Does Alcohol Make Shingles Worse?

Shingles and Alcohol: A Dangerous Mix?

Imagine this: you wake up one day with an awful rash on your neck. You run through a mental list of possible causes. That new office plant? Some poison ivy you somehow managed to stumble into on your way home? Are you allergic to the new mohair sweater you got for Christmas? And while you start off hoping for the best (it’ll go away, right?) it doesn’t get better. Now it’s been days of feeling like everything you’re wearing (even your flannel pajamas) is made of sandpaper soaked in acid, and you finally get a diagnosis from your doctor — you’ve got shingles.

Shingles can be a real pain, and thousands of others are feeling that same pain right along with you. In fact, according to the CDC, as many as 1 in 3 Americans will develop shingles at some point in their lives. Luckily, there’s a vaccine, as well as treatment for it. You won’t have to feel “like a human pin cushion” (as one vaccination campaign poster describes it) forever.

But in the meantime, you might be curious to know what happens if we add alcohol to the mix. Can you drink alcohol with shingles? Or does alcohol make shingles worse? Let’s unravel the mystery behind shingles and alcohol and see what science has to say!

Shingles as the Chickenpox Virus Reactivated: A Blast From the Past

Shingles, known officially as herpes zoster (not the other kind of herpes), is actually the unwelcome “ghost of chickenpox past.” It’s the reactivation of the varicella-zoster virus in people who have had chickenpox. (For those wondering if you can still get shingles after being vaccinated against chickenpox, the answer, according to the CDC, is yes, you can. But it’s a lot less common.)  

That said, shingles isn’t exactly chickenpox reincarnated — it’s a different condition caused by the same virus. Here’s how Penn Family Medicine physician Durvi Patel describes it: “The body’s first exposure to the virus leads to chickenpox. Shingles is the consequence of having the virus reactivate in the body later on. Shingles is contagious, but it is the virus that is transmittable, not shingles.” 

Shingles can happen to anyone, but there are a few risk factors that make some folks especially vulnerable:

• Age. Older adults are especially at risk due to age-related immune system glitches, which tend to make them vulnerable to infections. For that reason, the CDC recommends that everyone over 60 get vaccinated against shingles.
• A compromised immune system. Those with compromised immune systems — for example, people with HIV — are also more vulnerable than others.
• Stress. Stress or illness can serve as a trigger. A Journal of Clinical Virology study found a connection between the development of shingles and a “negative life event.”
• Nutrition. Our diet is also a factor. According to an International Journal of Epidemiology study, eating fruit significantly lowers the risk of developing shingles: those who ate less than one fruit serving per week had three times the risk. (So load up on those oranges and grapes!)

When an Itch Isn’t Just an Itch

According to the CDC, shingles shows up as a persistent, blistery rash on one side of the body or face. It usually starts to scab over in 7 to 10 days and clears up fully within a couple of weeks to a month. And while most people will only get it once (phew!), the unlucky few might experience two or more flare-ups. 

But while shingles certainly won’t last forever and can sometimes go away on its own, we really don’t want to leave it up to fate, as this Harvard Health Publishing article explains. If that rash is, indeed, caused by herpes zoster, we should see a doctor and get treatment. Why? By turning a blind eye, we risk certain complications.

• Persistent pain. There’s a possibility of long-term pain — known as postherpetic neuralgia — that can linger for a few months to a year. According to the CDC, about 10% to 18% of people with shingles will develop this complication.
• An itch that keeps on itching. We could be looking at prolonged itching, which can be just as uncomfortable (and is usually focused on the head and neck area).
• Vision and hearing problems. We could even end up damaging our vision and hearing if we let shingles go untreated for too long, especially if the rash is near our eyes or ears.
• Risk of stroke of heart attack. Worst case scenario? Our risk of having a stroke or heart attack goes up. As a PLOS study found, both risks more than double in the first week after diagnosis for those 65 and older.

So, Does Alcohol Make Shingles Worse?

