Who Gets Shingles?

7 groups at risk
Closeup of a retired couple against bright background

Talk about shingles and you might think of that quip, "What? Me, worry?" Though it's not an illness on most people's radar, a surprising swath of the American population is vulnerable to shingles, or herpes zoster, an often painful skin rash that can lead to chronic complications. One in three adults can expect to get it in his or her lifetime.

Find out if you might be among the unlucky one million who develop shingles this year.

Have you ever had chicken pox?

Shingles is caused by a reactivation of the same virus that causes chicken pox, varicella zoster. The virus lurks quietly in nerve cells for years, even decades, before suddenly reemerging as a secondary infection of shingles. Roughly one in five people who had chicken pox will later develop shingles.

It's not certain who that 20 percent will be, however. Anyone who's had chicken pox, even a mild case, is vulnerable to shingles -- and that's 99 percent of all American adults over age 40. Those under 40, including children, can also get shingles. The risk of pediatric shingles is especially high in those who had chicken pox before age 1, or if the person's mother had chicken pox in her last month of pregnancy, according to the National Institute of Neurological Disorders and Stroke.

The virus affects the nervous system more deeply with shingles than with chicken pox. This means there's a more concentrated and intense rash, and an increased risk of a lingering pain syndrome called postherpetic neuralgia, or PHN.

Are you under stress?

Stress is one of the more common triggers causing the varicella zoster virus to suddenly flare up again as shingles.

The stress can be sudden in nature, such as a loved one falling into a medical crisis. Or your immunity can be lowered by chronic stress -- excessive work, a bad relationship, the long-term care of someone with Alzheimer's disease, or the extreme fatigue that these situations can cause.

Are you over age 50?

Age is the likeliest risk factor for shingles. Although you can develop shingles at any age after having had chicken pox, the older you get, the more wear and tear your immune system has experienced. And that increases your vulnerability to shingles.

Age 50 seems to be the year when cases begin to rise dramatically. Before age 50, about 2 people in 1,000 get shingles. After age 50, about 6 people in 1,000 get shingles. By age 85, you have a 50 percent chance of getting shingles. More than half of all cases are in people over 60.

Has a close relative had shingles?

A 2008 study at the University of Texas Medical School at Houston found that those with shingles were four times more likely to have had a first-degree relative who'd had shingles in his or her history. The more close relatives you know who had shingles (especially parents or siblings), the higher your risk.

Shingles isn't contagious, however. You can't "catch" it from someone who has it. (Someone who hasn't yet had chicken pox or its vaccination can catch chicken pox from someone with shingles. But you can't get shingles itself.)

Do you have, or have you had, cancer or a serious chronic illness?

Chronic serious diseases known to trigger shingles include diabetes; inflammatory conditions such as lupus, rheumatoid arthritis, and inflammatory bowel disease; emphysema and other forms of chronic obstructive pulmonary disease (COPD); and AIDS.

Add to this list people with chronic kidney disease who are on dialysis. You can't contract shingles from the dialysis process, but kidney illness plus the stress of having dialysis lowers immunity against all kinds of viruses, including herpes zoster, according to the American Association of Kidney Patients.

Cancer -- especially Hodgkin's disease, lymphoma, and leukemia -- can compromise the immune system, either because of the physical stress of the disease itself or the nature of treatments used (such as chemotherapy). Pediatric cancers weaken the immune system from a young age, raising the odds of shingles later in life over those of someone who never had cancer.

Children with asthma also face an increased risk of shingles, according to information from Mayo Clinic researchers in 2012.

Do you take medications that compromise your immunity?

In addition to being more common among those who receive chemotherapy drugs, shingles is more common in people who take immunosuppressive medications, which alter the immune system. These include TNF-alpha blockers such as infliximab (brand name Remicade) and adalimumab (brand name Humira) for rheumatoid arthritis, lupus, and other inflammatory conditions. Medications such as prednisone, for the treatment of these and other autoimmune diseases, such as multiple sclerosis or Crohn's disease and other inflammatory bowel disorders, can likewise be culprits. Protease inhibitors for HIV infection and drugs used in organ transplants also can trigger shingles.

Have you had shingles before?

Most people experience shingles just once. But it's possible to have more than one episode. Doctors aren't sure what causes this to happen, but people who have pain from the initial attack that lasts more than 60 days are more than 5 times as likely to have a recurrence, researchers at Olmsted Medical Center in Rochester, Minnesota, reported in 2009. Among the 1,700 people studied, the time between shingles episodes ranged from 96 days to 10 years. Recurrences were 60 percent more likely in women.


8 months ago, said...

Hello I have had episodes of shingles for the last 28 years, in the last two years I have shingles every month. I have linchen schellorous, a thyroid goitre and pains in my hands. I have had enough of feeling tired and miserable. Do you think there is a connection?


over 1 year ago, said...

Thank you for making a connection to Shingles for me about MS and Prednisone .. Seriously , I thought I was cuckoo about what was happening ..


about 2 years ago, said...

Can having shingles and bronchitis effect my crohns?


about 3 years ago, said...

The article was helpful, though it didn't answer some of my questions. Reader's responses was just as helpful. Some questions, can shingles return, should I get the vaccine after experiencing full blown shingles, how long is the vaccine good for, a year 5 years? More detailed info would still be helpful.


over 3 years ago, said...

Hi,my 4year old daughter has just had a small bout of shingles around her right hip area,she has recovered well and was well during the time of infection,ie good apetite,temp etc,she had chickenpox when she was maybe 10mths old,my wife is paranoid that shingles in the young are a link to cancer,isthere


over 4 years ago, said...

