Can You Die From Shingles?

For most healthy adults, shingles is not life-threatening, although it can be quite painful. 

Untreated shingles can lead to complications in certain people. This might include older adults and those with compromised immune systems. Complications in these groups could lead to death.

Learn about shingles, its complications and risk factors, and when to reach out to your healthcare provider.

What Is Shingles? 

Anyone who has had chickenpox can develop shingles, often decades later. Both shingles and chickenpox come from the same virus, the varicella-zoster virus. 

Signs and symptoms of shingles usually appear on one side of the body. Symptoms might include: 

• Burning, pain, numbness, and tingling of the skin
• Sensitivity to touch
• Red rash that appears after a few days of pain
• Fluid-filled blisters that will burst open and crust
• Itching 

Additional symptoms include:

• Headaches
• Fever
• Sensitivity to light
• Fatigue

Pain is one of the earliest signs of shingles, and for some people, pain can be intense. It is possible to experience shingles pain without a rash.

Rash and blisters are most often seen on the waist, chest, abdomen, or back, but a person may also experience symptoms on the face, on the arms, and in the eyes, ears, and mouth. While rare, the virus can also affect internal organs.

According to the Centers for Disease Control and Prevention (CDC), one in three American adults will develop shingles in their lifetime. Shingles is rare in children.

Up to 4% of people who get shingles will be hospitalized for complications, and most are older adults and people with weakened immune symptoms. According to the CDC, shingles kills up to 100 people a year, many of whom come from high-risk groups.  

Risks and Complications

The most common complication of shingles is long-term nerve pain called postherpetic neuralgia (PHN). PHN pain usually occurs in the area where the shingles rash originally appeared and eventually healed.

According to the CDC, up to 18% of people will develop PHN after a shingles outbreak. Older adults have a higher risk for PHN than middle-age or younger adults after a shingles outbreak.

Untreated shingles is also associated with other severe and sometimes life-threatening complications. Left untreated, some complications of shingles could lead to death.

Vision

Vision loss or eye damage may occur if shingles affects the eyes. According to Harvard Medical School, up to 20% of shingles cases involve nerves of the head, including various parts of the “the eyelid, the eye surface, and the deeper portions of the eye.” In some of these cases, vision impairment can occur, including blindness.

Hearing

Hearing loss or hearing problems may occur due to a condition called Ramsay Hunt syndrome if a shingles outbreak affects the facial nerve near one of the ears. This syndrome can cause facial paralysis and hearing loss in the affected ear.

Skin Infections

Bacterial skin infections can occur as a result of open blisters and can become severe if left untreated.

Pneumonia

Although rare, shingles can lead to pneumonia. However, it is a more frequently observed complication of primary varicella zoster viral infection (chickenpox).

Encephalitis

Encephalitis (brain inflammation) occurs when an infection spreads to the brain. This is rare, but is often seen with viruses like varicella-zoster and is more common in people who are immunocompromised.

Cardiovascular Events

Shingles can increase a person's risk of stroke and heart attack.

A stroke occurs when the blood supply to part of the brain is interrupted or reduced, keeping the brain from getting vital oxygen and nutrients. Brain cells can die within a few minutes if this interruption continues.

A study reported in 2014 in Clinical Infectious Diseases found a significantly increased risk for stroke up to six months after a shingles outbreak. That study looked at the medical records of British patients from 1987 to 2012 and identified over 6,500 people who had experienced a stroke weeks to months after developing shingles.

Researchers also found that the risk for stroke was 63% higher during the first four weeks of a shingles episode, with that risk decreasing over the six months after that episode. Further, that risk was three times higher for people who developed a shingles rash that affected the eyes. Oral antiviral treatment can decrease the risk of stroke related to shingles.

A heart attack, or myocardial infarction, occurs when a blockage impairs blood flow in the arteries that feed the heart. As a result, the heart cannot get the oxygen it needs.

One study reported in 2017 in Journal of the American College of Cardiology found that shingles raised the risk of heart attack by 59%. This risk was highest during the first year after the onset of shingles and decreased with time. The study analyzed 23,213 people with shingles among 519,880 patients that were followed in South Korea's National Health Insurance Service's "medical check-up" database from 2003-2013.

Who Is at Risk?

Anyone who has ever had varicella-zoster virus is at risk for developing shingles. But having certain health conditions might increase your risk for shingles and the potential for related complications.

Risk factors for shingles complications are:

• Having a condition that weakens your immune system, such as HIV, cancer, or an autoimmune disease
• Taking medications that cause your immune system to become immunocompromised, such as the long-term use of corticosteroids
• Being older than age 60: Your risk for complications of shingles can increase with age.

If any of these risk factors apply to you, talk to your practitioner about your risk for shingles, what you can do to prevent it, and its possible complications should you develop the condition.

When to See a Healthcare Provider

You should see a healthcare provider as soon as you first notice signs and symptoms of shingles. The National Institute on Aging recommends that people see their practitioner no later than three days after the appearance of a shingles rash.

Early treatment will reduce your risk for complications, heal the rash quicker, and even reduce the potential for scarring.

It is always a good idea to reach out to your healthcare provider if you notice persistent pain or an itchy rash on your body. This is especially important if you are older because, with older age, the risk of developing PHN (with longer lasting and more severe pain) after a shingles outbreak is higher than for younger adults.

Even if you have already been diagnosed, you should reach out to your practitioner if the rash spreads to your face, an eye, or an ear. You will need immediate attention if you think your rash or a shingles blister has improperly healed or appears infected. Signs of a skin infection might include swelling, redness, pain, pus, and itching in the affected skin area.

A Word From Verywell

Most people who get shingles will recover fully from it, and few people die from this condition. The rash and blisters should clear up within a few weeks. While the pain can last a couple of months, it usually improves with time and eventually goes away.

For some people, however, the pain will last longer than the rash and blisters, and they will experience PHN pain that will come and go long after the rash has cleared. But PHN and other complications are preventable with early diagnosis and treatment.

If you suspect you might have shingles, reach out to your healthcare provider right away to start treatment. This is especially important if you are at a higher risk for complications because you are an older adult, have a compromised immune system, or receive treatments that leave you immunocompromised.