How does alcohol fit into the picture? The story boils down to four parts: alcohol’s interaction with shingles treatment, its impact on the immune system, its possible interaction with the herpes virus itself, and its effect on symptoms. Let’s unpack these reasons further to see just why shingles and alcohol are not a good mix.

1. Alcohol and Shingles Medication: Itching for Trouble

For one thing, alcohol doesn’t mix well with shingles medications. The combination can set us up for some unpleasant surprises. It mentions that while the medication bottles for antivirals used to treat shingles might not include a no-booze warning, it’s still best to avoid the mix, since alcohol can make some meds less effective while increasing the risk of uncomfortable and potentially dangerous side effects. Let’s look at these medications in a bit more detail.

The first line of treatment includes medications such as Acyclovir (Zovirax), Famciclovir, and Valacyclovir (Valtrex). All three can help alleviate symptoms as well as prevent future outbreaks by keeping the shingles-causing virus from replicating.

• Acyclovir is the OG of the “cyclovirs” and has been around since the 1970s. It throws a wrench in the viral DNA replication process by targeting guanine, one of the four nucleotides that make up the gene-encoding sequence.
• Valacyclovir is an updated version of Acyclovir developed in 1995. Like Acyclovir, it’s mostly used to treat herpes simplex — the virus that causes cold sores and genital herpes. In fact, Valacyclovir turns into Acyclovir in the body and works in a very similar way (but requires fewer doses).
• Famciclovir, on the other hand, is used more frequently to treat shingles than other forms of herpes. Another Acyclovir cousin, Famciclovir is an “updated” version of the medication that is absorbed by the body more easily.

There are other treatments as well. 

• Capsaicin topical patch (Qutenza)
• Anticonvulsants, such as gabapentin (such as Neurontin, Gralise, and Horizant)
• Tricyclic antidepressants (such as amitriptyline)
• Numbing agents (such as lidocaine, in the form of a cream, gel, spray, or skin patch)
• An injection (including corticosteroids and local anesthetics)

2. Alcohol and the Immune System: Defenses Down 

Another part of the problem? The impact of alcohol on our ability to fight off infections, including the virus that causes shingles.

It’s no secret that alcohol can wreak havoc on our immune system. (For an in-depth look, check out our blog “Alcohol's Impact on the Immune System.”) The connection was originally discovered decades ago, in the context of alcohol’s influence on pneumonia. However, in recent years scientists have found evidence of alcohol’s effects on many other conditions, including sepsis, liver disease, and even certain cancers. Moreover, there’s plenty of evidence to show it slows down the process of healing from infections, injuries, and physical trauma in general.

According to an article in Alcohol Research, alcohol weakens the immune system in three ways: 

• It makes it harder to fight off infection by affecting innate and adaptive immunity.
• It contributes to organ damage via chronic inflammation.
• It makes recovery and tissue regeneration more difficult.

One of the first points of entry (where damage to the immune system begins) is actually the GI tract. Alcohol disrupts the gut microbiome while damaging epithelial cells, T cells, and neutrophils in the GI system, disrupting gut barrier function and facilitating leakage of microbes into the circulation.

3. Alcohol and Shingles: A Direct Attack

One study in the Central European Journal of Medicine found a possibility of a direct connection between shingles and alcohol. The people in the shingles group showed a much higher level of alcohol consumption compared to the control group. The correlation, in turn, could eventually help scientists understand aspects of the mechanism behind the disease that remain a mystery. For now, however, it’s worth keeping the possible connection in mind as we consider the relationship between alcohol and shingles.

4. Alcohol and Shingles Symptoms: Double Trouble

Finally, alcohol doesn’t do us any favors when it comes to dealing with the symptoms of shingles.

• Dehydration. Alcohol is notoriously dehydrating, leaving us with dry skin that can amp up the irritation.
• Pain. While booze might take the edge off our shingles-related pain for a short while, chances are it’ll come back to haunt us later.
• Sleep trouble. In a similar way, while a drink might make us initially drowsy, it interferes with our sleep quality by causing middle-of-the-night disruptions and robbing us of the most restorative REM phase of sleep. And since rest is essential for recovery, the result could mean a longer healing process.

