Shingles and stress: Is there a link?

Stress can affect the immune system and may be a trigger for shingles in those who have the varicella-zoster virus (chickenpox) in their body.

Shingles, also known as herpes zoster, is a viral infection that causes a painful, stripe-shaped rash with small blisters to appear on one area of the body. It occurs when the varicella-zoster virus, the same virus that causes chickenpox, reactivates.

Shingles is common. According to the Centers for Disease Control and Prevention (CDC), it affects 1 in 3 people in the United States.

A person who has had chickenpox still has the virus that causes it inside their body. It remains dormant and reactivates later in life as shingles.

Experts are not certain about what triggers the reactivation of shingles. However, many believe that significant or long-term stress may play a role.

This article explores the connection between shingles and stress. It also discusses the risk factors and triggers that may put a person at risk of shingles.

While anybody can get shingles, it is more common in older adults and people with weak immune systems. Experts believe that a weak immune system is crucial in triggering herpes zoster reactivation.

A 2018 study found that perceived mental stress, negative life events, and a low sense of purpose may contribute to the development of shingles and postherpetic neuralgia, a complication of shingles. Moreover, men with high mental stress were twice as likely to be at risk of incident herpes zoster.

In a 2022 review, researchers also argued that the reemergence of shingles among people with COVID-19 might be related to the interplay between psychological and immunological stress in the body.

A stressful event causes the release of cortisol and adrenaline, which are part of the fight or flight response. Cortisol also suppresses the immune system. Meanwhile, prolonged stress can alter bodily processes leading to a host of health problems, including:

• weight gain
• sleep difficulties
• high blood pressure
• heart disease
• heart attack
• memory and concentration problems
• depression
• anxiety
• gastrointestinal issues

However, there are also studies with conflicting results. A 2014 study reassessed the link between shingles and stress using data from 39,811 people who experienced stressful events, including the death of a spouse, ICU admission, surgeries, and injuries. The researchers found that the stressors increased mental health visits but not shingles.

Similarly, a 2016 study found no increase in herpes zoster after the death of a partner.

Having chickenpox is the primary risk factor for getting shingles. Age is another factor that increases a person’s likelihood of getting shingles and having severe complications.

Certain health conditions and treatments weaken the immune system and put a person at a higher risk of getting shingles. They include:

• leukemia
• lymphoma
• HIV and AIDS
• undergoing radiation therapy and chemotherapy
• taking drugs that prevent the immune system from working properly, including immunosuppressants such as glucocorticosteroids

Aside from these, a 2020 review found that people with a family history of shingles and physical trauma also have a greater risk of getting shingles. The researchers also saw that being female, having psychological stress, and having the following conditions also put a person at a slightly smaller risk of shingles:

• rheumatoid arthritis
• cardiovascular disease
• renal disease
• lupus
• inflammatory bowel disease (IBD)

The primary symptom of shingles is a painful, blistery rash. It commonly appears as a single stripe on either side of the torso or one side of the face. These typically burst and scab over in 7–10 days and clear up within 2–4 weeks.

Learn more about how long shingles lasts here.

A person may feel pain, tingling, or itching in the area for several days before the blistery rash appears. Other symptoms can include:

• sensitivity to touch
• itching
• fever
• headache
• fatigue
• chills
• upset stomach
• sensitivity to light or vision problems (when the eyes are affected)
• vision loss

Shingles may appear throughout the body and look similar to chickenpox, though this is rare. This is more common in people with weakened immune systems.

Like other viral infections, it is self-limiting and usually without complications. However, it may cause long-term complications like:

• postherpetic neuralgia
• herpes zoster ophthalmicus, which is shingles in the eye
• bacterial infection
• Ramsay Hunt syndrome

Like other viral infections, shingles does not have a cure and has to resolve on its own. However, a doctor may prescribe antiviral medications to help speed up the healing process, reduce its severity, and avoid complications like postherpetic neuralgia.

Ideally, doctors give these medications to people who are older than 50 years and those who are immunodeficient or immunosuppressed. Antiviral therapy is most effective when given within 72 hours of the appearance of the rash.

Learn more about shingles treatment here.

