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<span>Shingles</span>
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<span class="page-url print-only">URL of this page: https://medlineplus.gov/genetics/condition/shingles/</span>
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<h1>Shingles</h1>
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<div class="mp-exp exp-full" data-bookmark="description">
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<h2>Description</h2>
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<section><div class="mp-content"><p>Shingles (also known as herpes zoster) results from infection by the varicella zoster virus. This common virus causes chickenpox (also known as varicella), which is characterized by itchy spots on the skin that cover the whole body and usually occurs in childhood or adolescence. After the body fights the initial infection, the varicella zoster virus remains in nerve cells for the rest of a person's life. Because the virus is controlled by immune system cells called <a class="image-modal" data-alt="Diagram showing cell-mediated immune response involving macrophages and T cells" data-caption="" data-credit="Designua/Shutterstock.com" data-filepath="images/PX0001A8_PRESENTATION.jpeg" data-imgtype="genetics" data-pix="PX0001A8" data-sourceurl="" data-title="Role of T cells in the immune response" href="https://medlineplus.gov/images/PX0001A8_PRESENTATION.jpeg" id="PX0001A8_1" title="Show image">T cells<img alt="" aria-hidden="true" class="image-modal-icon" src="https://medlineplus.gov/css/img/icon_camera_small.png"/></a>, it is generally inactive (latent) and typically causes no health problems. However, in some people, the virus becomes active again (reactivates) and causes shingles. Shingles can occur at any age, although it is rare in childhood and becomes more common after age 50.</p><p>Shingles is characterized by a severely painful, itchy, or tingling rash, most commonly on one side of the torso, although it can occur anywhere on the body. Reactivation of the virus usually occurs in a single nerve, leading to the symptoms of shingles in just the region of skin connected to that nerve. When the nerve connected to the eye and the skin surrounding it is affected, the condition is called herpes zoster ophthalmicus. This form of shingles, which accounts for about 20 percent of cases, can cause permanent vision impairment.</p><p>Some individuals with shingles feel throbbing or tingling in the affected region shortly before the rash appears. Blisters form in the rash area, break open, and scab over in a few days. Healing usually takes 2 to 4 weeks. Most people have only one episode of shingles, although it can recur in rare cases.</p><p>In 5 to 20 percent of people with shingles, severe pain continues in the affected region after healing of the rash, which is known as postherpetic neuralgia (PHN). PHN is the most common complication of shingles. It can also involve severe itchiness or an overactive pain response to things that do not usually cause pain (allodynia), such as a light touch. PHN can last weeks, months, or even years. The likelihood of developing PHN after shingles and its severity increase with age. The pain caused by shingles and PHN can disrupt day-to-day activities and reduce a person's quality of life.</p></div>
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</section>
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<div class="mp-exp exp-full" data-bookmark="frequency">
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<h2>Frequency</h2>
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<section><div class="mp-content"><p>Because everyone infected with the varicella zoster virus is at risk of developing shingles, the condition is relatively common, particularly in older adults. Shingles occurs in 20 to 30 percent of people at some point in their lives, and about half of people over age 80 have had shingles.</p><p>The risk of shingles varies by ethnic background. The condition is more common in people of non-Hispanic white ancestry than those of African American ancestry. For unknown reasons, women are more prone to develop shingles than men.</p><p>A vaccine to prevent chickenpox was introduced in the United States in 1995. Since then, the incidence of chickenpox has been reduced by 76 to 85 percent. Doctors suspect the reduction of varicella zoster virus infections will reduce the incidence of shingles as the vaccinated children grow into adulthood; however, it is too early to tell. Vaccines for adults to protect against shingles and subsequent PHN have been used since 2006 and are also expected to reduce the incidence of shingles and its complications.</p></div>
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</section>
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<div class="mp-exp exp-full" data-bookmark="causes">
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<h2>Causes</h2>
