Can you get shingles more than once?

Shingles is also called herpes zoster. It is a condition that develops when the varicella-zoster virus, which also causes chickenpox, reactivates after staying dormant in your body.

Most people only experience shingles once. Nonetheless, it is possible to get shingles more times.

Treatment is most effective if it starts early after the shingles rash appears. The shingles vaccine is generally safe for most people and is very effective at preventing the condition. 

Shingles overview

Shingles causes a painful rash on the body. It’s a condition from the varicella-zoster virus that also causes chickenpox. If you get chickenpox, the virus can stay in your body and later cause shingles.

About 1 in 3 people in the United States who have the varicella-zoster virus develop shingles as adults, according to the Centers for Disease Control and Prevention.

It’s not known why some people get shingles while others don’t. Some triggers of the reactivation of the varicella-zoster virus include:

• use of immunosuppressant medications
• acute or chronic illness
• new exposure to the varicella-zoster virus
• emotional stress

Herpes zoster is more common among older adults. The incidence rate for younger individuals is 1.2–3.4 per 1000 every year, while for those over the age of 65 years, the rate is 3.9–11.8 per 1000 every year. 

A case of shingles usually lasts 3 to 5 weeks. Some people experience long-term pain after having shingles, called post-herpetic neuralgia.

Can you get shingles more than once? 

It is possible to get shingles repeatedly, but most people get it only once.

A 2018 study analyzed the rate of herpes zoster recurrence in Korea between 2002 and 2013. The rate was 12 in 1000 person-years, which means that on average, 12 people would experience shingles recurrence if 1000 people were followed for one year.

Causes of recurring shingles

Some factors may make people more likely to have more than one case of shingles. According to the same 2018 study, the following factors are associated with a greater chance of recurrence:

• age over 50
• female gender
• presence of long-lasting shingles pain
• some immunocompromising conditions, such as blood cancer or autoimmune diseases
• conditions such as hypertension and dyslipidemia

Although 17.8% of the people in the study were immunocompromised when they had their first case of shingles, not every immunocompromising condition led to an increased chance of recurrence. There was no greater risk among those with non-blood cancers, HIV, or AIDS, for example.

Treatment and prevention 

Shingles is treated with antiviral medications. A healthcare professional can also prescribe drugs to prevent infection and reduce pain.

The shingles vaccine, also called the recombinant zoster vaccine, is highly effective at preventing shingles.

Medication is most effective if you start it early during the course of shingles, preferably within the first 24 to 72 hours of the appearance of the rash. If you have a rash that could be shingles, you may want to see a healthcare professional as soon as possible to get a diagnosis and treatment plan. 

You can also use home treatments to increase personal comfort while you experience shingles.

Antiviral medications

Antiviral drugs are available by prescription. They include:

• acyclovir (Zovirax)
• valacyclovir (Valtrex)
• famciclovir (Famvir)

The course of treatment is generally 5 to 7 days, depending on which medication you take. You should follow the instructions of a healthcare professional.

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Other medications

A healthcare professional can also give you medication to help treat the symptoms of shingles.

• antibiotic creams like mupirocin (Bactroban) to prevent bacterial infection
• prescription pain medication
• nerve blockers or topical lidocaine for pain
• capsaicin cream or combination lidocaine and prilocaine (Emla) cream for lesions from post-herpetic neuralgia

You may also consider starting with over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil). 

Home treatment

To increase comfort while you experience shingles, consider the following:

• oatmeal baths or calamine lotion to soothe skin
• cool washcloth on blisters to help dry them
• loose-fitting clothing
• avoiding stress 
• resting, eating healthily, and exercising
• washing hands often

Consider keeping the rash covered and not touching or scratching it. This can prevent infection and reduce the chance of spreading shingles to another person.

Shingles prevention

The recombinant zoster vaccine (Shingrix) is 90% effective at preventing shingles, according to the U.S. Department of Health and Human Services. 

You may want to consider the shingles vaccine if you:

• are ages 50 years or older
• are ages 19 years or older with a compromised immune system
• have received the Zostavax vaccine
• have already had shingles
• are uncertain if you’ve had chickenpox

In some cases, a healthcare professional may not advise you to get the shingles vaccine. You should seek professional advice if you:

• are not immune to the chickenpox virus
• are pregnant or nursing
• are currently experiencing shingles
• are allergic to any ingredient of the shingles vaccine

The shingles vaccine requires two doses, 2 to 6 months apart. The side effects include:

• headaches, shivering, or fever
• muscle pain or fatigue
• stomach pain or upset
• swelling, pain, or difference in skin color at the site of injection

More serious side effects of the shingles vaccine are rare.

Summary

Shingles comes from the varicella-zoster virus, which also causes chickenpox. About 1 in 3 people who have had exposure to the virus will eventually develop shingles.

It is possible to develop shingles more than once, but there are different treatment options. Antiviral medications are commonly used to treat shingles, and there are also some home remedies you can try.

In addition, the shingles vaccine is 90% effective in prevention, so you may consider asking a healthcare professional for this if you feel you are at risk.

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