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Shingles Can Develop at Any Age

Though getting older increases your risk of shingles, young adults can develop this condition as well. Learn more about why this happens. The idea that only older people should be concerned with getting shingles is untrue. The rates of singles have been stable in older adults since 2008. However, the rates of shingles are increasing in middle-aged and, especially, younger adults.The

  • Posted on 19th May, 2022 18:55 PM
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The idea that only older people should be concerned with getting shingles is untrue. The rates of singles have been stable in older adults since 2008. However, the rates of shingles are increasing in middle-aged and, especially, younger adults.

The exact reason for this increase is unknown. Still, studies suggest that it could be caused by decreased early exposure to the shingles virus, known as the varicella-zoster virus (VZV), due to childhood varicella vaccinations. VZV is also the virus that causes chicken pox.

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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 serious complications, such as postherpetic neuralgia (PHN), a long-term condition that affects the nerve fibers of the skin where shingles occurred, causing pain.

Shingles occurs when VZV reemerges after a period of inactivity in the body. If you've had chicken pox, 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 (chicken pox) vaccination have a lower risk of later contracting shingles compared to those who do not. Despite this, there are certain factors that can increase your risk of contracting 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.

Theories

Since 1998, the rates for shingles in the United States have been growing among young and middle-aged adults, while the rates have remained stable for older adults since 2008. Researchers aren't sure why this is, but there are a few theories to explain the rise in young and middle-aged adults. These include:

Childhood varicella vaccinations: Studies show that the rates of shingles have increased since varicella vaccines were introduced in 1996. Varicella vaccines use a live-attenuated (weakened) form of VZV to stimulate the immune system into producing antibodies that fight off the virus (the vaccine does not cause varicella itself). In doing so, the body is protected against the disease.

Some researchers speculate that an increase in shingles may be attributed to the lack of exposure to wild varicella-zoster virus. As their immunity wanes over time, adults aren't given a natural "boost" by being exposed to children who have chickenpox.

Increased chronic diseases: Chronic diseases such as cancer, HIV, and diabetes are on the rise in the United States. These diseases may hinder the immune system's ability to fight off infections, leading to an increased risk of developing shingles. Also, immunosuppressive drugs are more widely used for various chronic diseases.

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

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.

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 seizures and 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 to 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.

Summary

The rates of shingles are increasing in younger adults. The exact reason for this increase is unknown, but studies suggest that it could be caused by decreased exposure to the shingles virus, known as the varicella zoster virus (VSZ), due to childhood varicella vaccinations.

Shingles, which is also known as herpes zoster, is a viral infection that causes painful rashes and blisters on the skin. Some infections can lead to serious 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

Shingles can occur at any age. The best prevention against shingles is by getting vaccinated. If you have children, the possible correlation between childhood varicella vaccinations and the increase in rates of shingles should not deter you from getting them vaccinated.

Vaccine-acquired immunity (introduction of weakened or killed pathogens) from varicella vaccines is still much safer than natural-acquired immunity (exposure to pathogens from the actual disease), as the symptoms of chicken pox 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.

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