Does shingles come back in the same spot? (+3 facts)

In this article, we will discuss if shingles may appear in the same spot after flareup. We will also discuss some clinical interventions which your doctor may take to lessen the symptoms and pain associated with recurrent shingles.

Does shingles come back in the same spot?

Yes, shingles may come back in the same spot, but it is relatively uncommon. Usually, you may get recurrent shingles on the opposite side of your body. It means that if you had shingles on the right side, next time you will get them on the left side.

The Herpes zoster virus remains dormant in the nerve cells throughout your body. During recurrence, shingles may appear at the same site or different sites. According to research, the incidence of getting shingles in the same spot is 16% (1).

If you think that your symptoms are getting back, including the formation of blisters and postherpetic pain, consult your doctor immediately. Early diagnosis and treatment can lessen the severity of recurrent shingles.

What does research suggest?

In one of the studies, researchers established that 28.9% (53 of 183) of the patients were more likely to have shingles in the same spot within 8 years of recurrence. On the other hand, 38.3% of the patients had shingles at different spots (3).

Overall, 16.3% of the patients established shingles in the same dermatome after shingles recurrence. About 76.3% of the patients established shingles in a single dermatome, whereas 23.7% had shingles in multiple spots (3). 

According to a prospective cohort study, the recurrence of shingles in the same spot is rare and reported in approximately 6% of the population. The shingles may recur on the anogenital site (38%), head/neck (26%), chest/abdomen/back (24%), and lower extremities (11%) (2).

According to a cohort study, the occurrence of recurrent shingles in immunocompetent elders (<70 years) was 0.99 (vaccinated group, n=1036) and 2.20 (unvaccinated group, n=5180) cases/1000 patients (3).

What factors cause shingles to come back in the same spot?

There are several factors which may increase the recurrence of shingles and the appearance of the symptoms in the same spots. Some of these factors include:

Age

Elderly patients are more likely to develop shingles in the same spot mainly because of low immunity, rheumatoid arthritis, the use of certain medications, or other disease conditions. Elderly patients are more likely to develop postherpetic neuralgia and rashes in the same spot.

Low immunity

You are more likely to get recurrent shingles if your immunity is low. Low immunity may occur due to ageing, bone marrow transplant, Hodgkin and non-Hodgkin lymphomas, underlying autoimmune disease conditions, and some medications (4).

Vaccination

The incidence of recurrent shingles is less common in vaccinated patients as compared to the unvaccinated group. However, the incidence rate of developing shingles in the same spot is still rare (3).

Disease

You are more likely to get shingles in the same spot due to underlying disease conditions that compromise your immune system. These diseases may include rheumatoid arthritis, lupus, leukaemia, multiple sclerosis, lymphomas, and HIV/AIDS (5). 

Medications

Some medications may compromise your immune system, allowing herpes zoster virus to reactivate to cause shingles in the same spot. These medications may include methotrexate, steroids like prednisolone, and immuno-suppressive therapy given during organ transplant (6).

What are the symptoms of recurrent shingles?

According to a research study, the patients (n=78) are more likely to get the following symptoms during recurrent shingles (2):

How to manage recurrent shingles?

The treatment and management of recurrent shingles are the same as that given for shingles. You should consult your doctor if you think that the previous symptoms are reemerging since the last time you had shingles.

Your doctor may prescribe antiviral drugs like Acyclovir, famciclovir, and Valacyclovir to speed up the healing of sores. You may take gabapentin and pregabalin for postherpetic pain if necessary. 

If you have extreme pain, you may take acetaminophen and ibuprofen after consulting your doctor. Some patients find relief from itching and blistering by using topical calamine lotion or taking oatmeal baths.

As a pharmacist, I would advise you to take shingle vaccination after one year of having shingles if you are an adult (≥50 years of age). This may prevent the recurrence of shingles and postherpetic pain (7).

You should eat a healthy balanced diet and drink plenty of water to keep your immune system strong. Don’t drink too much alcohol or smoke frequently. Always take medications on the advice of your doctor.

References