Older adults have a greater risk of developing complications from shingles, typically due to having weaker immune systems. In most cases, a person will only get shingles once in their lifetime. However, shingles can sometimes flare up again.

Shingles is a disease that causes a painful blistering rash due to reactivation of the varicella-zoster virus (VZV). It is also known as herpes zoster (HZ).

VZV also causes chickenpox. It lives in the cells and can reactivate as people age or become immunosuppressed.

Doctors diagnose more than 1 million cases of shingles in the United States every year. One in 3 people will develop HZ in their lifetime. Aging, illness, and stress are typical triggers for shingles.

Shingles is more likely to affect older adults. The Shingrix vaccine can help prevent shingles in adults ages 50 years and older.

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Older adults’ immune systems typically weaken as they age. This means people over age 60 are at a higher risk of experiencing complications from shingles.

About half of all shingles cases occur in adults age 60 or older. Many adults get shingles by age 70.

When VZV reactivates, the virus multiplies and migrates along the nerves. This can lead to long-term neurological complications due to interference with the nervous system.

A 2017 study suggests that patients with VZV are at a higher risk of ischemic or hemorrhagic strokes. In the study, patients had a greater risk of stroke shortly after an acute episode of shingles. However, the risk was still notable after the first year. Patients with HZ ophthalmicus infection were at a higher risk still.

Another study analyzed data from over 200,000 adults. It found that people with shingles had an almost 30% increased risk for a future cardiovascular event, such as a heart attack.

The first symptom people typically notice is pain in a band on one side of the body. The pain can be mild to severe. This symptom may develop before a rash appears.

Most people with shingles develop one or more of the following symptoms:

Blisters may occur on the face or near the eyes, known as HZ ophthalmicus. This can lead to eye damage and blindness, hearing loss, or brief paralysis of the face. Rarely, it can lead to inflammation of the brain (encephalitis).

A person should contact their doctor immediately if they notice blisters on the face.

Older adults have a higher risk of complications from shingles.

The most common complication of shingles is postherpetic neuralgia (PHN). PHN is a continuous, chronic nerve pain that remains even after the blisters heal and the rash clears up. PHN is extremely painful and can disrupt daily life.

According to the Centers for Disease Control and Prevention (CDC), around 10–18% of people who have shingles experience PHN. People under age 40 are less likely to develop PHN.

Other complications include:

Read about some after-effects of shingles.

A person with shingles symptoms should contact a doctor for diagnosis.

Several treatment options are available, including the following antiviral medications:

These medications may help shorten the length and severity of shingles. However, a person may also need pain relief medications to help with shingles pain. These can include topical medications with numbing agents to relieve mild pain, such as lidocaine.

Doctors typically prescribe steroids for people with PHN to help improve recovery.

Along with prescription medication, a person with shingles can manage symptoms at home by:

  • wearing loose-fitting clothing and keeping the rash covered to avoid scratching
  • applying cool, damp cloths to the blistered areas
  • avoiding stress
  • engaging in light exercise, such as walking and stretching
  • resting and eating well-balanced meals
  • soaking in an oatmeal bath

The rash typically appears 1–5 days after the first symptoms. It looks like small red spots that turn into blisters. Shingles blisters typically form scabs after 7–10 days. Most cases of shingles last 3–5 weeks.

Read more about recovering from shingles.

A shingles vaccination may help prevent shingles.

The CDC recommends that adults age 50 and over receive two doses of recombinant zoster vaccine (RZV, Shingrix). This can help prevent shingles and related complications.

People age 19 and over with a weakened immune system due to illness or medication should also receive the vaccine.

The virus is infectious while someone has blisters. As a result, it is important to cover the rash, wash hands regularly, and avoid contact with people at risk of serious infection. These include:

  • pregnant females
  • babies younger than 12 months
  • anyone who is sick, especially due to cancer or AIDS
  • anyone receiving immunosuppressing treatment, such as chemotherapy
  • anyone who has not had chickenpox

Receiving the shingles vaccine can greatly reduce a person’s chance of spreading the disease.

While anyone can develop shingles, it predominantly affects adults over 50. Sometimes, it can lead to serious complications in people with weakened immune systems.

It is important to contact a doctor as soon as possible if someone is experiencing shingles symptoms. These can include a rash occurring in a band on one side of the body.

People over age 50 should speak with a doctor about receiving a shingles vaccination.