Hi, my older brother had shingles and I've always wondered if I would get it. The info you provided was very helpful. Thank you!! Pam


over 4 years ago, said...

If you ever had chicken pox you can get shingles becaue the virus resides forever in nerve tissue. Chicken pox confers no protective antibodies that will prevent shingles. If you have had chicken pox vaccine, check with your doctor on current immunity. If you are not, you would be at risk from children who are ill, and adults with active shingles Antiviral drugs can be prescribed and may be helpful IF you catch an outbreak immediately. It's almost impossible to do this. They can be mild [my 1 outbreak on left leg didn't hurt, it itched] or thay can be devastating, and for some the pain [post-herpetic neuralgia] NEVER goes away. If they are on your face - around an eye ( my father suffered this] they are particularly dangerous. One person said they couldn't get the vaccine because they were too young. Recommendations have been relaxed on age guidelines. Anyway, if there are signs that your immune system is compromised - [getting shingles multiple times would be a sign] - you should be able to get a shot. GET VACCINATED if you are in a risk group. If you are over 50. Even tho' it doesn not promise 100% immunity - if your can prevent or lessen the impact of an outbreak it's worth it. Using my own father - he suffered for about 20 years, at which time he died. Nothing ever relieved the pain completely, and it aggravated eye problems, contributing to loss of vision.. Need I say more?. GET VACCINATED. Don't set yourself up for a miserable condition that can poison your life - one of the few you can avoid.


over 4 years ago, said...

Very informative. My dad had shingles, and a friend just got the shingles. Here is hoping I don't get them. Is there a vaccine you can get BEFORE you have an outbreak.


over 4 years ago, said...

I had my first shingles breakout in 1987 and they were inside my skin not on my skin. It felt like a nasty rope burn on my back but, when i looked at my back there was nothing there. The pain became so intense that i went to my doctor to find out what was causing it. He told me it was inside and that one blister will appear and the pain will go away. He also told me that there could be reappearing pain at the sight that could come at any time, especially during stress or illness. Since then i've had shingles 5 times, all in different areas, and could pretty much say it was stress related.


over 4 years ago, said...

I have never seen this in print, however I have used topical benadryll cream during the first 48 hours applied every 2 to 3 hours. It certainly worked favorably for me.


over 4 years ago, said...

All of this article was helpful, as I have never had chicken pox and wondered if I could get shingles from someone who has had shingles.


over 4 years ago, said...

Very helpful re possible causes (medications, etc.) and re who is at risk.


over 4 years ago, said...

i am only 41 and have had mild cases of shingles 5 times now. it is very painful. i cannot receive the vaccine because they say i am too young...! they usually appear when i am extremely stressed and they typically appear in the same area. i cannot use neosporin, i am allergic to it, i actually made my 2nd attack worse by doing so, that was when i found out i was allergic to it. i now have scarring on my left hip area from the shingles.


over 4 years ago, said...

Put Neosporin (the one with the painkiller in it) on a shingles rash; it will alleviate the pain and it will heal a LOT faster, too!


over 4 years ago, said...

If you have not had chicken pox can you still get shingles? What about if you have herpes?


over 4 years ago, said...

Is the vaccine that is given a "live" vaciene or not? Since there are chicken pox antibodies already present in the system is a live vaccine necessary? I ask because they can be very dangerous to people on protease inhibitors and with compromised inume systems, I am told.


over 4 years ago, said...

Excellent information. We are going to get the shot for the Shingles!


over 4 years ago, said...

Very helpful


over 4 years ago, said...

A nice summary. I gave it to a friend who has been worried about shingles ever since I had it.


over 4 years ago, said...

dear, I got shingles about 10 years ago, I am still remembering the type of pain I had- unbarable, I reccomend that, don't ignore any pain or red spots und axila or sleep disorder, if this happen straight to your doctor because the delay in taking the proper treatment is a big risk - keep a warm water bag on pumples will appear on skin also an ointment to apply on them to reduce the burning and scratch sensiation, sincerely talking, i don't wish this desease to happen to any person in this world. it is very harmful.


over 4 years ago, said...

I was also told not to go around infants, babies and small children who had not had chicken pox or vacinated for chicken pox. Also, there are some Rx drugs that you take at the instant there is some burning or itching announcing a new breakout.


over 4 years ago, said...

It doesn't give you any thing to do to help. If you have a cancer, you can't get the vaccine. what things can you do to improve the outcome if you get shingles?


over 4 years ago, said...

I have had nerve ending pain for over 5 years now. Does it ever go away?


over 4 years ago, said...

My first case of shingles was 1998.Two times they were full blown..worse pain in all my life..after the second case,someone in a health food store told me to try what was "his remedy"...if I got them again.Well I did...5 times in total since 98..I tried his suggestion..l-lysine...vit c & e in really large doses 3 times a day...at the slightest twinge of an onset, I started the pills...it did not completely stop the shingles, but I had mild...bearable ...cases...I got the shot last summer..im waiting for the results from N.I.H. or someone..will they do a survey after a few years to see the results and benefits of the shot??? Im anxious to find out.....


over 4 years ago, said...

My mother was diagnosed last week with shingles. It appeared two days after her second "round" of prednisone which was prescribed for back/hip pain. Her diagnosis was early enough so that she received an antiviral drug to minimize the pain and duration. She is very grateful that it was diagnosed so early. I have a question: does the vaccine always work, or do some people get singles regardless of having been vaccinated?