A doctor may also give pain relievers to manage the pain. Applying calamine lotion, taking oatmeal baths, and placing cool, damp washcloths over the rash can help reduce the itch of the blisters.

Certain home management strategies can help a person manage their symptoms and be more comfortable, including:

• wearing loose-fitting clothes
• eating well-balanced meals
• reducing stress
• doing gentle exercises
• doing things that take the mind off the pain
• getting plenty of rest

It is also important to cover the rash and practice proper hygiene to avoid spreading the virus.

Read on to learn more about whether shingles is contagious.

Since shingles is caused by the virus that causes chickenpox, getting vaccinated with the varicella or chickenpox vaccine can protect a person from shingles. Getting two doses of the chickenpox vaccine offers more than 90% protection against chickenpox.

Moreover, the CDC recommends people aged 50 and older and immunocompromised individuals aged 19 and older take two doses of Shingrix to prevent shingles and its related complications.

Taking measures to eliminate or better cope with stress may prevent shingles and help improve a person’s overall health and well-being.

Some tips that can help a person reduce stress include:

• avoiding things that trigger stress
• keeping a journal to take note of a person’s daily mood and possible stress triggers
• exercising regularly
• eating a healthy, well-balanced diet
• using stress relaxation techniques
• learning to say “no”
• setting realistic goals
• setting aside time for self-care
• spending time with family and friends
• practicing mindfulness and gratitude
• getting enough sleep
• turning off the phone or reducing screen time

Learn more about managing stress here.

A person who suspects they have shingles should immediately consult their doctor. It is best to speak with a doctor as soon as the shingles rash appears so they can prescribe antiviral medications to help reduce the severity and duration of the condition.

Shingles is a common viral infection caused by the varicella-zoster (chickenpox) virus. It is characterized by a painful, blistery rash that typically appears in a single stripe on one side of the body.

While healthcare professionals are unsure exactly why the virus is reactivated in the body, some studies have suggested that stress could be a factor, as it weakens the immune system.

A person who has not had the chickenpox virus previously can get vaccinated with the varicella or chickenpox vaccine to protect them from shingles.

Learning how to better manage or cope with stress may also help prevent shingles in people and improve general health.

Shingles and stress: Is there a link?

Stress can affect the immune system and may be a trigger for shingles in those who have the varicella-zoster virus (chickenpox) in their body.

Shingles, also known as herpes zoster, is a viral infection that causes a painful, stripe-shaped rash with small blisters to appear on one area of the body. It occurs when the varicella-zoster virus, the same virus that causes chickenpox, reactivates.

Shingles is common. According to the Centers for Disease Control and Prevention (CDC), it affects 1 in 3 people in the United States.

A person who has had chickenpox still has the virus that causes it inside their body. It remains dormant and reactivates later in life as shingles.

Experts are not certain about what triggers the reactivation of shingles. However, many believe that significant or long-term stress may play a role.

This article explores the connection between shingles and stress. It also discusses the risk factors and triggers that may put a person at risk of shingles.

While anybody can get shingles, it is more common in older adults and people with weak immune systems. Experts believe that a weak immune system is crucial in triggering herpes zoster reactivation.

A 2018 study found that perceived mental stress, negative life events, and a low sense of purpose may contribute to the development of shingles and postherpetic neuralgia, a complication of shingles. Moreover, men with high mental stress were twice as likely to be at risk of incident herpes zoster.

In a 2022 review, researchers also argued that the reemergence of shingles among people with COVID-19 might be related to the interplay between psychological and immunological stress in the body.

A stressful event causes the release of cortisol and adrenaline, which are part of the fight or flight response. Cortisol also suppresses the immune system. Meanwhile, prolonged stress can alter bodily processes leading to a host of health problems, including:

• weight gain
• sleep difficulties
• high blood pressure
• heart disease
• heart attack
• memory and concentration problems
• depression
• anxiety
• gastrointestinal issues

However, there are also studies with conflicting results. A 2014 study reassessed the link between shingles and stress using data from 39,811 people who experienced stressful events, including the death of a spouse, ICU admission, surgeries, and injuries. The researchers found that the stressors increased mental health visits but not shingles.

Similarly, a 2016 study found no increase in herpes zoster after the death of a partner.

