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.

Shingles and stress

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.

Shingles triggers and risk factors

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)
Symptoms of shingles

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 daysTrusted Source and clear up within 2–4 weeks.

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
Treatment for shingles

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.

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.

Tips to avoid shingles

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 CDCT 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
When to speak with a doctor

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.