How Much Is “Too Much”?

Will a night out trigger an outbreak or slow down your recovery from shingles? As we’ve seen, research does point towards alcohol affecting how quickly you bounce back.

And while the effect is probably more cumulative when it comes to triggering shingles, studies show that a stressful event can do the trick. It’s also important to keep in mind that drinking doesn’t have to be chronic to have a negative effect on immunity. In fact, occasional binge drinking — defined as having 5 or more drinks at one occasion for men and 4 or more for women — can be just as damaging. What does this mean for us? It’s hard to know for sure, but it’s safe to say that a particularly stressful night out could, in theory, lower our body’s defenses and cause an outbreak.

Is there a “best” alcohol to drink with herpes zoster, if we’re set on going out? Once again, individual factors might come into play, but overall the answer is that one type isn’t necessarily safer than another. Overall, it’s best to stay away from booze altogether until we’re feeling better.

How Can I Treat Shingles at Home?

Many of us hope to find some ways to treat shingles at home, and there are, indeed, a few tricks that have a track record of bringing relief. Others, on the other hand, not so much.

For example, will rubbing alcohol dry up shingles? It’s unlikely. Rubbing alcohol will probably just irritate the wound, causing a burning feeling. And with the virus already at work inside the body, a surface treatment won’t lead to faster recovery.  

That said, Listerine seems to help ease the discomfort. The Seattle Times published this reader comment recently: “It took about a week or two, but the Listerine got rid of that terrible pain. I didn’t develop blisters.” Another reader reported a similar experience in the past: “The itching stopped, the rash disappeared and the pain went away for good.”

As for the Seattle Times editors, the reports have them a bit stumped: “We have no idea why Listerine might be helpful against shingles pain. We could find no research in the medical literature, though some doctors seem to know about this home remedy.” Still — there seems to be no harm in it, so whatever works!

Tip: If Listerine doesn’t do it for you, try some homemade baking soda or cornstarch paste. Mix 2 parts of either ingredient with 1 part water and apply to the rash for about 10-15 minutes. Another old-time favorite from the days of chickenpox? A warm bath with some soothing Epsom salts.

Advice for Coping With Shingles (and Cutting Back on Booze)

If you’re struggling to stay away from alcohol during this time, here are some tips to make it a bit easier.

• Put your health first. Self-care is key, and when we’re fighting off an infection, that’s more true than ever. Make sure to nourish your body with nutritious food, hydrate, and get plenty of rest. When getting over shingles in particular, make sure to include plenty of orange and yellow fruits, leafy green vegetables, good sources of protein (eggs, chicken, or wild-caught fish), whole grains, legumes, and tomatoes.

• Follow your doctor’s instructions. It’s important to get shingles checked out by a doctor, so make sure you follow their advice, especially when it comes to taking medication.

• Explore other options. There’s plenty of fun to be had out there without alcohol! Explore the world of mocktails, host a booze-free movie night (just not when you’re contagious), or spend time outdoors. 

• Try to see this challenge as an opportunity. Why not use this break from alcohol as a chance to get sober-curious? Instead of seeing it as a restriction, try to look at it as an opportunity to explore the world beyond booze. Notice any changes you feel. Maybe you’re waking up more clearheaded? Getting better quality rest? Who knows, you might just decide that you want to keep exploring!

Summing Up

In the words of writer C. JoyBell C., “Pain is a pesky part of being human … something I wish we could all do without, in our lives here.” And it’s true, we can’t escape pain. Still, as C. JoyBell C. goes on to say, pain allows us to feel the freedom of healing, which “feels like the wind against your face when you are spreading your wings and flying through the air! We may not have wings growing out of our backs, but healing is the closest thing that will give us that wind against our faces.”

So, while shingles may, indeed, be quite a pain in our side (literally), remember that this is temporary and that healing is just around the corner. Here at Reframe, we’re cheering for you and wishing you the best with healing from shingles as well as when it comes to reexamining your relationship with alcohol.