Can Stress Cause Shingles?

Stress is any type of change that results in physical, emotional, and psychological strain, and almost everyone experiences it to some degree. However, too much stress can overwhelm you causing a fight, a flight, or a freeze response. 

Moreover, stress affects your body and mind and is sometimes linked to other conditions like depression and heart disease.

But can stress cause shingles?

This post explores the link between stress and shingles. We also address some of the risk factors of shingles and stress and how to deal with the two conditions.

Stress and shingles overview

While stress is a common term, even among children, shingles might be new to some. So before we dive into the link between the two conditions, let's highlight the basics to give you a better understanding of stress and shingles.

What are shingles?

Shingles, also called herpes zoster, is a viral infection that brings about a large, painful rash with blisters. The infection is caused by the varicella-zoster virus (VZV), the same virus that brings about chickenpox. 

When you have chickenpox in childhood, your body fights the VZV virus, and the chickenpox symptoms disappear. However, the varicella-zoster virus always remains in the body and may become active again in your adulthood. This second appearance comes in the form of shingles. 

Before the rash develops, you may experience pain, tingling, or itching in the area where it will form.

According to the Centers for Diseases Control and Prevention (CDC), nearly one out of every three adults in the US will develop shingles in their lifetime. Moreover, approximately one million Americans get shingles every year. As you get older, your risk of developing shingles increases.¹

Symptoms of shingles

The main symptom of shingles is a painful, blistery rash. Often, the rash pops up as a single stripe on one side of the face or either side of the torso. The rash turns into fluid-filled blisters within a few days and typically bursts and scab over within 7–10 days and clear up within four weeks. 

If the shingle develops on the face, it may affect your eye and cause vision loss. Rarely, the rash may spread widely over your body and resemble a chickenpox rash. This may happen, especially if you have a weakened immune system.

Other symptoms of shingles include:

• Headache

• Pain, burning, tingling, and numbness around the rash

• Fever

• Upset stomach

• Chills

• Vision problems or sensitivity to light (if the shingles affect your eye)

An overview of stress

Stress is a feeling you experience when you feel overwhelmed, under pressure, or unable to cope. It affects both children and adults, but differently. 

While small amounts of stress can be good, pushing you to achieve your goals, too much of it can be detrimental to your physical, mental, and psychological health.

Moreover, stress can be caused by multiple factors or situations. 

Symptoms of stress

Stress can bring about a mix of physical and emotional symptoms, including:

• Aches and pain

• Muscle tension or jaw clenching

• Dizziness, headaches, or shaking

• Stomach or digestive problems

• Anxiety or irritability

• Depression

• Sadness 

• Sexual problems

The connection between stress and shingles

It's known that stress has a negative impact on your body. But some studies reveal that stress or stressful moments trigger the development of shingles. Although further research is needed, there might actually be a link between stress and shingles.²

A weakened immune system can reactivate the varicella-zoster virus (the virus that causes shingles). Moreover, a weakened immune system limits your body's ability to fight viruses like VZV. And because stress impacts your immune system, researchers believe it could be a possible trigger for shingles. 

However, stress might be a risk factor for shingles if other factors are present. This includes mood disorders, poor diet, and advancing age, which negatively impact your immune system.³

Another 2018 study found that negative life events, perceived mental stress, and a low sense of purpose may trigger the development of herpes zoster (shingles) and postherpetic neuralgia — a complication of shingles.⁴

The study also revealed that men with high mental stress levels were twice as likely to develop herpes zoster. Men and women with a high sense of purpose in life had 60% less risk of developing shingles.

A 2022 review also argues that the interplay between stress and immunity triggers herpes zoster in people with COVID-19. The review justifies the argument that increased immunological and psychological stress leads to shingles in people with COVID-19.⁵

Based on the above data, we can conclude that the connection between stress and shingles lies in the immune system. The risk of getting shingles increases when your immune system is compromised or weakened. So how does stress affect our immune system?

How does stress affect our immune system?

Chronic stress can take a toll on your immune response. Your immune system is sensitive to chronic psychological stress.

Moreover, stress minimizes your immune system's ability to fight antigens, increasing your body's susceptibility to infections. Stress lowers the number of killer cells, or lymphocytes, in your body, which fight viruses like the varicella-zoster virus.

Also, chronic stress triggers the production of the hormone cortisol at higher levels. This, in turn, hampers the body's anti-inflammatory response and causes continual infections. 

What can make shingles worse?

Shingles can cause pain, itching, and a lot of discomfort. Moreover, certain factors and activities can worsen your shingles symptoms. Therefore it's crucial to identify and avoid such triggers to manage your symptoms.

Here is what can make your shingles worse:

• Picking and scratching at the rash — increases the risk of infection and delays healing

• Physical activities or exercises that cause irritation and friction to your skin

• Activities that cause more sweating

• Lack of rest

• Activities or responsibilities that increase stress levels

• Tight-fitting clothing that irritates the open rash

Who's at risk of facing a shingles outbreak?

Anyone who has had chickenpox is at risk of a shingles outbreak. The varicella-zoster virus doesn't leave your body, even when the chickenpox symptoms fade away.

However, other factors place you at greater risk of developing shingles. 

Common risk factors for shingles include:

• Age — those 50 years and older are at significant risk for getting shingles

• Having a weakened immune system

• Some medical conditions and their treatments, including cancer (chemotherapy and radiation) and HIV

Treating shingles

Shingles have no cure. However, various antiviral medicines like valacyclovir, acyclovir, and famciclovir can help relieve symptoms and shorten the severity and length of the illness. These drugs are most effective if you take them immediately after the rash pops up.

Moreover, you can relieve pain from shingles using over-the-counter pain medicines or a prescription from your healthcare provider.

Also, you can relieve itching using calamine lotion, wet compresses, lots of rest, and colloidal oatmeal baths.

Here are other self-care tips for shingles:

• Visit your doctor within 72 hours of developing shingles

• Care for the rash until it clears — uses a fragrance-free cleanser to wash the rash

• Take good care of yourself — eat healthy, well-balanced meals, avoid stress, and get plenty of rest

• Talk to your healthcare provider about any other health problems

Furthermore, you can protect yourself from shingles and postherpetic neuralgia by getting a shingles vaccine known as Shingrix. However, you must be 50 years or older to get the Shingrix vaccine — given in two doses.

How to deal with stress

People react differently to stress. However, there are healthy ways to cope with stress, including:

• Take care of yourself and your body — exercise, eat healthily and get plenty of sleep

• Talk to others — express your feelings and concerns to someone you trust

• Avoid drugs and alcohol — they create more problems and increase your stress levels

• Distract yourself — engage in activities you love, like playing football

• Get help from a psychologist, social worker, or professional counselor

The lowdown

Stress lowers your body's immune response to fight viruses and infections, making your body susceptible to diseases and infections. This is why some researchers believe that stress causes shingles. There is a link between stress and shingles, although further research is still needed.

Frequently asked questions

What triggers an outbreak of shingles?

Anyone who's had chickenpox is at risk of getting shingles. However, a weakened immune system, old age (50 and older), and certain medical conditions and treatments can trigger an outbreak of shingles.