The Shingles Virus: Everything You Need to Know

It's estimated in about 10-20% of cases, people who have recovered from the active stage of shingles may continue to experience pain, skin sensitivity, numbness and itching. Postherpetic neuralgia occurs when the nerve fibers become damaged during the outbreak of shingles, and can no longer send normal messages from the skin to the brain.

Risk factors for postherpetic neuralgia include:

• Experiencing shingles after the age of 60
• People who are immunosuppressed
• Experiencing a prodromal phase
• Experiencing touch or skin sensitivity or severe pain during the active phase
• People with diabetes mellitus
• People who experienced shingles that affected the eye

Postherpetic neuralgia can last anywhere from several months to years in some individuals, causing chronic pain and sensitivity, and affecting quality of life. 

Yes, the shingles virus can spread from the facial nerve to the ear, eye or mouth. Shingles that occurs on the face can be much more dangerous than other types due to the risk of permanent damage. It's important to see your healthcare provider as soon as possible if you suspect symptoms. 

After having chickenpox as a child, the virus lays dormant in the nervous system and the viral cells can be reactivated, causing shingles. It is believed shingles occurs due to the immune system failing to keep the virus under control. 

The most common trigger of shingles is stress. Shingles can also be triggered by immunosuppressant medications, illness, being exposed to the virus or malignant tumors.

Shingles only affects people who have had the chickenpox virus. It is most common in adults over the age of 65 or immunosuppressed individuals, but can occur in younger healthy adults as well. 

Studies have shown there are some potential risk factors for the development of shingles including:

• Family history
• Age (60 and older)
• Immunosupression (such as HIV/AIDS and Lymphoma)
• Autoimmune disorders (such as Lupus and Rheumatoid arthritis)
• Experiencing physical trauma

Shingles is most commonly treated with antiviral therapy. Healthcare providers may also prescribe topical antibiotic creams and analgesics. 

Shingles is not directly caused by stress, but stress can be a definite component. Because the immune system is strongly tied to stress levels, learning ways to help manage stress can help improve your overall health. Here a few key ways to help control stress naturally:

• Regular exercise: at least 30 minutes of moderate exercise (such as walking, yoga or swimming) most days of the week, can help to reduce stress and boost the immune system. 
• Sleep: getting at least 7 hours of quality sleep every night is a key factor in living a healthy life. It's hard for many of us to prioritize sleep when our schedules are so busy, but chronic poor sleep is associated with lower immune function. Other long-term issues of inadequate sleep can include higher risk of diabetes, high blood pressure, obesity, depression and anxiety. If you have issues sleeping well, try working on your sleep hygiene.  
• Diet: a balanced diet that contains mostly fruit, vegetables, whole grains and lean proteins (such as the Mediterranean diet) can not only support immune function, but can also reduce stress through the gut-brain connection. 
• Socializing: as many of us learned during COVID lockdowns, social support is a key component to our mental health. Having a social support system also provides physical health benefits as well, including lowering heart rate, blood pressure and cortisol (stress hormone). 

Psychological stress has been shown to reduce cellular immunity, which could increase the risk of reactivation of latent infections, such as shingles. A study of 77,000 people in Denmark found that people "reporting high levels of perceived stress had a 14% elevated risk" of shingles. The authors of the study hypothesized that "experiencing persistent daily stress" may depress cell immunity and trigger the reactivation of chickenpox.

Not only does stress increase the risk of shingles, but can cause shingles symptoms to last longer and be more severe. Cortisol, also known as the stress hormone, can suppress the immune system's ability to effectively fight the reactivated chickenpox virus, leading to an increase in severity of symptoms.

Once you're in a shingles outbreak, it may be hard to think straight. The pain, itchiness or fatigue can cause serious distress. After you see your healthcare provider and follow their advice, remember there are several ways to help calm the symptoms of shingles, including: 

• Reduce stress: use mindfulness, meditation, breathing exercises or some gentle yoga to help control the stress you're feeling. Don't forget to use all your daily stress management techniques listed aboved as well. 
• Manage pain: speak to your healthcare provider about ways to help manage pain including over-the-counter and prescription medications or topical treatments. 

It is possible to have a recurrence of shingles, however it is relatively rare, with the likelihood between 4-5% of cases. It is more likely to recur in individuals who experienced pain for more than 30 days after the original onset, and the recurrence is more likely within the first 3-4 years after the first occurrence. 

Quality of life can be greatly affected for those that continue to experience symptoms 3 months or longer after the rash has recovered. Most symptoms are experienced at the site where the rash first occurred, but can also be along the same dermatome. Symptoms may be experienced constantly or intermittently and can be worse at night or with hot or cold temperatures. Common symptoms of postherpetic neuralgia include:

• Stabbing or burning pain
• Extreme skin sensitivity to touch or clothing
• Tingling, numbness or pins and needles sensations
• Itchiness

Common treatments for postherpetic neuralgia generally include lidocaine patches, capsaicin cream, antidepressants and gabapentin. 

There are several alternative treatments that may offer relief from pain and itching related to chronic shingles. 

• Acupuncture is a safe and effective way to help combat pain and other symptoms related to chronic shingles, as well as improving immune function and lowering stress levels.
• Vitamin C deficiency may increase chances of developing chronic shingles symptoms. High-dose IV vitamin C has been shown to reduce the pain associated with postherpetic neuralgia.
• Shingles Lotion is made from a combination of soothing essential oils and vegan lotion to ease discomfort naturally, as well as help strengthen and tone nerves.