Having chickenpox is the primary risk factor for getting shingles. Age is another factor that increases a person’s likelihood of getting shingles and having severe complications.

Certain health conditions and treatments weaken the immune system and put a person at a higher risk of getting shingles. They include:

• leukemia
• lymphoma
• HIV and AIDS
• undergoing radiation therapy and chemotherapy
• taking drugs that prevent the immune system from working properly, including immunosuppressants such as glucocorticosteroids

Aside from these, a 2020 review found that people with a family history of shingles and physical trauma also have a greater risk of getting shingles. The researchers also saw that being female, having psychological stress, and having the following conditions also put a person at a slightly smaller risk of shingles:

• rheumatoid arthritis
• cardiovascular disease
• renal disease
• lupus
• inflammatory bowel disease (IBD)

The primary symptom of shingles is a painful, blistery rash. It commonly appears as a single stripe on either side of the torso or one side of the face. These typically burst and scab over in 7–10 days and clear up within 2–4 weeks.

Learn more about how long shingles lasts here.

A person may feel pain, tingling, or itching in the area for several days before the blistery rash appears. Other symptoms can include:

• sensitivity to touch
• itching
• fever
• headache
• fatigue
• chills
• upset stomach
• sensitivity to light or vision problems (when the eyes are affected)
• vision loss

Shingles may appear throughout the body and look similar to chickenpox, though this is rare. This is more common in people with weakened immune systems.

Like other viral infections, it is self-limiting and usually without complications. However, it may cause long-term complications like:

• postherpetic neuralgia
• herpes zoster ophthalmicus, which is shingles in the eye
• bacterial infection
• Ramsay Hunt syndrome

Like other viral infections, shingles does not have a cure and has to resolve on its own. However, a doctor may prescribe antiviral medications to help speed up the healing process, reduce its severity, and avoid complications like postherpetic neuralgia.

Ideally, doctors give these medications to people who are older than 50 years and those who are immunodeficient or immunosuppressed. Antiviral therapy is most effective when given within 72 hours of the appearance of the rash.

Learn more about shingles treatment here.

A doctor may also give pain relievers to manage the pain. Applying calamine lotion, taking oatmeal baths, and placing cool, damp washcloths over the rash can help reduce the itch of the blisters.

Certain home management strategies can help a person manage their symptoms and be more comfortable, including:

• wearing loose-fitting clothes
• eating well-balanced meals
• reducing stress
• doing gentle exercises
• doing things that take the mind off the pain
• getting plenty of rest

It is also important to cover the rash and practice proper hygiene to avoid spreading the virus.

Read on to learn more about whether shingles is contagious.

Since shingles is caused by the virus that causes chickenpox, getting vaccinated with the varicella or chickenpox vaccine can protect a person from shingles. Getting two doses of the chickenpox vaccine offers more than 90% protection against chickenpox.

Moreover, the CDC recommends people aged 50 and older and immunocompromised individuals aged 19 and older take two doses of Shingrix to prevent shingles and its related complications.

Taking measures to eliminate or better cope with stress may prevent shingles and help improve a person’s overall health and well-being.

Some tips that can help a person reduce stress include:

• avoiding things that trigger stress
• keeping a journal to take note of a person’s daily mood and possible stress triggers
• exercising regularly
• eating a healthy, well-balanced diet
• using stress relaxation techniques
• learning to say “no”
• setting realistic goals
• setting aside time for self-care
• spending time with family and friends
• practicing mindfulness and gratitude
• getting enough sleep
• turning off the phone or reducing screen time

Learn more about managing stress here.

A person who suspects they have shingles should immediately consult their doctor. It is best to speak with a doctor as soon as the shingles rash appears so they can prescribe antiviral medications to help reduce the severity and duration of the condition.

Shingles is a common viral infection caused by the varicella-zoster (chickenpox) virus. It is characterized by a painful, blistery rash that typically appears in a single stripe on one side of the body.

While healthcare professionals are unsure exactly why the virus is reactivated in the body, some studies have suggested that stress could be a factor, as it weakens the immune system.

A person who has not had the chickenpox virus previously can get vaccinated with the varicella or chickenpox vaccine to protect them from shingles.