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<section><div class="mp-content"><p>The causes of shingles are complex. Development of the condition is influenced by a combination of factors, including age, health, and genetics.</p><p>The strongest risk factor for shingles is age. The varicella zoster virus is controlled by the immune system, particularly <a class="image-modal" data-alt="Diagram showing cell-mediated immune response involving macrophages and T cells" data-caption="" data-credit="Designua/Shutterstock.com" data-filepath="images/PX0001A8_PRESENTATION.jpeg" data-imgtype="genetics" data-pix="PX0001A8" data-sourceurl="" data-title="Role of T cells in the immune response" href="https://medlineplus.gov/images/PX0001A8_PRESENTATION.jpeg" id="PX0001A8_1" title="Show image">T cells<img alt="" aria-hidden="true" class="image-modal-icon" src="https://medlineplus.gov/css/img/icon_camera_small.png"/></a> that keep the virus from infecting other cells. As people age, growth and division (proliferation) of T cells are diminished, reducing the immune system's ability to control the virus, which can allow its reactivation. Health factors that impair T cells can also trigger reactivation of the varicella zoster virus. For example certain drugs, such as chemotherapies used to treat blood cancers like <a data-pid="16591" href="https://medlineplus.gov/genetics/condition/multiple-myeloma/">multiple myeloma</a> or drugs that prevent rejection of a transplanted organ, impair the immune system and can lead to virus reactivation. Infection with human immunodeficiency virus (HIV), which infects and kills T cells, can also allow the virus to become active again. In addition, some studies suggest that emotional stress or physical trauma may be involved in virus reactivation.</p><p>The role of genetics in shingles is not clear. Several studies indicate that having a family member who developed the condition increases a person's risk, suggesting a shared genetic risk factor, although other studies did not find such a link. Genes that help regulate the immune system have been found in some studies to be associated with the development of shingles or of PHN after shingles. In particular, the risk of developing PHN appears to be increased by certain variants of genes that belong to a family of genes called the <a class="image-modal" data-alt="Human chromosome 6 with amplification of the human lymphocyte antigen (HLA) region. The locations of specific HLA loci for the class I B, C and A alleles and the class II DP, DQ, and DR alleles are shown." data-caption="Human chromosome 6 with amplification of the human lymphocyte antigen (HLA) region. The locations of specific HLA loci for the class I B, C and A alleles and the class II DP, DQ, and DR alleles are shown." data-credit="© 2012 Terese Winslow LLC for the National Cancer Institute" data-filepath="images/PX0001UL_PRESENTATION.jpeg" data-imgtype="genetics" data-pix="PX0001UL" data-sourceurl="https://visualsonline.cancer.gov/details.cfm?imageid=10431" data-title="HLA complex" href="https://medlineplus.gov/images/PX0001UL_PRESENTATION.jpeg" id="PX0001UL_3" title="Show image">human leukocyte antigen (HLA) complex<img alt="" aria-hidden="true" class="image-modal-icon" src="https://medlineplus.gov/css/img/icon_camera_small.png"/></a>. The HLA complex helps the immune system distinguish the body's own proteins from proteins made by foreign invaders such as viruses and bacteria. It is unclear if certain HLA variations also play a role in the development of shingles.</p></div>
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</section>
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<section>
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<div class="related-genes mp-exp exp-full">
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<h3>Learn more about the genes associated with Shingles</h3>
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<ul class="relatedmp">
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<li><a href="https://medlineplus.gov/genetics/gene/hla-b/">HLA-B</a></li>
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<li><a href="https://medlineplus.gov/genetics/gene/polr3a/">POLR3A</a></li>
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<li><a href="https://medlineplus.gov/genetics/gene/stat1/">STAT1</a></li>
|
||
|
||
|
||
<li><a href="https://medlineplus.gov/genetics/gene/stat3/">STAT3</a></li>
|
||
|
||
|
||
</ul>
|
||
|
||
<p><strong>Additional Information from NCBI Gene:</strong></p>
|
||
<ul class="relatedmp">
|
||
|
||
<li><a href="https://www.ncbi.nlm.nih.gov/gene/3105" target="TheNewWin">HLA-A</a></li>
|
||
|
||
<li><a href="https://www.ncbi.nlm.nih.gov/gene/3586" target="TheNewWin">IL10</a></li>
|
||
|
||
<li><a href="https://www.ncbi.nlm.nih.gov/gene/10623" target="TheNewWin">POLR3C</a></li>
|
||
|
||
</ul>
|
||
|
||
</div>
|
||
|
||
</section>
|
||
|
||
</div>
|
||
<div class="mp-exp exp-full" data-bookmark="inheritance">
|
||
<h2>Inheritance</h2>
|
||
|
||
<section><div class="mp- mp-content"><p>The inheritance pattern of shingles is unclear. Having a <a class="image-modal" data-alt="First degree relatives include parents, offspring, and siblings." data-caption="A first degree relative is a family member who shares about 50 percent of their genes with a particular individual in a family. First degree relatives include parents, offspring, and siblings." data-credit="Darryl Leja, NHGRI" data-filepath="images/PX0000I8_PRESENTATION.jpeg" data-imgtype="genetics" data-pix="PX0000I8" data-sourceurl="" data-title="First-degree relatives" href="https://medlineplus.gov/images/PX0000I8_PRESENTATION.jpeg" id="PX0000I8_1" title="Show image">first-degree relative<img alt="" aria-hidden="true" class="image-modal-icon" src="https://medlineplus.gov/css/img/icon_camera_small.png"/></a> (such as a parent or sibling) who developed shingles appears to slightly increase the risk of developing the condition. However, shingles is relatively common in the general population, particularly among older adults, and so it would not be surprising to see more than one case in a family just by chance.</p></div>
