Young people can get shingles, but older adults have a much higher risk of the condition. However, trends show an increasing rate of shingles among younger and middle-aged people.

Shingles is a condition that typically affects older adults. While the risk of getting shingles increases as a person ages, anyone who has had chickenpox may develop shingles.

This article explores shingles and why young people may also get shingles. It also compares younger people and children who develop the condition, possible complications, treatment, and prevention.

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Shingles is a viral infection characterized by a painful, blistering skin rash.

It occurs due to the reactivation of the varicella-zoster virus (VCV) — the same virus that causes chickenpox. The virus remains dormant in the body and may reactivate later in life. VZV belongs to a group of viruses called herpes viruses. People also refer to shingles as “herpes zoster.”

Almost 1 in 3 people in the United States will develop shingles.

Most who get shingles are older than 50 years. Its incidence increases with age and is 10 times more likely in adults 60 years and older than in children under 10 years.

A 2022 article notes the incidence among younger healthy individuals is 1.2–3.4 per 1,000 persons, while the incidence among people over 60 is 3.9–11.8 per 1,000.

However, while the rate of shingles among older adults has been reducing from 2008–2016, its rate among adults ages 30 and up has increased.

Similarly, a 2016 study found a 4.5-fold increase in the incidence of shingles among all age groups over the past six decades in the U.S.

Shingles can develop in anyone who has had chickenpox. The virus lies dormant in the body even after they recover from chickenpox.

Read more about the link between shingles and chickenpox.

What causes the virus to reactivate remains unknown. However, it occurs more in people with weakened or suppressed immune systems.

The cause of the increasing incidence of shingles also remains unknown. However, there are several theories outlined below.

People unknowingly had chickenpox or missed their vaccines

The chickenpox vaccine became available in the U.S. in 1995 for children ages 1 year and above.

Those born before may have had chickenpox or not received the vaccination, which may explain the occasional cases of shingles in young adults.

Increased childhood vaccinations

The rate of shingles has increased since the chickenpox vaccine became available. The increased number of shingles may be due to the diminishing immunity provided by the vaccine over time.

The theory is that a person’s immunity may not be as strong as the natural immunity a person gets from exposure to chickenpox. Since the varicella vaccines use the weakened form of the virus, it induces the body to produce antibodies against the virus rather than naturally developing it.

Alternatively, parents and caregivers may encourage their children to build immunity before adulthood.

Learn more about pox parties.

Rise of chronic diseases

More than half of adults in the U.S. have at least one of 10 chronic conditions, such as weak or failing kidneys and diabetes. More than 1 in 4 have multiple chronic conditions.

Increased healthcare-seeking and awareness

Another theory is that more people are seeking healthcare than before. The increase in healthcare professionals may also contribute to increased awareness about the disease.

Many studies show that an altered immune system plays a central role in processes involved in chronic diseases.

People with chronic diseases may also have poor immune functions, which may put them at an increased risk of developing shingles.

Environmental factors

Another speculation is the role of environmental factors in the reactivation of the virus.

Several studies reported a higher incidence in summer due to increased exposure to UV radiation, which may suppress cell-mediated immunity and promote virus reactivation.

A person’s risk of developing shingles increases as their cell-mediated immunity against the virus declines. This decline can result from increasing age and other factors.

People with the following conditions are at risk of shingles:

Shingles typically present symptoms before the rashes appear. These include:

Learn more about the timeline of shingles.

A painful rash typically appears 2–3 days after the initial symptoms.

While the rash can appear on any part of the body, it typically appears on the trunk and does not cross the midline. It usually occurs on one side of the body supplied by a skin nerve — dermatome.

The rash develops into clusters before drying and crusting. This phase may last for 2–4 weeks before healing.

People with shingles can not pass the virus on before their rashes blister or after they crust.

Direct contact with the fluid from the blister can spread the VCV virus and cause chickenpox in people who have never received the chickenpox vaccine or have never had chickenpox.

Learn more about how a person can contract shingles.

Other effects

Shingles can also appear on the face and affect the eyes and mouth.

Shingles in the eye or herpes zoster ophthalmicus occur in 10–25% of cases. It also presents with:

Learn more about shingles in the eye.

This condition may lead to:

Shingles oticus, also known as Ramsay Hunt syndrome type II, occurs when the virus spreads from the facial nerve to the vestibulocochlear nerve. It can lead to vertigo and hearing loss.

Children younger than 3 years rarely develop shingles. It tends to be less severe when it affects younger age groups.

It typically presents with initial symptoms of pain and tingling sensation — paresthesia — followed by a flat rash.

Learn more about the early stages of shingles.

Throughout the course of the condition, as with adults, shingles in children may involve:

  • tingling
  • sharp burning pain
  • itching

Child risk factors

Children who are at risk of shingles include those:

  • who have had chickenpox before turning 1 year old
  • whose birthing parent contracted chickenpox very late in their pregnancy
  • with a weakened immune system

Infants whose birthing parent contracts chickenpox 5–21 days before giving birth may develop shingles during the first 5 days of their life. This development may occur due to their immune system not yet being able to keep the virus latent.

Children may also present with the following symptoms:

Read more about shingles in children.

Complications of herpes zoster include:

  • Disseminated zoster: This occurs if there are more than 20 lesions outside the initial site. It may also affect organs, causing encephalitis and hepatitis.
  • Postherpetic neuralgia: This may result in persistent pain 1 month after the onset of shingles.
  • Other conditions: The involvement of the nervous system, leading to:
  • Pregnancy complications: Shingles early in the pregnancy may cause complications in the fetus.

A person who thinks they have shingles should talk with a doctor within 3 days after the rash appears.

It is also essential to seek immediate help if shingles are near the eye or ear to avoid complications such as hearing and vision loss.

While there is no cure for shingles, antiviral medications can help limit the pain and clear blisters faster.

Antiviral medications can help reduce the length and severity of shingles. However, these are most effective when a person takes them within 3 days after the rashes appear. These medications include:

A person may also use the following to relieve pain and discomfort caused by shingles:

Vaccination is the best way to prevent shingles.

Both children and adults who have never had chickenpox should get the varicella vaccination. Nine out of 10 children who receive a single dose develop immunity against chickenpox.

Meanwhile, the Centers for Disease Control and Prevention (CDC) recommend 2 doses of Shingrix in adults 50 years and older and those 19 years and older with weakened immune systems. This vaccine is more than 90% effective in preventing shingles.

People who received the now-discontinued Zostavax vaccine before 2020 should consider getting the Shingrix vaccine.

Most shingles clear within 3–5 weeks. In others, postherpetic neuralgia may last from months to years. However, this is rare in people younger than 40 years.

Learn more about the recovery of shingles.

Shingles can affect anyone who contracted chickenpox in the past. While shingles is a condition that affects older adults, current trends show an increasing rate of viral infection in younger adults.

A person who develops shingles should immediately seek medical help for prompt treatment. Getting antiviral medication within 3 days of the appearance of the rash can help quicken recovery, reduce its severity, and prevent the likelihood of postherpetic neuralgia.