From the Guidelines
Yes, shingles can occur approximately 1 month after being treated, especially in immunocompromised patients. According to the 2014 practice guidelines for the diagnosis and management of skin and soft tissue infections by the Infectious Diseases Society of America 1, herpes zoster (shingles) can occur most frequently during the first year following chemotherapy treatment, or following receipt of a hematopoietic stem cell transplant (HSCT) or a solid organ transplant (SOT). Key points to consider include:
- The risk of developing shingles is higher in patients with weakened immune systems, with 25%–45% of such patients developing dermatomal zoster 1
- Shingles typically causes a unilateral, vesicular eruption with dermatomal pain that often precedes the skin findings by 24–72 hours 1
- Early lesions are erythematous macules that rapidly evolve to papules and then to vesicles, which can coalesce, form bullae, and scab before healing 1
- In immunocompromised hosts, skin lesions may continue to develop over a longer period (7–14 days) and generally heal more slowly unless effective antiviral therapy is administered 1
- High-dose IV acyclovir remains the treatment of choice for VZV infections in compromised hosts, while oral acyclovir, famciclovir, and valacyclovir are beneficial for VZV infections in otherwise healthy hosts 1. If you experience a recurrence of shingles symptoms, contact your healthcare provider immediately for evaluation and possible retreatment.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Shingles Occurrence After Treatment
- Shingles can occur in anyone with a history of chickenpox, but it is more prevalent and usually more severe in older patients 2.
- The cutaneous manifestations of shingles usually resolve in approximately 4 weeks, but the pain can persist for several months or even years in untreated patients 2.
- Antiviral therapy, such as aciclovir, famciclovir, and valaciclovir, can shorten the duration of post-herpetic neuralgia (PHN) but does not affect its incidence 2, 3, 4.
- There is no direct evidence to suggest that shingles cannot occur approximately 1 month after being treated, as the studies focus on the treatment and prevention of PHN rather than the recurrence of shingles 2, 3, 5, 4, 6.
Treatment and Prevention
- Antiviral agents, such as aciclovir, famciclovir, and valaciclovir, are effective in reducing the duration and intensity of zoster-associated pain (ZAP) and providing more rapid skin lesion healing 3, 4, 6.
- Valaciclovir has been shown to be more efficacious than famciclovir in managing herpes zoster, with a significant decrease in pain scores and accelerated resolution of zoster-associated pain 6.
- Immunization to prevent herpes zoster and PHN is recommended for most adults 60 years and older 3.