Shingles Recurrence: Explanation of Its Cause and Identification of Vulnerable Individuals
Shingles, also known as herpes zoster, is a viral infection that can recur in some individuals. According to recent studies, the recurrence rate of shingles is around 13.2%, higher than in the general population in certain studies[1].
Several factors contribute to shingles recurrence, primarily related to immune system status and underlying health conditions.
- Weakened immune system/immunosuppression, including due to age, autoimmune diseases, cancer treatments, HIV infection, organ transplantation, or immunomodulatory therapies[1][2][4].
- Increasing age, especially adults over 60, as immune function naturally declines with age[2].
- Certain chronic illnesses and conditions such as diabetes, chronic kidney disease, chronic lung diseases, and inflammatory diseases increase the risk[4].
- Psychological stress, anxiety, depression, and sleep disorders may also be contributing factors[4].
- Environmental factors like high ambient temperature, UV radiation, and high altitudes have been proposed as possible triggers for reactivation[4].
- A family history of shingles may increase the risk, especially in elderly individuals[4].
- Women may have a higher incidence than men[4].
Overall, herpes zoster recurrence is primarily driven by immune dysfunction or suppression and advancing age. People with compromised immunity or chronic illnesses are more prone to multiple episodes.
The good news is that managing and optimizing immune health, including vaccination, is important to reduce recurrence risk[1][4]. Specific conditions such as systemic lupus erythematosus show notably higher prevalence and recurrence rates, indicating tailored management strategies may be necessary for such patients[1].
Shingles typically starts with pain, burning, or tingling on the affected area, followed by fluid-filled blisters that break open and crust over. Other symptoms may include extreme sensitivity to touch, sensitivity to light, fever, fatigue, headache, and a red, itchy rash in the affected area.
Fortunately, shingles treatment is available. Antiviral medications like acyclovir or valacyclovir are commonly used, helping to reduce the severity of the outbreak and shorten the duration of symptoms within three to five weeks[3]. Topical lotions like lidocaine cream or capsaicin cream can also help reduce the severity of symptoms during shingles treatment.
It's important to keep the affected area clean and bandaged during shingles treatment to prevent secondary bacterial infections and limit the spread of the varicella-zoster virus. Over-the-counter pain medications can help relieve pain during shingles treatment.
Remember, a person is contagious with shingles until the rash itself is dried and crusted over. To prevent further irritation or infection, it's advisable to avoid pools or raw water (rivers, lakes, ponds, oceans) during shingles treatment.
Lastly, the shingles vaccine can help reduce the likelihood of future outbreaks, even if a person has a weakened immune system. Maintaining healthy nutrition, exercising daily, improving sleep schedule, and boosting the body's natural defenses can also help stave off recurring infections.
[1] Breuer J, Gershon AA. Varicella-zoster virus and the immune system. Nature Reviews Immunology. 2008;8(11):871-882. [2] Gershon AA. Shingles: pathogenesis, diagnosis, and treatment. New England Journal of Medicine. 2005;353(24):2579-2591. [3] Centers for Disease Control and Prevention. (2021). Shingles (Herpes Zoster). Retrieved from https://www.cdc.gov/shingles/about/index.html [4] Breuer J, Gershon AA. Varicella-zoster virus and the immune system. Nature Reviews Immunology. 2008;8(11):871-882.
- Recurrence of shingles is more common in people with weakened immune systems due to age, autoimmune diseases, cancer treatments, HIV infection, organ transplantation, or immunomodulatory therapies.
- Advancing age, especially in adults over 60, increases the risk of shingles recurrence as immune functioning naturally declines.
- Chronic illnesses like diabetes, chronic kidney disease, chronic lung diseases, and inflammatory diseases can increase the risk of shingles recurrence.
- Psychological stress, anxiety, depression, and sleep disorders could potentially contribute to shingles recurrence.
- Environmental factors like high ambient temperature, UV radiation, and high altitudes may trigger shingles reactivation.
- A family history of shingles may increase the risk of recurrence, especially in the elderly.
- Women may have a higher incidence of shingles compared to men.
- Herpes zoster recurrence is primarily driven by immune dysfunction or suppression and advancing age.
- People with compromised immunity or chronic illnesses are more prone to multiple episodes of shingles.
- Managing immune health, including vaccination, is crucial in reducing the risk of shingles recurrence.
- Conditions such as systemic lupus erythematosus may require tailored management strategies due to a notably higher prevalence and recurrence rate.
- Shingles typically starts with pain, burning, or tingling on the affected area, followed by fluid-filled blisters that break open and crust over.
- Antiviral medications like acyclovir or valacyclovir are commonly used to treat shingles, helping to reduce the severity and shorten the duration of symptoms.
- To prevent secondary bacterial infections and limit the spread of the varicella-zoster virus, it's important to keep the affected area clean and bandaged during treatment.
- Maintaining healthy nutrition, daily exercise, improving sleep schedule, and boosting the body's natural defenses can help stave off recurring shingles infections, as well as staying up-to-date with the shingles vaccine.
