Shingles can activate in anyone who has experienced chickenpox. In addition, certain factors, such as age or a weakened immune system, may increase a person’s risk of developing shingles.

The varicella-zoster virus (VZV), which healthcare professionals may also call human herpesvirus 3, causes both shingles and chickenpox. Shingles may result in a range of symptoms, including a painful rash on the skin.

This article considers the possible causes of shingles in more detail. It also discusses shingles symptoms, treatment, and prevention, as well as when to contact a healthcare professional.

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Shingles can develop in any person who has previously had chickenpox. After chickenpox clears, VZV remains in the person’s body for the rest of their life.

According to the American Academy of Dermatology Association, anyone born before 1980 has a very high chance of having had chickenpox, even if they have no memory of the illness.

In many cases, a person will fully recover and never experience any other issues from VZV. However, in the United States, about 1 in 3 individuals will develop shingles at some point. The majority of people only develop shingles once. However, some individuals may experience multiple occurrences of shingles.

It is important to note that if a person has not experienced chickenpox, they cannot develop shingles later in life.

A person who has not received the chickenpox vaccine or has never had chickenpox can acquire VZV when they come into close contact with someone with shingles. However, in this case, the virus will cause chickenpox rather than shingles.

Researchers still do not fully understand why dormant VZV becomes active and leads to shingles in some people and not others. The most likely cause may be the weakening of the immune system as a person ages.

Risk factors and potential triggers

The risk of getting shingles increases as a person ages. People over the age of 50 have the highest risk of developing the illness. While it can develop in younger adults and children if they have had a previous case of chickenpox, this is less common.

Other people at high risk of developing shingles include those with a weakened immune system. This can include people who are:

  • living with HIV
  • receiving treatment for cancer
  • living with certain cancers, such as leukemia
  • taking immunosuppressants, which are medications that suppress a person’s immune system

Additionally, according to a 2017 article, women are at an increased risk of developing the condition.

Other possible triggers may include:

In other words, some experts believe that the immune system may keep VZV in the body suppressed and that any event that weakens the immune system may trigger the virus and shingles development.

Shingles typically causes a blistering, painful rash to appear on a person’s skin. Often, the rash appears in the following pattern:

  • A person’s skin may feel tingly, burning, or painful 1–2 days before the rash develops.
  • A painful blistering rash appears where a person felt skin irritation in the days before, usually on one side of their body. Additional blisters may also appear after the original rash in the surrounding area.
  • The blisters may start to crack open and bleed or form scabs as the healing process begins, with the rash usually clearing within 1–2 weeks.

Typically, the rash only appears on one side of the body or in a band around a person’s torso. It can occur in other areas, including the face. Due to the risk of vision impairment, a person should contact a doctor immediately if a shingles rash appears on their face.

In some cases, a person may also develop symptoms that include:

About 10–18% of people will develop a complication from shingles called postherpetic neuralgia (PHN). This condition causes lingering pain where the rash appeared.

Treatments for shingles may help ease symptom severity and shorten the duration of the infection.

Treatment typically consists of taking antiviral medications. They can include:

A person should start taking the medications as soon as possible following a shingles diagnosis. If a person takes antiviral drugs , it may help reduce the risk of PHN.

A healthcare professional may also recommend taking acetaminophen or ibuprofen to help manage pain.

The best prevention for shingles is the recombinant zoster vaccine (Shingrix). The Centers for Disease Control and Prevention (CDC) recommend everyone over the age of 50 and those over the age of 19 with a weakened immune system receive 2 doses.

According to the CDC, the vaccination is 90% effective in preventing shingles and PHN.

It also advises that children under 13 years receive the chickenpox vaccine. People over the age of 13 who have never experienced chickenpox should also consider getting the vaccine, as preventing chickenpox can effectively stop shingles from developing later in life.

Once a person develops a shingles rash, they can pass VZV to anyone who has not had a chickenpox vaccination or previously had the virus. To prevent transmission, people with shingles should avoid contact with anyone who may be at risk of developing chickenpox or shingles.

A person should contact a doctor right away if they suspect they have chickenpox or shingles. A healthcare professional can diagnose the condition and, if necessary, provide antiviral treatment to help shorten the duration of shingles and help prevent PHN.

Individuals should also consult a doctor immediately if a shingles rash forms on the face, as this can cause potentially permanent vision issues in some cases.

Shingles may activate in older adults and anyone with a weakened immune system. Only people who have had chickenpox in the past can develop shingles. However, VZV can transmit from a person with shingles to young children and unvaccinated adults if they have never had chickenpox and cause a chickenpox infection.

Individuals should contact a doctor as soon as possible if they notice any signs of shingles. A healthcare professional can provide treatment to help a person recover faster and avoid potential complications.