|
||
</section>
|
||
|
||
</div>
|
||
<div class="mp-exp exp-full" data-bookmark="synonyms">
|
||
<h2>Other Names for This Condition</h2>
|
||
|
||
<section>
|
||
<ul class="bulletlist">
|
||
<li>Herpes zoster</li> <li>Zoster</li>
|
||
</ul>
|
||
</section>
|
||
|
||
</div>
|
||
|
||
<div class="mp-exp exp-full" data-bookmark="resources">
|
||
<h2>Additional Information & Resources</h2>
|
||
|
||
<section>
|
||
<div class="mp-content">
|
||
|
||
<h2>Genetic and Rare Diseases Information Center</h2>
|
||
<ul>
|
||
|
||
<li><a href="https://rarediseases.info.nih.gov/diseases/7525/index" target="TheNewWin">Ramsay Hunt syndrome</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
|
||
|
||
</ul>
|
||
|
||
</div>
|
||
</section>
|
||
|
||
<section>
|
||
<div class="mp-content">
|
||
|
||
<h2>Patient Support and Advocacy Resources</h2>
|
||
<ul>
|
||
|
||
<li><a href="https://rarediseases.org/" target="TheNewWin">National Organization for Rare Disorders (NORD)</a></li>
|
||
|
||
</ul>
|
||
|
||
</div>
|
||
</section>
|
||
|
||
<section>
|
||
<div class="mp-content">
|
||
|
||
<h2>Clinical Trials</h2>
|
||
<ul>
|
||
|
||
<li><a href="https://clinicaltrials.gov/search?cond=%22Shingles%22" target="TheNewWin">ClinicalTrials.gov</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
|
||
|
||
</ul>
|
||
|
||
</div>
|
||
</section>
|
||
|
||
<section>
|
||
<div class="mp-content">
|
||
|
||
<h2>Scientific Articles on PubMed</h2>
|
||
<ul>
|
||
|
||
<li><a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Herpes+Zoster%5BTI%5D%29+OR+%28shingles%5BTI%5D%29%29+AND+english%5Bla%5D+AND+human%5Bmh%5D+AND+%22last+360+days%22%5Bdp%5D" target="TheNewWin">PubMed</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
|
||
|
||
</ul>
|
||
|
||
</div>
|
||
</section>
|
||
|
||
</div>
|
||
|
||
<div class="mp-exp exp-full" data-bookmark="references">
|
||
<h2>References</h2>
|
||
|
||
<section>
|
||
<div class="mp-content">
|
||
|
||
<ul>
|
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|
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<li>Canadian Pain Society Study Day participants. Safety and effectiveness of the
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herpes zoster vaccine to prevent postherpetic neuralgia: 2014 Update and
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consensus statement from the Canadian Pain Society. Pain Res Manag. 2015
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Jan-Feb;20(1):46-7. doi: 10.1155/2015/438597. <a href="https://pubmed.ncbi.nlm.nih.gov/25664540" target="TheNewWin">Citation on PubMed</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325890/" target="TheNewWin">Free article on PubMed Central</a></li>
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||
<li>Chen N, Li Q, Yang J, Zhou M, Zhou D, He L. Antiviral treatment for preventing
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postherpetic neuralgia. Cochrane Database Syst Rev. 2014 Feb 6;2014(2):CD006866.
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doi: 10.1002/14651858.CD006866.pub3. <a href="https://pubmed.ncbi.nlm.nih.gov/24500927" target="TheNewWin">Citation on PubMed</a></li>
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<li>Cho JW, Shin DH, Lee KS. Polymorphism of the IL-10 gene is associated with
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<li>Crosslin DR, Carrell DS, Burt A, Kim DS, Underwood JG, Hanna DS, Comstock BA,
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<li>Gagliardi AM, Andriolo BN, Torloni MR, Soares BG, de Oliveira Gomes J,
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<li>Gatti A, Pica F, Boccia MT, De Antoni F, Sabato AF, Volpi A. No evidence of
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<li>Hernandez PO, Javed S, Mendoza N, Lapolla W, Hicks LD, Tyring SK. Family
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2011 Dec;52(4):344-8. doi: 10.1016/j.jcv.2011.08.014. Epub 2011 Sep 15. <a href="https://pubmed.ncbi.nlm.nih.gov/21924676" target="TheNewWin">Citation on PubMed</a></li>
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<li>Meysman P, De Neuter N, Bartholomeus E, Elias G, Van den Bergh J, Emonds MP,
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Haasnoot GW, Heynderickx S, Wens J, Michels NR, Lambert J, Lion E, Claas FHJ,
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Goossens H, Smits E, Van Damme P, Van Tendeloo V, Beutels P, Suls A, Mortier G,
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immediate early 62 protein (IE62) affinity. Immunogenetics. 2018
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<li>Meysman P, Ogunjimi B, Naulaerts S, Beutels P, Van Tendeloo V, Laukens K.
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<li>Siegel AM, Heimall J, Freeman AF, Hsu AP, Brittain E, Brenchley JM, Douek DC,
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broad clinical phenotype. Blood. 2016 Jun 23;127(25):3154-64. doi:
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||
<li>Warren-Gash C, Forbes H, Breuer J. Varicella and herpes zoster vaccine
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development: lessons learned. Expert Rev Vaccines. 2017 Dec;16(12):1191-1201.
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|
||
|
||
|
||
</ul>
|
||
|
||
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||
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<li><a href="https://medlineplus.gov/ency/article/000858.htm">Shingles</a></li>
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