shingles, varies among individuals. Approximately 1 in 10 people who have had shingles will experience another episode. Recurrence rates can range from 1.2% to 9.6% in the general population, rising to 18% for those with compromised immune systems.
Several factors can increase the chances of shingles recurring. Advanced age, particularly being over 50, is a significant risk factor, as the immune system’s effectiveness naturally diminishes with age. Individuals with weakened immune systems due to conditions such as HIV/AIDS, cancer, diabetes, or autoimmune diseases, or those taking immunosuppressive medications like chemotherapy or corticosteroids, face an elevated risk. Experiencing long-lasting pain, known as postherpetic neuralgia (PHN), after the initial shingles episode can also increase the likelihood of recurrence. Women are slightly more prone to recurrent shingles than men. The average time between a first and second episode can vary, with some research suggesting about 2 years for individuals aged 45-54 and 3 years for those 55 and older.
Reducing the Chances of Shingles Returning
Taking proactive steps can help reduce the risk of shingles returning, with vaccination being the most effective measure. The Shingrix vaccine is recommended for healthy adults aged 50 and older, as well as for immunocompromised individuals aged 19 and above. This vaccine is highly effective, demonstrating over 90% efficacy in preventing shingles in healthy adults, and 68% to 91% in those with weakened immune systems.
The Shingrix vaccine is administered as two doses, typically given 2 to 6 months apart. Its protection has been shown to be long-lasting, with efficacy remaining high for up to 11 years. Even if someone has already experienced shingles, vaccination is still advised to prevent future episodes. Shingrix has replaced the older Zostavax vaccine due to its superior effectiveness and durability. While vaccination is the most direct preventive strategy, maintaining a healthy lifestyle, managing stress, and ensuring adequate sleep can generally support immune function.
What to Expect if Shingles Returns
If shingles returns, the symptoms are generally similar to the initial episode. People typically experience pain, a rash, and fluid-filled blisters that form in a single stripe on one side of the body. Early symptoms such as tingling, itching, or a burning sensation in the affected area may precede the rash by several days. Other accompanying symptoms might include headaches, fever, chills, or an upset stomach.
Seeking prompt medical attention is important if symptoms of recurrent shingles emerge. Early treatment with antiviral medications, such as acyclovir, valacyclovir, or famciclovir, can help reduce the severity and duration of the outbreak. These medications are most effective when started within 72 hours of the rash onset. While postherpetic neuralgia (PHN) can occur again with a recurrent episode, it does not always happen. If the rash appears on the face or near the eyes, consulting a doctor immediately is important to prevent potential complications.