Shingles, also known as herpes zoster, is caused by the varicella zoster virus – the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in the body. Years later, the virus can reactivate as shingles. It is not fully understood why the virus reactivates in some people and not others, but it is believed that factors like aging and weakened immunity allow for reactivation. Stress is also often cited as a potential trigger for shingles. In this article, we will examine the link between stress and shingles, looking at the scientific evidence.
What are the symptoms of shingles?
Shingles causes a painful rash that usually appears on one side of the body, often as a stripe of blisters. The rash most commonly occurs on the trunk, usually on the torso, back or chest. Less commonly, it can appear on the face, eyes or genitals. Other symptoms of shingles can include:
- Burning, tingling, numbness or itchiness of the skin in the affected area
- Fever
- Chills
- Upset stomach
- Headache
In most people, the rash and pain associated with shingles clears up within a few weeks. But some people develop ongoing nerve pain called postherpetic neuralgia, which can persist for months or years.
What causes shingles?
As mentioned, shingles is caused by the varicella zoster virus. After a person recovers from chickenpox, the virus remains latent in the body, residing in the nerve cells without causing problems. Years or decades later, the virus can reactivate as shingles. What leads it to reactivate is not completely understood, but it is believed that a weakened immune system allows for viral reactivation. As people age, their immunity declines, making them more prone to shingles. Other factors that can weaken immunity and trigger shingles include:
- Cancer
- HIV/AIDS
- Immunosuppressant medications
Stress has also been suggested as a potential trigger for shingles. Next, we’ll review the evidence surrounding the link between stress and shingles.
Can stress cause shingles?
There are several reasons why stress is believed to potentially contribute to the reactivation of varicella zoster virus:
- Stress can weaken the immune system. Short-term stress causes the release of hormones like cortisol and epinephrine. Chronic stress prolongs exposure to these hormones, impairing immune function over time.
- Stress alters nerve function. The varicella zoster virus resides dormant in nerve cells. Stress may alter nerve function in ways that trigger viral reactivation.
- Stress can reawaken latent viruses. Research shows stress can trigger reactivation of other latent viruses like Epstein-Barr virus (which causes mono). Stress may have a similar effect on varicella zoster virus.
Some research studies provide evidence for a link between stress and shingles, but the data is not conclusive. Below is a review of some key studies.
Studies on the link between stress and shingles
| Study | Findings |
|---|---|
| A 2008 study followed over 1,700 older adults for up to 10 years, monitoring shingles outbreaks and assessing life stress factors. Participants who reported high levels of psychological stress were over twice as likely to develop shingles compared to those with lower stress. | Higher perceived stress was associated with more than double the risk of developing shingles. |
| A 2015 study assessed over 4,700 older adults and found that those with a higher number of stressful life events in the past year had a 30% greater risk of developing shingles over the following year. | More stressful life events were linked to a moderately higher shingles risk. |
| A 2010 study followed over 1,700 older adults and found no association between psychological stress or personally stressful life events and risk of shingles over a 10-year period. | No relationship observed between stress and shingles. |
As the table shows, some studies have linked higher stress levels to increased shingles risk, while others have not. Overall the research is mixed, with some evidence pointing to a stress-shingles link but no conclusive proof. More research is still needed.
It’s also important to note that studies show stress impairs immunity and reactivates latent viruses. So there is a biologically plausible mechanism by which stress could contribute to shingles risk. However, stress alone may not directly cause shingles. It likely interacts with other factors like age, genetics, and immunity to influence risk.
Can managing stress help prevent shingles?
Given the potential effects of stress on immunity and viral reactivation, it seems plausible that managing stress could help lower shingles risk. However, no studies have directly examined whether stress reduction prevents shingles.
Some general research points to stress management benefits:
- Mindfulness meditation may reduce cortisol and improve immune responses.
- Yoga has been found to lower stress and boost immunity in older adults.
- Stress management therapy reduces distress and improves quality of life in chronic disease.
Based on this broader research, stress-reducing therapies like mindfulness, yoga, and counseling may lower shingles risk by strengthening immunity. But more targeted research is needed to determine if they can help prevent shingles specifically.
Until more evidence is available, stress management techniques remain an adjunct strategy. They support overall wellness alongside other shingles prevention tips like getting adequate nutrition, physical activity, and rest.
Medical options for preventing shingles
Vaccination is the only medical intervention proven to prevent shingles. The FDA has approved two shingles vaccines for adults 50 years and older:
- Shingrix: This is the preferred vaccine, requiring 2 doses. Clinical trials show it is over 90% effective at preventing shingles and postherpetic neuralgia.
- Zostavax: This older vaccine requires just one dose but is only 51% effective. It still provides some protection and is an option for healthy adults ages 60+.
The CDC recommends healthy adults 50+ receive two doses of Shingrix, separated by 2 to 6 months. People with weakened immunity may receive the vaccine but it may be less effective. Discuss your options with your doctor.
Beyond vaccination, some medications used to treat shingles and postherpetic neuralgia may help prevent recurrence. But more research is needed on their efficacy for prevention. Talk to your doctor about whether antiviral drugs like valacyclovir (Valtrex), famciclovir (Famvir), or acyclovir (Zovirax) are appropriate options for you.
The bottom line
Some research points to a possible link between high stress levels and increased shingles risk. Theories suggest stress may promote shingles by weakening immunity or altering nerve function. However, the data is not definitive and more studies are needed.
Managing stress through lifestyle and therapies like meditation may provide some benefit. But proven medical prevention, through shingles vaccination, remains the best option for healthy adults over age 50. Getting vaccinated can significantly lower your chances of developing this painful viral infection.