Learning how to better manage or cope with stress may also help prevent shingles in people and improve general health.

Derma Clinic Riga – Shingles

Shingles

What is ?

Herpes zoster, or Herpes zoster , is a disease caused by the Varicella zoster virus, a group α herpesvirus that initially causes chickenpox, and subsequently, if it reactivates, shingles.

What causes shingles ?

Theoretically, anyone who has had chickenpox can develop shingles. Virus Varicella zoster , after a person suffers from chickenpox, settles in nerve cells and stays there at rest. But under the influence of adverse conditions, it is activated and expressed in the form of shingles. It can happen spontaneously or as a result of stress, trauma, fever (fever), radiation therapy, or a weakened immune system (immunosuppression). In this case, the virus continues to multiply in the infected part of the nerve – the ganglion – and causes inflammation. As a result of the spread of the virus along the nerve, the skin segment, the dermatome, is damaged.

What are the symptoms of shingles ?

• Pain and tenderness in the area where skin damage will later appear. Younger patients are more likely to experience itching and a slight burning sensation.

• Rashes appear 1-2 days after the above sensations.

• May have headache and/or fever.

• At first, there is reddening of the skin with small red grouped dots, which quickly turn into blisters with liquid. This occurs on the 3-5th day after the onset of the disease.

• Drying, they form a crust, which disappears within 2-3 weeks.

The rash is usually concentrated on one side of the body. The area affected by the disease of the skin depends on the nerves associated with the process. Most often, rashes are localized on the trunk – within the chest, abdomen, back, pelvis, in the shoulder region. In rare cases, rashes occur on the face, around one eye.

After the disappearance of the rash, postherpetic neuralgia may persist – pain in the affected areas; this is most common in older patients. Most often, it passes within six months, but some can be tormented for longer.

How is shingles treated ?

• To shorten the course of the disease, antiviral drugs such as acyclovir or valaciclovir are used. It is important to start treatment within the first three days.

• Non-steroidal anti-inflammatory drugs, such as ibuprofen, can be taken to relieve pain.

• To prevent postherpetic neuralgia, antiviral agents should be used, and if there is pain, antidepressants and anticonvulsants may be additionally prescribed.

• To cope with complications, in the case of eye damage, you need to visit an ophthalmologist. And in order to be treated for an attached bacterial infection, agents for external or internal use are sometimes prescribed, which include antibiotics.

Preventive measures :

• High-risk patients (newborns, the elderly, immunocompromised people, and those who have not had chickenpox, especially pregnant women) should avoid contact with people with shingles until the blisters begin to dry out and crust over.

• If you suspect shingles, see your doctor immediately. Early treatment gives the best results.

We use cookies. By continuing to use the website, you accept our cookies. Our cookie policy.

Herpes zoster – causes, symptoms, treatment in adults

Enroll

Effective treatment of herpes zoster and postherpetic neuralgic pains in Hadassah Medical Clinic. All analyzes and consultations in one place for the convenience of patients. The selection of an individual treatment plan and a multidisciplinary approach make it possible to successfully cure the infection even in immunocompromised patients.

Shingles (herpes zoster) is a viral infection that affects the skin and nervous system. It is caused by the causative agent Varicella zoster (VZV) – type 3 herpesvirus. The disease is manifested by blisters along the nerves and burning pains that bother a person for several months. Herpes zoster is dangerous not only with subjective symptoms, but also with complications from the brain and sensory organs.

Show all

Doctors of department

All doctors

Zhukova
Daria Grigoryevna

Allergist-immunologist, Ph.D.

Work experience: 14 years

Cost of admission: from 9000 ₽

Make an appointment

Zaitseva
Galina Valerievna

Allergist-immunologist

Work experience: 10 years

Cost of admission: from 6500 ₽

Make an appointment

9 0004 All doctors

Benefits of treatment at the Hadassah clinic

Rapid diagnosis

Analyzes are performed in our own laboratory, which is equipped with modern equipment and test systems for all types of research.

Multidisciplinary approach

Herpes zoster will be treated by neurologists, infectious disease specialists, immunologists and other specialists, if the patient’s health condition requires it.

Personalized therapy program

Our doctors follow the principle of “treat the patient, not the disease”, so they are attentive to each situation and take into account the characteristics of a particular person when choosing a therapeutic program.

