Will My Shingles Come Back?

If you've had shingles once, you probably won’t get it again.

That doesn’t mean it can’t happen, it’s just unlikely. Also called herpes zoster, shingles can come back a second or, rarely, a third time. But you can take steps to help prevent it, or ease it the next time around.

How Often Does Shingles Return?

Experts don't know exactly how many people get shingles more than once. They do know it comes back more often in people with weakened immune systems.

If your immune system is healthy:

  • Your short-term chances of getting shingles again are very low. One study of people over age 60 found that only 1% got shingles again within about 3 years. Having shingles once lowers your chances of getting it a second time, at least for a while.
  • Over time, your chances of a second bout go up. Another study found that within 7 years, the odds of getting it again may be almost 6% in people 22 and older. That's about the same as the odds of getting shingles the first time.

Who Is Most Likely to Get Shingles Again?

You're more likely to get it again if:

  • You had severe pain from shingles that lasted more than 30 days. This is called post-herpetic neuralgia (PHN).
  • You are a woman.
  • You were 50 or older when you had shingles the first time.
  • Your immune system is weak from conditions like leukemia, lymphoma, or HIV, or you take medicines that suppress your immune system.

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Does the Vaccine Help Prevent It?

The CDC suggests getting the shingles vaccine (Zostavax) if you're 60 or older, although you should talk to your doctor about getting it at 50. Even if you've already had shingles, the CDC says the vaccine can help prevent a second round of it. How much it helps is unclear, though. There is no data yet on how well it works to prevent shingles a second time.

Talk to your doctor about when to get the vaccine. If you've just gotten over shingles, you may want to wait for a few years, when your immunity starts to wane.

You can get the shingles vaccine as young age 50. But since shingles tends to be more severe and PHN pain is more likely the older you are, your doctor may suggest getting the vaccine later.

You should not get the vaccine if you have a weakened immune system or are pregnant.

Does Shingles Come Back in the Same Place?

Shingles is likely to return in a different part of your body. In general, the rash is most common on the torso or face. So if you've had it on the right side of your stomach, it might come back on the left side – or on your face, chest, neck, or back.

What Are the Symptoms?

A blistering rash in the shape of a band is the telltale sign of shingles. If your immune system is weak, the rash may come on several parts of your body.

Other symptoms to look out for:

When Should I See a Doctor?

See your doctor at the first sign of shingles. Getting treated early can help it go away faster and may help you avoid related problems. For instance, shingles on the face can cause hearing or sight problems, including blindness. Early treatment can also help prevent or ease PHN pain.

If you have a weak immune system and can't get the vaccine, early treatment is your best defense against shingles.

Sometimes what seems to be shingles is really herpes simplex. Though it usually appears as "cold sores" around the mouth or genitals, this form of herpes can show up elsewhere. A different treatment is used to clear it up. Your doctor can do tests, such as a viral culture, to confirm whether you have shingles and to get you the right treatment.

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How Is Shingles Treated When It Comes Back?

As with a first case of shingles, antiviral medicines can help ease a second case and hold off PHN pain. These include:

To relieve itching, try:

  • Oatmeal baths
  • Wet compresses
  • Calamine lotion

If you get PHN pain, your doctor may suggest gabapentin (an anti-seizure medicine) or a rub-on cream or lotion. Antidepressants can also help pain.

Shingles treatments like antivirals work best when you start them right away. Call your doctor as soon as a rash appears -- or you have any symptom you think may be shingles. If you had it once, you know the symptoms. That can give you a head start on the road to recovery.

WebMD Medical Reference Reviewed by David T. Derrer, MD on August 21, 2014

Sources

SOURCES:

CDC: "Shingles (Herpes Zoster)," "Shingles Vaccine: What You Need to Know."

FDA: "Zostavax (Herpes Zoster Vaccine) Questions and Answers."

Harvard Health Publications: "The shingles vaccine."

National Shingles Foundation: "Shingles and PHN: Your Questions Answered."

New England Journal of Medicine: "Herpes Zoster."

NIH National Institute of Neurological Disorders and Stroke: "NINDS Shingles Information Page."

NIH News in Health: "The Sting of Shingles."

Tseng, H. Journal of Infectious Diseases, June 4, 2012.

Up to Date: "Clinical manifestations of varicella-zoster virus infection: Herpes zoster."

Yawn, B. Mayo Clinic Proceedings, February 2011.

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