If you believe you’re too young to worry about shingles, just look at Tyrese Haliburton.
He missed three weeks of the NBA season earlier this year after being diagnosed with the disease.
At his age, the 26-year-old All-Star point guard for the Indiana Pacers doesn’t fit the typical profile of a shingles patient. That’s because the infection—which is caused by the same virus that leads to chickenpox in children—most often strikes older adults.
But Haliburton is among a group of young and otherwise healthy celebrities who have developed shingles in recent years.
And it is exposing a terrifying medical issue where this painful virus could be unlocking a brutal new reality for younger generations.
Here’s everything you need to know to protect yourself and your loved ones from shingles, according to the experts.
The Rise of Shingles in Young People
Shingles—aka herpes zoster—is a common condition that affects many people, particularly those aged 50 and older. The Centers for Disease Control and Prevention (CDC) estimates that about one in three individuals in the U.S. will experience shingles in their lifetime, but what’s striking is the rising trend among younger adults.
Between 1998 and 2019, the number of shingles cases surged across all age groups, and the increase was especially notable among those in their 30s and 40s. A recent study published in Open Forum Infectious Diseases examined data from 2019 to 2022 and revealed that while the annual incidence of shingles in people aged 20-29 is relatively low at 1.2 cases per 1,000 individuals, this rate tends to double with each subsequent decade.
It’s also important to note that the study illustrates that individuals with long-term health conditions that compromise their immune systems face a much higher risk of developing shingles.
“Over the past few decades, there has been an increase in the incidence of shingles cases, both in people over age 50 and also younger,” notes Rebecca Choudhury, M.D., an infectious disease physician and an assistant professor of medicine (infectious diseases) at the Icahn School of Medicine at Mount Sinai in New York City, said in a recent interview with Health Central. However, she adds that the reasons remain somewhat unclear. “It’s hard to say what is behind it,” she explained.
@abcnews Is shingles in young people on the rise? Justin Bieber, Ed Sheeran and Tyrese Haliburton are just a few of the notable celebrities to get shingles, which is often associated with older people. ABC News medical contributor Dr. Alok Patel shares what you need to know.
♬ original sound – ABC News
It’s Not Just Big Mama’s Rash Anymore
For many people, a shingles infection has been lurking in their bodies for decades, often unbeknownst to them. If you were born before 1995, it’s likely that you had chickenpox as a child, since 99% of Americans born before 1980 have had the virus, according to the CDC, even if you don’t remember it.
However, the culprit behind chickenpox is the varicella-zoster virus, which doesn’t just pack up and leave your system after you recover. Instead, it goes into hiding, residing dormant in a small area near your spinal cord. As time goes on, various triggers like stress, illness or a weakened immune system can cause this sneaky virus to wake up and reemerge as shingles. And when it does, it travels along nerve pathways to the skin, resulting in that infamous, painful rash that many describe as feeling like fire blisters with millions of ants crawling on their skin. Alongside this uncomfortable rash, shingles can bring along unwelcome buddies like fever, chills, nausea, diarrhea and headaches, making the experience quite a rough ride.
Doctors say that while shingles blisters usually scab over in about a week and heal within two to four weeks, around 10% of people who get shingles experience post-herpetic neuralgia (PHN). This is a type of nerve pain that can persist in the area where the rash appeared, even after the rash has healed.
“PHN can develop in those who have severe amounts of inflammation of the sensory nerve ganglion,” Dr. Robert Hopkins, the medical director of the National Foundation for Infectious Diseases and a professor of internal medicine and pediatrics at the University of Arkansas for Medical Sciences in Little Rock, explained in a recent interview. “The healing process is quite slow, and the pain can linger for months or even years.”
Dr. Hopkins explains that usually, shingles affects the skin, but it can also impact cranial nerves that compromise the eyes, ears, and mouth. In about 10% of cases, the virus targets the trigeminal nerve, which can lead to herpes zoster ophthalmicus (HZO), a serious condition that may result in vision loss.
An increase in HZO cases has been noted across all age groups, but unpublished studies show that the largest rise (around 37%) is in people under 30.
The reason for this is still uncertain. Dr. Jennifer Moffat, an associate professor at SUNY Upstate Medical University in Syracuse, NY, who studies the varicella virus, but the relative increase of this subtype among young adults, says that the reason for this is still uncertain, but says that the rise is logical. “If there are more cases overall in younger people, it makes sense that there would also be more cases of HZO,” she says.