Evidence-based medicine

In our work, we use only generally recognized clinical protocols, international recommendations, and the results of randomized trials.

Original medicines

The clinic cooperates with leading pharmaceutical companies, which makes it possible to purchase certified and high-quality medicines.

Rehabilitation

We pay great attention to the restoration of a full life of the patient, the elimination of residual pain syndrome and other symptoms that interfere with normal activities.

By clicking on the button, you agree to the terms of use and processing of personal data

Symptoms of herpes Zoster

Up to 80% of cases of the disease begin with a prodromal period. Patients experience moderate pain, itching and tingling in the area of ​​one dermatome – where a rash appears after 3-4 days. It is also characterized by fever, malaise, headaches.

Eruptions have characteristic features:

• initially pink spots 3-5 cm in diameter with indistinct edges appear;
• a day later, small blisters form in their place, similar to a rash with chickenpox;
• vesicles are usually located on the chest or abdomen, which corresponds to the course of one of the sensory nerves;
• the appearance of signs of herpes on the back, neck, limbs is typical for a generalized form of the disease and is mainly associated with immunodeficiencies;
• rashes gradually shrink into crusts that fall off after a few weeks, leaving behind unstable pigmentation on the skin.

The acute period is always accompanied by intense burning pains in the area of ​​the affected nerve. Pain is aggravated by touch. They can be permanent or paroxysmal in nature, some patients describe the symptoms as “electric shock”.

You can see a photo of what shingles looks like, but do not use the information as a way for self-diagnosis and self-treatment. This is a dangerous disease that should be treated under the supervision of an infectious disease specialist and a neurologist.

Causes

Most people come into contact with the pathogen in childhood, when they fall ill with classic chickenpox or suffer it in an erased form. After the initial infection, the virus does not disappear from the body anywhere. It remains in the nerve ganglia and can remain there in a latent state for decades. Under adverse conditions, it again manifests itself, causing shingles.

VZV reactivation occurs when the body’s immune defenses decrease due to the following factors:

• hypothermia or overheating;
• chronic stress;
• excess ultraviolet exposure;
• unbalanced diet, beriberi;
• acute respiratory diseases;
• injuries, surgical operations;
• acute and chronic diseases of internal organs;
• secondary immunodeficiency states;
• receiving immunosuppressive, antibacterial therapy.

One of the most important predisposing factors is called HIV infection. When the level of CD4-lymphocytes falls below 500 cells per μl, the body’s resistance to latent infection is sharply reduced, and symptoms of herpes zoster appear.

Diagnosis

The diagnosis of herpes zoster is usually based on pathognomonic lesions and pain. Herpes simplex virus (HSV) can cause nearly identical lesions, but unlike herpes zoster, HSV tends to recur and is not dermatomal (associated with a specific nerve). Before treating herpes zoster, the doctor must be completely sure of the diagnosis, so clarifying examinations are prescribed:

PCR test

to identify the genetic material of the pathogen;

ELISA

to detect antibodies to herpesvirus;

Clinical blood test

in which the specialist is interested in the level of leukocytes and the ratio of different fractions of white blood cells;

Microscopy of impression smears from affected areas of the skin

to detect multinucleated giant cells.

It is important to clarify what led to the manifestation of the disease. If there are no obvious causes, it is worth looking for a disease that initially does not cause independent symptoms, but reduces immunity (cancer or infection with the human immunodeficiency virus). Exclusion of HIV infection is necessary in all patients under 50 years of age.

Methods of treatment of herpes zoster in Hadassah clinic

Therapy is carried out in two directions: etiotropic medicines to fight a viral infection and painkillers to alleviate a person’s condition. The best clinical results can be achieved with the start of pharmacotherapy in the first 72 hours from the appearance of rashes. The main drugs for the treatment of herpes zoster in adults are representatives of the acyclovir group, which are used according to an individual scheme.

All patients are prescribed analgesics in tablets and injections; local anesthetics are also used for post-herpetic pain. With intense pain syndrome, the treatment of herpes Zoster is supplemented with centrally acting medicines: antidepressants, tranquilizers, anticonvulsants. According to indications, methods of physiotherapy are used.

