Stress and shingles: Could there be a connection?

Shingles, a viral infection characterized by a painful, blistery rash, is a common health concern that affects many people worldwide. The condition, medically known as herpes zoster, is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox [1].

The reactivation of VZV, which remains dormant in nerve ganglia after an initial chickenpox infection, is closely linked to weakened immunity. Stress, while not directly causing reactivation, can contribute by impairing immune defenses [3][4]. Chronic stress, in particular, is recognized as a physical stressor that can weaken the immune system, making VZV reactivation more likely [3][4].

Research suggests that stressful life events and chronic psychological stress impact immune function, potentially increasing susceptibility to shingles by depressing antiviral immunity. However, studies remain somewhat contradictory and inconclusive, with no firm consensus yet established [5].

While the exact reason for VZV reactivation is unknown, it's clear that managing stress, along with other health factors, may help reduce the risk of shingles outbreaks [4][5].

Shingles is more common in older adults and people with weakened immune systems, including those with certain health conditions such as leukemia, lymphoma, HIV and AIDS, undergoing radiation therapy and chemotherapy, taking drugs that prevent the immune system from working properly, and having rheumatoid arthritis, cardiovascular disease, renal disease, lupus, inflammatory bowel disease (IBD) [6].

Fortunately, getting vaccinated can protect a person from shingles. The Centers for Disease Control and Prevention (CDC) 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 [7].

If a person suspects they have shingles, it's crucial to consult a doctor immediately. Antiviral medications can be prescribed to help speed up the healing process, reduce the severity, and avoid complications like postherpetic neuralgia. These medications are most effective when given within 72 hours of the appearance of the rash [2].

In addition to medical treatment, certain home management strategies can help a person manage their symptoms and be more comfortable. These include 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, and covering the rash and practicing proper hygiene to avoid spreading the virus [2].

Recent findings also suggest that the reemergence of shingles among people with COVID-19 might be related to the interplay between psychological and immunological stress in the body [8].

While shingles can lead to long-term complications such as postherpetic neuralgia, herpes zoster ophthalmicus (shingles in the eye), bacterial infection, and Ramsay Hunt syndrome, taking measures to eliminate or better cope with stress may not only prevent shingles but also improve a person's overall health and well-being [1][4][5].

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274831/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140722/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789480/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725599/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380909/ [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380909/ [7] https://www.cdc.gov/shingles/about/prevention-vaccination.html [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8768054/

Stress, a recognized physical stressor, can weaken the immune system, making the reactivation of the varicella-zoster virus (VZV) more likely, as seen in people with chronic stress.
Shingles, a predictive condition of dermatitis characterized by a painful, blistery rash, can be more common in older adults and people with certain medical-conditions like leukemia, lymphoma, HIV and AIDS, undergoing radiation therapy and chemotherapy, and those taking drugs that prevent the immune system from working properly.
In addition to causing shingles, the varicella-zoster virus, which remains dormant in nerve ganglia after an initial chickenpox infection, is also linked to chronic diseases such as diabetes and hepatitis.
Atopic individuals may be at a higher risk of developing shingles due to their weakened immune system, which might be exacerbated by conditions like obesity and mental-health issues.
The science community still debates the role of stressful life events and chronic psychological stress in immune function and the susceptibility to shingles, with no firm consensus yet established, but research remains ongoing.
The Centers for Disease Control and Prevention recommends people aged 50 and older and those with immunocompromised conditions to take two doses of Shingrix to prevent shingles and its related chronic diseases and complications.
When diagnosed with shingles, it's essential to seek medical attention immediately to receive antiviral medications that can speed up the healing process, reduce the severity, and help manage long-term complications like postherpetic neuralgia.