Additionally, Health Central reports that the virus can occasionally cause Ramsay Hunt Syndrome, a neurological disorder that occurs when a shingles outbreak affects the facial nerve near the ear. It can cause temporary facial paralysis, like what happened to Justin Bieber in 2022. Most individuals who get shingles experience it just once in their lives, but it’s possible to have it multiple times, according to Jessica Leung, an epidemiologist at the CDC’s National Center for Immunization and Respiratory Diseases.
The good news, Leung notes, is that children and teens who have received chickenpox vaccines have a lower chance of getting shingles. If they do get shingles, their symptoms are usually milder, and they are at a lower risk for postherpetic neuralgia (PHN).
Managing a Health Condition? Shingles Just Entered the Chat.
Doctors are increasingly cautioning that shingles isn’t just a concern for the elderly anymore. Anyone can get it, but those with chronic diseases are particularly at risk. Dr. Choudhury points out that certain health conditions are closely linked to shingles, especially those that compromise the immune system.
Autoimmune diseases like rheumatoid arthritis, lupus, multiple sclerosis, inflammatory bowel disease and psoriasis significantly increase the likelihood of shingles outbreaks. Plus, treatments that lower immune function, such as disease-modifying therapies, can also heighten this risk.
A strong immune system plays a vital role in keeping the varicella virus under wraps. Your immune cells, particularly T-cells, are constantly on patrol, ensuring the dormant varicella virus remains inactive. However, when those levels dip, the chances of the herpes zoster virus reactivating rise sharply.
“Usually, your T-cells are always checking for signs that the virus is trying to reactivate and stopping it. When they can’t do that, it allows the virus to surface,” Dr. Moffat said.
They are referring to a study that revealed how people under the age of 50 with autoimmune diseases have a 1.5 to 2 times higher chance of getting shingles. So, anything that weakens your immune system raises your risk, according to Dr. Hopkins. He also mentioned that there is a much higher risk of developing painful PHN, where it can affect up to 45% of individuals who are immunocompromised as well.
Why is my TikTok feed filling up with millennial shingles horror stories?
The speculation for the noticeable rise in shingles cases among people in their 20s and 30s might be partly because famous individuals are speaking out more than before and social media is spreading this information widely. However, according to Dr. Moffat, those born after 1995 who got the chickenpox vaccine as kids are less likely to get shingles. They have a lower rate of shingles compared to those who weren’t vaccinated.
Still, the medical community is scratching its head about why more people of all ages are getting shingles. Dr. Moffat suggests it might be due to environmental factors or climate changes that weaken our immune systems, such as increased pollution.
They are also examining the role of stress in this situation.
A report from the American Psychological Association showed that while the average stress level for all ages is ranked 5 out of 10, 22% of adults aged 18 to 34 and 27% of those aged 35 to 44 rate their stress as 8 out of 10.
“I’ve seen many patients who get shingles because they are dealing with intense emotional stress,” Dr. Choudury said.
Studies have also shown that people with high levels of psychological stress have increased rates of shingles and some research indicates that women under 60 who are depressed also have a higher risk of getting the disease.
In addition, Dr. Choudhury points to the increasing number of young people who are facing long-term health issues that could raise their risk of developing shingles. Research from the CDC found that in 2023, 59.5% of young adults (age 18 to 34) reported having at least one chronic health condition, with 27.1% having multiple chronic conditions.
The Final Takeaway
Doctors agree that the most effective way to prevent shingles is by getting vaccinated with the Shingrix vaccine, which gained approval in 2017. It boasts an impressive efficacy rate of about 90% for people over 50 who have a healthy immune system, especially when administered in two doses spaced two to six months apart.
For those with chronic health conditions, the vaccine still offers protection, though its effectiveness drops to around 70%, as noted by Dr. Hopkins. The CDC recommends that adults over 19 with weakened immune systems due to illness or treatment also consider getting vaccinated. This is because a key advantage of the shingles vaccine is that it does not contain a live virus which makes it a safer choice for individuals with compromised immune systems.
While the chances of developing shingles are relatively low for those under 50 and who are generally healthy, those with chronic health conditions face a significantly higher risk, particularly during stressful periods.
With that in mind, consulting with your doctor about the best preventive measures that fit your specific situation is always the best first step.
