The alarming surge in shingles cases among midlife women: It was once seen as a painful disease of old age, but experts reveal why it’s now soaring through different ages – and what it means long-term

At first, Anne Larchy assumed that the itchy red welts that appeared suddenly across the right side of her back were insect bites.

The shooting pains in her chest that began the next day felt more concerning – as was the excruciating tenderness of her skin around the blisters. ‘If it had been on my left side, I would have assumed I was having a heart attack,’ says Anne, 48, a health coach in London. ‘But as it was, I had a GP appointment booked for the next day for something else, so I decided to just bring it up then.’

After one look at the rash, Anne’s GP told her it certainly wasn’t a bite. Instead, she received a far more unexpected diagnosis: shingles.

‘It was something that had never crossed my mind,’ says Anne. ‘I thought shingles was something that affected old people.’

Shingles is caused by the chickenpox virus, part of the herpes family of viruses, which lies dormant in the body’s nerve cells for decades after the initial infection. If the immune system weakens with age or illness, the virus can reactivate, travelling along nerves and causing painful blisters on one side of the face or body, as well as headache and fever.

About 50,000 Britons develop shingles every year. The majority of cases occur in older adults, when the immune system is naturally less effective. As a result, only adults aged 65 and above are currently eligible for the shingles vaccine on the NHS.

But experts warn an unexpected group of Britons are seeing an alarming surge in shingles cases: midlife women.

While cases of the illness across all age groups have been steadily rising since the 1960s, the most dramatic increase is among those in their 30s, 40s and 50s.

A 2016 study by US researchers found that shingles cases in under-50s had as much as quadrupled from the 1940s to the early 2000s – with women more likely than men to develop the condition across almost every age group. Celebrities such as Holly Willoughby, 45, Demi Moore, 63, and Sex And The City star Kristin Davis, 61, have all spoken out about suffering from shingles in recent years.

The Mail on Sunday has spoken to dozens of women who say a shingles diagnosis took them totally by surprise – and left some with long health problems.

‘Midlife women are more susceptible to shingles on a number of fronts,’ says Professor Fatheem Latheef, consultant dermatologist at the British Association of Dermatologists.

‘They’re more likely to have autoimmune conditions, which increase the risk of shingles.’

Women are disproportionately affected by these diseases, possibly because hormonal and genetic differences can make their immune systems more prone to attacking healthy tissue.

Both autoimmune diseases, such as inflammatory arthritis, lupus and multiple sclerosis, and many of the drugs used to treat them, can reduce the immune system’s ability to keep the dormant chickenpox virus under control.

This makes shingles more likely to develop, explains Prof Latheef. He adds: ‘But there’s also another factor that we know can trigger shingles that also disproportionately impacts women of this age: stress.

‘Not only are women under increasing pressure to balance busy working and family lives, they face hormonal changes in perimenopause and menopause that stress the body, making them much more prone to shingles.

‘The problem is, when younger patients get shingles, symptoms often go missed – increasing the risk of lasting symptoms.

‘We need to do more work to raise awareness that shingles is increasingly impacting younger adults.’

At first, symptoms can be as vague as tingling, or numbness, on a patch of skin. But as the infection takes hold, the characteristic line of blisters appears, often accompanied by fever and extreme fatigue.

The area where shingles appears depends on the infected nerve it stems from, says Dr Charlotte Houldcroft, lecturer at Cambridge University and herpes virus expert.

‘The virus travels down that nerve, causing pain and a rash where it ends,’ she explains.

Shingles has a very effective vaccine, Shingrix. But the Government has chosen to limit access to the jab to adults over 65, or younger adults with conditions that put them at higher risk of the illness. Over-50s can pay privately for the vaccine, which costs around £500.

Luckily for those not eligible for the vaccine, when shingles develops it’s easily treated with antiviral medications. But to be most effective, drugs need to be administered within 72 hours of the rash appearing, making early diagnosis crucial.

This becomes particularly important for shingles cases impacting the facial nerves, as left untreated it can lead to partial facial paralysis and even blindness.

While more than three-quarters of patients will recover within a few weeks, some are left with lasting side effects. The most debilitating of these is postherpetic neuralgia (PHN), persistent nerve pain, burning or tingling that can linger for months or even years.

The quicker the treatment, the less likely a patient is to develop PHN, says Dr Houldcroft – with less severe blistering correlating to reduced chance of chronic pain.

‘Patients get most benefit from the drug being administered at tingle stage,’ she says. ‘This stops the virus replicating and prevents further nerve damage.’

