This article addresses what causes shingles to activate.
Shingles Causes
Most people develop shingles after they have recovered from a bout of chickenpox in their childhood. The main culprit, the varicella-zoster virus, remains dormant (inactive) in the nervous system and reactivates when triggered.
The exact triggers of VZV reactivation and the mechanism by which this happens are unknown, but the following risk factors have been shown to put you at higher risk of developing a shingles outbreak:
Weakened immune system Being more than 50 years old Experiencing high levels of physical or emotional stress Cancer, especially leukemia and lymphoma
Shingles Symptoms
Shingles commonly present as a localized rash on the trunk that doesn’t cross the midline of your body. This feature of shingles—in which the rash remains within one or two adjacent bands on the body (dermatomes)—is called localized zoster.
Some people develop pain, itchiness, or tingling in these areas prior to the rash developing. The rash may be flat or form clusters of fluid-filled blisters that progressively dry out and peel off over the course of three to five days.
Additional associated symptoms may include:
Fever Headache Photophobia (sensitivity to bright light) Malaise Sensitivity to touch in the affected area Upset stomach
Shingles Treatment
Early shingles may be treated with creams and lotions to relieve pain and itching. Using a cool compress may also provide symptomatic relief. Several medications have been shown to be helpful, but their effectiveness is based on the time of initiation, the extent of the disease, and overall health.
Lasting eye damage and blindness Hearing loss Brief paralysis of the face
In very rare cases, VSV reactivation has been associated with encephalitis—inflammation of the brain.
Generally, the earlier you start taking antiretroviral medication such as — acyclovir (Sitavig, Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) — the better. Early antiretroviral use — taking these medications as soon as you experience pain or see the appearance of a rash — has been shown to shorten the length and severity of the illness. If these medications do not work, your healthcare provider may prescribe the following drugs to help provide relief:
Steroid (steroid injections to reduce pain and inflammation)Tricyclic antidepressantsAnticonvulsantsCapsaicin patches
Can You Get Shingles More Than Once?
VZV usually remains dormant in the body, but about 1 in 3 people who have had chickenpox will have a shingles outbreak in their lifetime. Most people develop shingles at one time in their lives, but it is possible to have more than one outbreak, especially if you have one or more risk factors predisposing you to VZV reactivation.
What Triggers a Shingles Outbreak?
Experts do not know what exactly triggers a shingles outbreak, but it is theorized that high levels of stress and a weakened immune system are two major factors that may play a role in VZV reactivation. In addition, the following risk factors have been shown to put you at higher risk of developing a shingles outbreak:
Weakened immune system — this may be the case after taking immunosuppressive medication after an organ transplant, undergoing chemotherapy, contracting HIV or AIDS, developing diabetes, or after a bone marrow transplantOlder age, particularly over 50Experiencing high levels of physical or emotional stressCancer, especially leukemia and lymphoma
Prevention
Vaccination with the recombinant zoster vaccine (RZV), also known as Shingrix, is the single most effective way to prevent shingles and its complications. Getting vaccinated is particularly important for those who are immunocompromised or over 50. Two doses of the Shingrix vaccine have been shown to be 90% effective.
Summary
Shingles, also known as herpes zoster, is a painful rash caused by reactivation of varicella zoster virus (VZV), the same virus that causes chickenpox.
A Word From Verywell
Getting the recombinant zoster vaccine is the best method to prevent shingles, especially in those who are over 50 or immunocompromised with a history of chickenpox.
Shingles is rarely life-threatening, but its symptoms can greatly affect your quality of life. Shingles is common and may go away on its own, but there are ways to reduce your pain and the duration of your symptoms. The sooner you get treated with antiviral medication, the more likely you will avoid serious medical complications like postherpetic neuralgia and nerve damage.
