Many of these patients are juggling multiple demands: an intense career, travel, young kids, and buying a home. “Often they’re sleep-deprived, not getting the right nutrients for their body, [and] not getting enough sun exposure,” Dr. Vo says.
Both short-term and chronic stress can weaken your immune system, making it easier for the dormant varicella-zoster virus to reactivate. Major short-term stressors, such as recovering from surgery or an illness, or even preparing for a big work presentation, can also be enough to trigger an outbreak, Dr. Vo says.
Similarly, when stress becomes chronic, it ramps up inflammation. That’s because stress activates your fight-or-flight response, which boosts levels of cortisol, the main stress hormone, Dr. Bhayani explains. Though cortisol can help regulate inflammation in the short term, chronically high levels can actually suppress immune function, making it harder for your body to keep the dormant virus in check.
Hormonal shifts
Generally speaking, shingles tends to be more prevalent in women than in men. Hormones may help explain why, Dr. Bhayani says.
Both estrogen and progesterone help regulate your immune system. Estrogen also has anti-inflammatory properties. When those levels fluctuate or begin dropping during perimenopause, it can make your body more vulnerable to infections, including shingles. Add in other factors such as age, stress, and disrupted sleep, and your risk can climb even more.
But normal hormonal shifts in premenopausal people can potentially trigger shingles as well. After ovulation, during the luteal phase of the menstrual cycle, is one prime time, Dr. Vo says. During this phase estrogen and progesterone levels dip, along with certain immune factors like antibodies and cytokines, temporarily weakening the body’s defenses.
Viral infections
Imagine finally getting over COVID-19 or the flu just to break out in a painful shingles rash. It may sound random, but it’s not. When you’re fighting off and then recovering from an illness, your immune system isn’t working at full capacity to also keep shingles at bay, leaving you more prone to an outbreak, Dr. Bhayani says.
To be clear, illnesses like COVID-19 don’t cause shingles. But research has found that people who’ve had COVID may be more susceptible to developing shingles, likely because of temporary immune disruption. One study found that adults 50 and older had a 15% to 21% higher risk of experiencing shingles within six months of a COVID-19 infection, compared with those who never had the illness.
Although uncommon, there have also been cases where folks got shingles after receiving a COVID or flu vaccine. Research suggests this may be because the immune system is temporarily challenged post-vaccination, giving the virus an opportunity to “turn on.”
Sunburn
Need yet another reason to slather on the sunscreen? A bad sunburn can also reactivate the varicella-zoster virus.
Turning into a human tomato is a form of skin trauma that your body interprets as stress. Any kind of stress, whether it’s physical or emotional, can ramp up inflammation and stress hormones, creating the perfect conditions for the virus to rear its head, says Dr. Vo.
