It’s tough enough to endure shingles once in your life. After all, it’s painful to experience the red blister-like bumps that are characteristic of shingles, caused by a reactivation of the varicella zoster virus (which also causes chickenpox).
You probably already know it’s really rare to get chickenpox twice. But is it possible to get shingles—which can feel intensely painful, like a burning, stabbing sensation, and can last for two to six weeks—more than once?
Unfortunately, it is possible to get shingles twice (or more). In fact, of the 1 in 3 people who experience shingles, women are at a higher risk of developing it a second time than men are. The longer you experience severe pain after shingles (called post-herpetic neuralgia), the higher your chances of a shingles recurrence.
Interestingly, if shingles comes back, it may recur on another side of your body. If the rash first appeared on the left side of your torso, for example, it’s likely to come back on the right side, says Nidhi Ghildayal, Ph.D., an infectious disease specialist and senior research associate at the Harvard T.H. Chan School of Public Health.
“The reason for this is that once you’ve had chickenpox, the virus remains alive in your nerves,” Ghildayal explains. “When the virus reactivates, the infected nerves become inflamed.” The skin those nerves reach also becomes inflamed. “Once the virus subsequently reaches the skin, the rash appears,” she says.
These rashes are most likely to occur on the chest, neck, face or leg, and that’s often how people identify that they have shingles; the rash might be the first sign that you should seek help from a medical professional.
“The shingles rash looks like red, blister-like bumps,” says David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California. “People describe them as looking like tear drops on a rose petal, and these appear on the path of the nerve that the virus is traveling on.”
The good news: It’s uncommon to get shingles again within three years, since your immune system is more prepared for the virus. But the reason why shingles can recur is clear: “After the episode, the virus becomes inactive inside your nerves but is able to reactivate in the future,” Ghildayal says.
How to avoid getting shingles more than once
Getting the shingles vaccine protects you against shingles—and protects you from a shingles recurrence too.
Zostavax, approved in 2006, was once the only shingles vaccine available to older individuals; it’s no longer available in the U.S. But a new vaccine, Shingrix, was approved in 2017 by the FDA for adults 50 and older, and it’s said to be over 90% effective, according to the Centers for Disease Control and Prevention.
“This new vaccine is a very important one for all of us to consider,” Cutler says. “In my practice we routinely recommend this vaccine to everyone over 50.”
With the possibility that shingles can recur, experts urge anyone who has had shingles to be vaccinated as well. “I believe that it’s imperative that you work with your health care provider to get vaccinated as soon as you’re in this age range or have had shingles,” Cutler says.
Shingrix is given in two doses, scheduled two to six months apart. “It’s important to note that you should also get Shingrix even if you had Zostavax, the older shingles vaccine,” Cutler adds. “You should also get it if you don’t know if you had chickenpox as a child.”
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