The trouble is, to get prompt treatment patients need to recognise the signs of shingles. And for many midlife women, it’s not a diagnosis they know to look out for.

Research shows they are 20 per cent more likely to get shingles than men throughout their lifetimes.

Between ages 46 and 64, this disparity becomes most stark – with women nearly twice as likely as men to develop shingles.

Stress is also a risk factor, due to hormonal effects it has on the body.

When the brain perceives a threat or period of prolonged pressure, it signals the adrenal glands to release cortisol, often referred to as the body’s primary stress hormone.

High levels of cortisol can suppress parts of the immune system, making it harder to keep the dormant virus in check.

As a result, says Dr Will Irving, emeritus professor of virology at Nottingham University, many report developing shingles after the death of a parent or partner – or following an accident or injury. But even lower-level stress can dampen the immune system.

Researchers from Kettering Medical Centre in the US found psychological or emotional stress was strongly associated with the virus – with shingles linked to chronic anxiety, depression and physical exhaustion.

Women aged 35 to 54 report the highest levels of stress of any group, according to recent British surveys, with most attributing it to juggling careers, children and caring for ageing parents. And they appear to be more stressed today than ever.

Research from charity Mental Health UK found stress levels have risen significantly – with more than 60 per cent of people saying they feel stressed at least weekly, a marked rise from just over a third six years ago. Women were nearly twice as likely as men to experience daily stress.

But it’s not just about having a full plate of responsibilities, says Prof Latheef. ‘Midlife women are also prone to experiencing more hormonal fluctuations, which can raise the body’s stress levels and put them at higher risk of shingles,’ he says.

For reporter Kate Skelton, it was a traumatic birth that triggered her shingles at 30.

‘I really struggled to recover from the birth, both physically and mentally,’ she says. ‘I was exhausted and kept getting hit by chest infections, along with bouts of mastitis.’

It was shortly after returning from a friend’s wedding, where she had been a bridesmaid, that Kate noticed a painful rash beneath her left breast. Within 24 hours it had developed into a line of blisters, accompanied by searing pain, fever and chills.

When her GP diagnosed shingles, Kate was stunned. At 36, she had no idea she could be at risk.

The experience was so debilitating, she still worries it could return. ‘I’ve read about the shingles vaccine and often wonder why I can’t get it,’ she says.

Kate may have been diagnosed relatively quickly. But that was not the experience of Sheron Boyle, who developed shingles in her early 40s. ‘It was less than two years after the birth of my twin sons and I had been feeling really rundown looking after them, as well as working part-time,’ she says.

‘I remember going out for lunch with my husband, and by the time the food came I felt too ill to eat. By that evening, I could barely move and I’d developed a rash across my face.’

Over the next five or so days, Sheron got out of bed just three times – to continually plead with her GP to give her something for the pain. Yet each time, she was sent home with just paracetamol.

‘I thought I had a brain tumour,’ she says. ‘The pain was so horrendous all I could do was lie in the dark and sip water.’

Eventually, on her third trip to the doctor, she was diagnosed with shingles and given anti-viral drugs, which immediately began to take the edge off the pain.

By this point, however, it had spread into her eye, leaving her with lasting vision damage.

‘I’ve been told by doctors that if anything else happens to that eye, I may need a full corneal replacement,’ she says. ‘I dread ever getting shingles again.’

Even those who recognise the condition can struggle to get treatment. Science researcher Alix Fox had suffered shingles in her 20s, so when the early symptoms – a tingling pain in her face – returned a decade later, she thought a diagnosis would be straightforward.

But she says her London GP, at first, said it was unlikely to be shingles at her age. It was only when she pushed for antivirals that he relented.

‘Shingles symptoms are missed all the time in younger patients,’ says Prof Latheef. ‘I’ve seen it misdiagnosed as eczema, psoriasis or a bacterial infection.’

But increased training for medics alone won’t make women seek help for shingles, says Marian Nicholson, director of charity Shingles Support Society.

More needs to be done to ensure patients recognise the signs on their body, she argues – which will only occur through awareness campaigns.

In the meantime, says Prof Latheef, the best way to avoid shingles complications is to not get it in the first place.

‘Anything that can keep your immune system healthy will help lower the risk of shingles,’ he says. ‘This can be getting adequate sleep, eating a balanced diet, getting regular exercise and managing chronic stress.’

Giving up smoking has also been shown to reduce the risk of shingles.

‘I don’t think enough people know they can get shingles until they get it,’ he adds, ‘and then it’s hard to forget.’