If you contract the chickenpox virus, also known as varicella-zoster, your illness will typically clear up in a week or two. However, this virus remains in your body even after you’ve recovered. When you first contract the varicella-zoster virus (VZV), you’ll get chickenpox. When you fight off this virus, your body creates immunity to it, so it’s very rare to get chickenpox a second time.
However, as Healthline reports, that doesn’t mean that your body rids itself of the virus entirely. Though a strong immune system will keep the virus inactive, it’s still there for the rest of your life. The virus lies dormant when your immune system is strong. But if something causes you to become immunocompromised, the virus can reactivate. This triggers shingles.
According to the Centers for Disease Control and Prevention (CDC), the chance of getting shingles at some point in your life is 1 in 3, and, over 99 percent of people in the United States born before 1980 have had chickenpox or been exposed to VZV. About 1 million people in the United States get shingles every year.
What is Shingles?
Typically, shingles shows up as a painful rash, usually only on one side of your body, on an area of skin that is supplied by a single nerve. This area, regardless of its location on the body, is known as a dermatome. Look for these hallmarks of a shingles rash:
- A band of blistering lesions may cover red, inflamed skin, often on one side of the torso or face.
- Pain starts out feeling tingly or burning. Other common sensations include itching and numbness.
- The pain progresses in severity over several days.
- It feels like the pain is coming from the organs in your abdomen, like your heart, gallbladder, appendix, or kidneys.
- Sometimes (though rarely) people experience severe pain without a rash, known as zoster sine herpete.
Some people also have other, more general symptoms, like fever, chills, and headache.
“One of the other things that can happen that’s more serious is if you get shingles on the head, it can infect the eyes,” says Dr. Ankush Bansal, a member of the American Medical Association who wrote about shingles for the AMA’s What Doctors Wish Patients Knew™ series. “And if it does infect the eyes, you need to see an ophthalmologist immediately. And you may have to be admitted to the hospital for medication because it can cause vision problems or even vision loss,” he added.
How Long do Symptoms Last?
Typically, shingles lasts about a week to ten days, “But that part where it crusts over usually happens within 48 to 96 hours or an average of about 72 hours.” However, symptoms can last up to 4 weeks or even persist for much longer. “What can happen after a shingles infection—which a lot of people are worried about—is that you can get what’s called postherpetic neuralgia,” Dr. Bansal said. “All that means is you have nerve pain after getting the shingles infection.”
About one in 10 people who get shingles develop nerve pain that can last for months or even years after the rash goes away. “It’s kind of like you have a pins and needle or sharp and shooting pain in that part of the body that got the shingles rash and it just doesn’t go away,” he said. “It’s there all the time and it’s debilitating and it’s stressful.”
How is Shingles Transmitted?
“It’s the same virus as chickenpox, so it is contagious and there are two ways that you can transmit shingles,” said Dr. Bansal. “In the case of chickenpox, it is airborne. So, the way it will spread is you breathe it in if an infected person coughs and you’ll catch it by air.”
“The second and more common way is, in the early phase when you’ve got those lesions on your skin from shingles or chickenpox, there’s going to be a little bit of fluid there. That fluid is highly infectious and it’s full of virus,” he said. “So, if you touch somebody’s lesion or somebody touches your lesion, they can” spread varicella zoster virus. And if you have never had chickenpox or received the vaccine, you can get chickenpox from someone who has shingles.
“That’s why it is really important to be careful who you are around and that you practice good hygiene,” Dr. Bansal emphasized.
Who is Most at Risk for Getting Shingles?
The primary risk factor associated with getting shingles is a weakened immune system. When your immune system isn’t functioning properly, VZV can reactivate. As you age, your immune system doesn’t fight off invaders as well.
“Basically, as you get older, the chance of you getting shingles increases. So, most people who get shingles are age 50 and above,” Dr. Bansal said. “And every 10 years above that, your chance of getting shingles increases. The main reason for that is your immunity starts to decrease as you get older,” he said. “If you’re 60 versus 50, your immune system is weaker than when you are at age 50 and same for age 70 and 80. So, the chance of shingles increases.”
“The other risk factors are if you’ve had any kind of transplant—whether it’s an organ transplant or even let’s say a bone marrow transplant for some kind of blood disorder or blood cancer,” Dr. Bansal said. “If you are on immunosuppressant medicines for various conditions, let’s say you’ve got Crohn’s disease or rheumatoid arthritis and you’re on one of these fancy biologic IV medications, it may increase your risk of getting shingles as well as other infections.” Additionally, says Dr. Bansal, “if you have HIV or AIDS, that increases your risk,” he said. “Or if you have to take steroids for a long period of time or you’re on a high dose, that can also increase your risk.”
Shingles is on the Rise in Younger People
One of the things that can weaken your immune system, and therefore leave you vulnerable to a shingles infection is stress. “We do see it in young people because people are getting stressed,” says Dr. Brian Lamb of Allegheny Health Network.
“And that can be physical stress such as an injury. It can also be an illness, whether you developed a cancer, a really bad infection, broke a bone or experienced head trauma… but it can also be very severe mental stress from any number of things,” adds Dr. Bansal. “Because mental stress can lead to physical problems and so when you have that stress, it’ll activate certain kinds of hormones or proteins, it’ll make your immune system go down.”
Get Vaccinated to Prevent Contracting Shingles
“The shingles vaccine is recommended for people 50 years of age or older, and people over age 19 if you have certain immune conditions,” Dr. Bansal said, noting it wouldn’t be recommended if “you are getting cancer treatment or it may interfere with some of the medicines you’re on like chemotherapy and that sort of thing.”
“But, generally speaking, everybody over the age of 50 is recommended to get the vaccine,” he said. “Now with all vaccines, getting a vaccine is not a guarantee that you will not get the infection, but it greatly reduces the chance of you developing shingles and if you develop shingles, it reduces the chance that it’ll be severe.”
A younger person can ask their doctor for the vaccine, but there is a catch. Currently insurance companies won’t cover the shingles vaccine unless you’re over 50. If you are younger than 50 and concerned because you have a high-stress job, talk to your doctor.
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