Shingles on the face and head
Shingles is a painful inflammation of a nerve that results in a rash. The painful rash usually forms in a shape of a strip that follows a dermatome. A dermatome is an area of skin supplied by one spinal nerve. Shingles on the face and head is painful and can lead to serious eye, ear and brain complications.
What causes shingles?
Shingles is caused by Varicella Zoster Virus, the same virus that causes chicken pox. Anyone can get Shingles if they had chicken pox or had the chicken pox vaccination. Once you are infected with this virus it can lay dormant in the nerve for a number of years.
• It is unclear why the dormant virus reactivates.
• The CDC estimate that approximately 1 in 3 Americans will be affected during their lifetime.
How Does shingles on the face and head present?
- The first signs and symptoms of Shingles may be a headache and or a fever.
- Burning pain or pins and needles may occur.
- Blisters or an area that resembles a burn will appear
- A rash that resembles hives will occur in a couple of days but may present a couple of weeks later.
- The rash usually forms on the trunk in a shape of a stripe but can also occur on the face.
- The rash usually lasts from 2 to 4 weeks but some people may exhibit residual pain for months to years afterward which is referred to as “postherpetic neuralgia”.
Shingles on the face and head
• Herpes Zoster Opthalmicus which can occur in the eye, the inflammation that occurs can lead to permanent damage such as blindness.
• Herpes Zoster Oticus can occur in the ear and lead to hearing loss. There may also be issues with balance and facial muscle weakness.
- Shingles may occur in the mouth. As you can imagine this would make eating difficult.
Diagnosis of shingles on the face and head
• The body is the most common place for shingles to develop, the second most common place is the face.
The shingles rash may occur along the forehead or cheek, it can even surround the eye.
Shingles around the eye can cause swelling of the eyelid. There may be redness and tearing. Some patients complain of blurry vision. Light sensitivity can occur as well.
Shingles can cause increased eye pressure which leads to glaucoma.
Bother the cornea which is the outer covering of the eye and the retina located at the back of the eye can be affected, usually vision problems will occur if these areas are involved.
• Prior to the appearing, diagnosis may be difficult.
- Once the rash appears the diagnosis of Shingles is easier to make as the rash appears as a strip along the dermatome. Usually, visual inspection is enough.
• Blood tests may detect the Varicella Virus-specific antibody (igM) in blood. This antibody only appears during chickenpox or herpes zoster and not while the virus is dormant.
• Fluid from a blister can be tested for Varicella DNA.
Risk factors for developing shingles on the face and head
• Age -Most cases are diagnosed in those who are over 50, but anyone can get shingles, even a child.
• People who are immunocompromised such as those with leukemia, lymphoma, HIV, organ transplants or have been on medications such as steroids.
• Stress increases the risk.
• Trauma also increases the risk of Shingles.
Prevention of shingles on the face and head
• The shingles vaccine can effectively prevent shingles.
• The CDC recommends that people aged 60 years and older get one dose of shingles vaccine, the FDA recommends the vaccine for those over 50.
The vaccine is thought to decrease the risk of getting shingles by a half. In addition, the risk of long term nerve damage is decreased.
Is shingles on the face and head contagious?
• Shingles cannot be passed from one person to another if the person has had chicken pox before.
• The virus can be spread to someone if they never had chickenpox which may result in an active case of chicken pox.
• A patient can pass the virus if they have blisters, they usually do not spread the varicella virus if they have not developed blisters yet or if the blisters have crusted over.
To help prevent the spread of the virus snsure the blisters are covered to help prevent spread of the virus. Avoid picking the at the blisters and wash hands often
• The CDC recommends people who have shingles should avoid contact with those who are pregnant, babies or those who are immunosuppressed.
Treatment of shingles on the face and head
- There is no cure for shingles on the face and head but early treatment can lower your risk of serious complications.
- Cool compresses.
- Once shingles starts, an antiviral medication can usually help decrease the duration of shingles if the medication is started within 72 hours.
- Steroid creams can help decrease inflammation.
• Calamine lotion and oatmeal baths may help relieve the itching.
Complications of shingles on the face and head
There is an increased risk of stroke.
According to the Mayo Clinic,
- Neurological problems. Depending on which nerves are affected, shingles can cause an inflammation of the brain (encephalitis), facial paralysis, or hearing or balance problems.
- Skin infections. If shingles blisters aren’t properly treated, bacterial skin infections may develop.” can occur.
Nerve problems are more common when patients have shingles on the face and head.
Skin care of the face after shingles
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Do you know someone who has had Shingles on the face and head?