Shingles Can Develop at Any Age
Medically reviewed by Lauren Schlanger, MD
The idea that only older people should be concerned about getting shingles is untrue. Although the rate of shingles increases with age, it can occur at any age in a person who previously had a varicella-zoster virus (VZV) infection, also known as chickenpox.
Shingles, also known as herpes zoster, is a viral infection that causes a painful rash and blisters on the skin. Some cases can lead to complications, such as postherpetic neuralgia (PHN), a long-term condition that affects the nerve fibers of the skin where shingles occurred, causing pain.
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Shingles occurs when VZV reemerges after a period of inactivity in the body. If you've had chickenpox, the virus stays in the body and can later become reactivated for reasons that are not fully understood. When VZV is reactivated, the condition it causes is known as shingles.
This article will provide an overview of shingles and explore theories that explain the rates of increase.
Incidence of Shingles
About 1 million cases of shingles, affecting about four out of 1,000 individuals, occur in the United States each year.
Risk Factors for Shingles
According to the Centers for Disease Control and Prevention (CDC), one in three people will develop shingles in their lifetime. Children who receive varicella (chickenpox) vaccination have a lower risk of later contracting shingles than those who do not. Despite this, certain factors can increase the risk of developing shingles.
These include:
Your age: While the incidence among younger people is on the rise, the risk of shingles increases significantly after 50 years of age. This is because the immune system's response to identifying and fighting off pathogens (disease-causing agents like viruses and bacteria) becomes reduced or delayed, and decreases substantially after 65 years of age.
If you have an underlying health condition: Certain cancers (such as leukemia) and human immunodeficiency virus (HIV) increase your risk of getting shingles. These conditions hinder the immune system's ability to function properly.
If you take immunosuppressants: Immunosuppressants are drugs that reduce the immune system's ability to fight infections. If you take immunosuppressants (such as chemotherapy drugs, corticosteroids, and some biologics) you are also at greater risk for developing shingles.
Signs and Symptoms
Although shingles can be visible on any area of the body, it usually appears as a band on the trunk of the body or on one side of the face in the form a painful rash or blisters. You can get shingles once or, in rare cases, two or more times.
The signs and symptoms of shingles vary from person to person. Common signs and symptoms include:
Itching, tingling, sensitivity, or numbness of the skin (usually occurs before a rash develops)
Rash (visible one to five days after symptoms begin)
Painful blisters
Fever and chills
Headache
Stomach discomfort and ache
Related: Can You Get Shingles More Than Once?
Treatment and Management
Although shingles has no cure, it is important to seek medical attention when appropriate. If you suspect you have shingles and experience any of its associated signs and symptoms within the first three days, consult your healthcare provider as soon as possible. Antiviral medications work best when taken 24 to 48 hours after symptom onset.
Your healthcare provider will evaluate and determine the best course of treatment based on:
Age
Medical history
How long you've had the infection
The extent of infection
If you've had a history of recurrence
Any adverse side effects to medication
Your medication preferences
Common treatments for shingles and PHN include:
Antiviral medications, which include Famvir (famciclovir), Valtrex (valacyclovir), and Zovirax (acyclovir), reduce the length of your symptoms and the progression of the disease by inhibiting VZV from replicating in your body. These antiviral medications work best within 72 hours after developing the rash.
Anticonvulsant medications, which include Neurontin (gabapentin) and Lyrica (pregabalin), can be used to treat neuropathic (nerve) pain from PNH. Several studies have shown that both medications can reduce pain by about 50%.
Topicals, which include creams and lotions containing just 5% lidocaine (a local anesthetic) or a combination of 5% lidocaine and capsaicin, are used to temporarily relieve nerve pain caused by PHN. Be careful not to use lidocaine if you have blisters, open sores, or other wounds, as it is toxic if it becomes absorbed into the body. Capsaicin, the active ingredient in chili peppers, can relieve neuropathic pain caused by PHN.
Over-the-counter (OTC) medications, which include Tylenol (acetaminophen) or Motrin or Advil (ibuprofen), are used to relieve pain.
Cold compresses, which include an ice pack or a cool, wet cloth, can help ease pain. When using a cold compress, keep the affected area on your skin dry for optimal effect.
How to Prevent Shingles
The best way to prevent shingles is through vaccinations. The CDC recommends individuals 50 years or older get two doses of Shingrix, a vaccine for shingles, which provides over 90% protection.
Shingrix is a recombinant vaccine, which means it is made from just a part of the virus and, therefore, the virus cannot replicate. The vaccine does not cause the infection itself. Shingrix also protects individuals against the complication of PHN.
Individuals who are 19 years or older and are immunocompromised should also receive two doses of Shingrix. However, the effectiveness of Shingrix varies if you are immunocompromised. Studies show a 68%–91% efficacy, with percentages differing based on the underlying health condition(s) you may have.
Who Should Get Shingrix?
The CDC recommends getting two doses of Shingrix if you:
Are 50 years or older (each dose separated by two to six months)
Are 19 years or older and are immunocompromised (each dose separated by one to two months)
Have a history of shingles (to prevent recurrences)
Received Zostavax, a shingles vaccine that has been discontinued in the United States as of November 18, 2021
Had chickenpox or received the varicella vaccine
You should not get Shingrix if you currently have shingles or are pregnant.
Related: Shingles Prevention
Summary
Shingles can occur at any age. Shingles (herpes zoster) is a viral infection that causes painful rashes and blisters on the skin. Some infections can lead to complications, such as postherpetic neuralgia (PHN), a condition characterized by chronic pain even after the infection is gone.
According to the CDC, one in three people will develop shingles in their lifetime. Risk factors that can increase your risk for contracting shingles include your age, if you have an underlying health condition, and if you are immunocompromised.
The best way to prevent shingles is through vaccinations. The CDC recommends individuals 50 years or older and those who are 19 years or older who are immunocompromised get two doses of Shingrix for protection against shingles.
A Word From Verywell
The best prevention against shingles is by getting vaccinated, including childhood chickenpox vaccination and adult shingles vaccination.
Vaccine-acquired immunity (introduction of weakened or killed pathogens) from varicella vaccines is much safer than natural-acquired immunity (exposure to pathogens from the actual disease), as the symptoms of chickenpox can be serious to life-threatening.
As always, speak to your healthcare provider if you have any concerns about the safety and efficacy of vaccines.
Frequently Asked Questions
Do you need to see a healthcare provider for a mild case of shingles?
If you notice any symptoms of shingles, especially if you develop a rash, consult your healthcare provider within the first three days (72 hours). This is because antiviral medications that are used to treat shingles work best within 72 hours after developing a rash.
What are the first signs of shingles?
The first signs of shingles are skin irritation, tingling, sensitivity, itching, numbness, or pain on one side of the body. A rash and blisters indicate a more advanced form of the disease.
How long does it take to recover from shingles?
It takes about three to five weeks to recover from shingles. In some cases, you may develop postherpetic neuralgia (PHN), a condition characterized by pain even after the infection is over. The risk for PHN increases the older you are.
Read the original article on Verywell Health.
