Are You at Higher Risk for Shingles?
An angry red rash. Oozing blisters. Electric pain. These are some of the common symptoms of shingles, a skin condition caused by varicella zoster, a.k.a. the chickenpox virus. Along with these uncomfortable symptoms, shingles can also lead to more severe complications. All things considered, this is definitely an illness you want to avoid—but what exactly puts someone at risk in the first place? Keep reading to learn more about what increases your chances of getting shingles and what you can do to prevent it.
What Chickenpox Has to Do With It
If you’ve had chickenpox—and 99.5% of Americans born before 1980 have—then you’re at risk of getting shingles. “Shingles is what we call a reactivation infection,” explains Anna Wald, M.D., head of the allergy and infectious disease division at University of Washington Medicine in Seattle. “Most people get chickenpox when they are young. The virus becomes latent, so it stays in your nervous system,” she says. Later in life, when the immune system starts to weaken, that same virus can reactivate and cause shingles.
A Note About the Chickenpox Vaccine
Here’s a little irony: Even if you never had chickenpox, if you got the vaccine, you are also able to get shingles. That’s because the chickenpox vaccine contains a live but weakened version of the varicella zoster virus, which will also hang out in your body long-term, according to the Centers for Disease Control. Still, that’s no reason not to vaccinate: Kids who get the chickenpox vaccine have a lower risk of getting shingles than those who had actual chickenpox, the CDC says, so the benefits outweigh the risks.
Risk Factor: Your Age
Wisdom and experience may come with more years, but unfortunately, so does the risk of shingles. In fact, most people who get shingles are in their 50s or older, according to the CDC. “Incidence of shingles increases sharply with age,” Dr. Wald says, thanks to a gradual loss of immunity as you get older. Your risk of shingles complications—like postherpetic neuralgia, or persistent pain in the rash location—also goes up as you age. “If you’re in your 80s, you’re much more likely to have chronic pain after shingles,” she says.
Risk Factor: Some Chronic Conditions
Having a suppressed immune system makes it more likely that the dormant varicella zoster virus in your body will reactivate and cause shingles, says Edward Jones-Lopez, M.D., an infectious disease expert with Keck Medicine at the University of Southern California in Los Angeles. So if you have a condition known to impact the immune system’s ability to do its job of combatting invaders, like diabetes or HIV, you’re at higher risk.
Risk Factor: Certain Cancers
Cancer cells may compete with healthy cells that are meant to fight infections, according to the American Cancer Society (ACS). That’s why having cancer and undergoing cancer treatments (like chemotherapy and some forms of radiation, which also affect the immune system) are another risk factor for shingles, says Dr. Wald. While any cancer may increase shingles risk, blood cancers like leukemia and lymphoma make you especially susceptible, tripling your risk compared with people without cancer, finds a study in The Journal of Infectious Diseases.
Risk Factor: Transplant Recipients
If you’ve had an organ transplant, you’re at an increased risk of shingles, because the procedure requires the use of immune system-weakening drugs to prevent your body from rejecting the new organ. In fact, people who have had a solid organ transplant may be 10 to 100 times more likely to get shingles than the general population, according to a study in BMC Infectious Diseases. And as many as 20% to 40% of this group are likely to develop postherpetic neuralgia, the shingles complication.
Risk Factor: Other Medications
Some drugs you may be taking for other conditions can actually up your chances of getting shingles, too, says Dr. Jones-Lopez. “Taking any medications that lower the immune system increases the risk of shingles,” he explains. For example, long-term use of steroids like prednisone can lower your immune system response, making you more susceptible to infection, according to the CDC.
Risk Factor: Facial Shingles
If your shingles rash appears on your face, it can increase your risk of certain complications, according to the National Institutes of Health (NIH). For example, shingles that occur near the eyes can impair vision. “The presentation in the eye is very dangerous because it could theoretically cause blindness,” says Dr. Jones-Lopez. Getting treated with antivirals as soon as symptoms arise is important to help reduce disease severity, Dr. Wald adds.
Prevention: The Shingles Vaccine
Having any of these risk factors can be anxiety-inducing. Luckily, there’s a vaccine for adults 50 and older that can reduce your risk of shingles by 90%, says Dr. Wald—and almost anyone can get it (exceptions: pregnant or breastfeeding women). Prepare yourself though, because the vaccine—which you’ll receive as two shots a few months apart—can have uncomfortable flu-like side effects, but it’s worth it, says Dr. Wald. “Get it on a Friday so you can rest for the weekend,” she suggests.
Take Steps to Stay Healthy
Experts agree: The shingles vaccine is the most effective way to protect yourself from getting this disease. Talk to your doctor about getting the two-dose vaccine and other ways to bolster your immune system, like healthy sleeping habits (get seven to nine hours a night), managing stress (hello, yoga!), and getting regular exercise (30 minutes a day, five days a week)—especially if you’re at higher risk due to age or a compromised immune system.
Cancer and Shingles Risk Study: The Journal of Infectious Diseases. (2019.) “Risk of Herpes Zoster Prior to and Following Cancer Diagnosis and Treatment: A Population-Based Prospective Cohort Study.” academic.oup.com/jid/article/220/1/3/5234729
Cancer and Infection Risk: American Cancer Society. (2020.) “Why People with Cancer are More Likely to Get Infections.” cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/infections/why-people-with-cancer-are-at-risk.html
Shingles Information From the CDC: The Centers for Disease Control and Prevention. (2020). “Shingles (Herpes Zoster).” cdc.gov/shingles/index.html
Shingles Risk Factors, Complications, and Transmission Information: National Institutes of Health. (2020.) “Shingles: Hope Through Research.” ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Shingles-Hope-Through-Research
Shingles Vaccine Information: The Centers for Disease Control and Prevention. (2020.) “Shingles Vaccination.” cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
Transplant and Shingles Risk Study: BMC Infectious Diseases. (2015.) “Incidence and risk factors of herpes zoster among adult renal transplant recipients receiving universal antiviral prophylaxis.” ncbi.nlm.nih.gov/pmc/articles/PMC4513398/