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What Causes Shingles to Flare Up?

November 5, 2015

Scientists are unsure about the exact reasons for recurrences of shingles. It may be due to the immune system weakening as people grow older. Shingles is more common in older adults and in people who have weak immune systems, including people living with HIV.

Currently, there is no way to predict an outbreak of shingles.

A Viral Infection

The underlying cause of shingles is the varicella-zoster virus -- the same virus that causes chickenpox. Anyone who's had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous system and lie dormant for years. Eventually, it may reactivate and travel along nerve pathways to your skin, producing shingles.

About 20% of people who have had chickenpox will eventually develop shingles. This reactivation of the virus is most likely to occur in people with a weakened immune system. This includes people over the age of 50 and people living with HIV. As people with HIV get older, flare-ups of shingles become more likely.

People with HIV may be more likely to have shingles when their CD4 count is low. Recurrences are also possible when taking HIV treatment for the first time -- this is thought to be due to immune restoration syndrome, a condition that occurs when a rapidly recovering immune system suddenly begins to fight off abnormalities it detects within the body.

More on Shingles at

To find out more about shingles, we recommend this article:

Our Q&A experts sometimes address questions about shingles in our "Ask the Experts" forums. Here are some of those questions and our experts' responses:

Copyright © 2015 Remedy Health Media, LLC. All rights reserved.

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