People experiencing the painful skin rash herpes zoster, better known as shingles, may have a higher risk of stroke – particularly during the first 4 weeks. The good news for sufferers is that oral antiviral drugs may significantly reduce that risk. 


Those findings, published in the journal Clinical Infectious Diseases, offer some important new information about the varicella zoster virus, which causes shingles in 1 million adults in the United States each year. 


When Sinéad Langan, MD, PhD, and fellow researchers at the London School of Hygiene & Tropical Medicine in the United Kingdom looked at a database of 6,584 stroke patients who also suffered from shingles, they found the stroke rate was 63% higher within the first 4 weeks of a shingles attack, compared with the patient’s baseline risk.

That risk began to taper off over the next 5 months—dropping to 42% in weeks 5 through 12 and then to 23% for up to 6 months later. The picture was somewhat different when the rash formed around one or both of the eyes: In those cases, stroke risk increased threefold, compared with baseline risk.


Treatment with antiviral drugs may reduce that risk, according to Langan. “We found that the risk of stroke was lower in people who were treated with antiviral medications for their shingles, compared with those not treated with antivirals,” she explained in a statement describing her team’s findings. 


Indeed, persons with shingles who were not treated with antivirals had nearly twice the risk of stroke compared with those who received medication. In addition to urging greater use of antiviral therapy, the authors called for improved shingles vaccination programs to prevent stroke associated with the virus.