Will My Shingles Come Back?

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

Video Transcript

CDC: “Shingles (Herpes Zoster).”; NIH Senior Health: “Shingles.”; AudioJungle; Image Source Pink; Troels Graugaard; itsmejust

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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:

  • In the first several years, your chances of having shingles again are lower than it is for people who have never had shingles.
  • Over time, your chances of a second bout go up. One study found that within 7 years, the odds of getting it again may be almost 5%. 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 age 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.

Does the Vaccine Help Prevent It?

The CDC suggests getting the shingles vaccine Shingrix if you're age 50 or older. It was approved in 2017 and has been found to be up to 90% effective in preventing shingles and the complications caused by the disease. Even if you've already had shingles, the CDC says the vaccine can help prevent a second round of it. Shingrix is preferred over an earlier vaccine, Zostavax. You should also get it if you previously had the Zostavax vaccine.

Talk to your doctor about when to get the vaccine. If you've just gotten over shingles,  he CDC recommends waiting at least until the shingles rash has disappeared.

You should not get the Shingrix vaccine if you:

  • Are pregnant or nursing
  • You are allergic to the vaccine
  • You tested negative for immunity to chickenpox (varicella zoster)- If so, you should ask about  the chicken pox (varicella) vaccine

Since the older vaccine, Zostavax, is a live virus, You should not get it if you are allergic to the vaccine, have a weakened immune system, or are pregnant or thinking about becoming pregnant in the next 4 weeks.

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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. 

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.

How Is Shingles Treated When It Comes Back?

As with a first case of shingles, antiviral medicines can help ease a second case. 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.

Steroids are sometimes used to treat shingles.

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 Melinda Ratini, DO, MS on May 15, 2018

Sources

SOURCES:

CDC: "Shingles (Herpes Zoster)" and "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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