Blisters on the skin contain a large number of viral particles that pose an epidemiological hazard to others. Herpes zoster itself is not transmitted because it is associated with the reactivation of an existing infection, but the patient can become a source of chickenpox for children and previously healthy adults. Since a person with skin manifestations of shingles is contagious to others, it is recommended to limit close contact with family members and others who have not yet encountered chickenpox.

Why the disease is dangerous

One of the main problems is postherpetic neuralgia, which can occur even with properly selected drugs for the treatment of herpes zoster in adults. The frequency of complications increases in direct proportion to age – more than 50% of patients over 60 suffer from this disease. Pain phenomena at the site of the rash persist for several months, in 10-15% of cases the symptoms last for six months.

Other negative effects of the infection are much less common, but are a serious health hazard. These include:

• transverse myelitis – inflammation of the segments of the spinal cord located close to the affected dermatome;
• meningitis, encephalitis – inflammation of the membranes and substance of the brain;
• ophthalmic herpes – damage to the eyeball, which is fraught with decreased vision and the development of glaucoma;
• pyoderma – suppuration of rash areas due to the addition of a secondary bacterial infection.

Such manifestations are more common in elderly patients, people with a weakened immune system, patients who have recently undergone serious illness or surgery.

To reduce the risk of dangerous complications from the nervous system, it is necessary to consult a doctor in a timely manner, who knows how to treat herpes zoster according to modern protocols from the standpoint of evidence-based medicine.

By clicking on the button, you agree to the terms of use and processing of personal data

Disease prevention

In people who have recovered from chickenpox, preventive measures are aimed at preventing VZV reactivation in regional nerve structures. To this end, it is recommended to strengthen the immune system and health-improving procedures, which include:

• balanced and fortified nutrition;
• prolonged sleep;
• avoidance of mental and physical overwork;
• timely treatment of somatic diseases, metabolic disorders;
• practicing safe sex to prevent HIV infection.

The only way to specifically protect against the Varicella Zoster virus is timely vaccination before the person has come into contact with the virus. Children are usually vaccinated to protect them from infection. However, immunization according to strict indications is also carried out for the elderly and debilitated people who are at high risk of developing symptoms of herpes zoster. Vaccination helps build immunity against infection and prevent it from reactivating.

For effective and evidence-based treatment of herpes zoster in adults, contact the Hadassah clinic in Moscow. Our doctors will conduct a comprehensive diagnosis and select a personal treatment plan. Specialists also treat postherpetic neuralgia and other complications, helping the patient return to a full life after illness.

#ZhukovaDYu

Zhukova
Daria Grigorievna

Allergist-immunologist, Ph.D.

Work experience: 14 years

Published: 06/08/2023

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

SOURCES

• Herpes zoster. Clinical recommendations of the All-Russian public organization “Russian Society of Dermatovenerologists and Cosmetologists”. – 2020.
• Isakov DV, Isakov VA Herpes simplex and herpes zoster (clinic, treatment and prevention). – 2021.
• Cairo A. N., Lavrov V. F. Herpes zoster: epidemiological features of incidence in 2019 // Epidemiology and vaccine prevention. – 2020. – T. 19. – No. 5. – S. 93-97.
• Ryumin AM et al. Neurological manifestations of herpes zoster virus reactivation // Journal of Infectology. – 2022. – T. 14. – No. 1. – S. 31-42.
• Ignatovsky AV Herpes zoster – modern approaches to diagnosis and treatment //Doctor/Vrach. – 2022. – T. 33. – No. 10.
• Avdeeva M.G., Alikeeva G.K., Antonova M.V. etc. Infectious diseases. National leadership. Ed. N.D. Yushchuk, Yu.Ya. Vengerov. M.; GOETAR; 2018.
• Polyakova D.M., Nikiforov V.V., Shakhmardanov M.Z. Immunity and vaccination in adults with infection caused by the Varicella zoster virus. Epidemiology and infectious diseases. 2019; 24(2): 84-7.
• Dooling K.L., Guo A., Patel M., Lee G.M., et al. Recommendations of the advisory committee on immunization practices for use of herpes zoster vaccines // Centers for disease control and prevention.