Complications of Shingles

What is shingles?

Shingles, or herpes zoster, is a viral infection that presents as a blister-filled rash typically appearing on one side of the body (although it may “wrap” around the torso). The rash associated with shingles is usually extremely painful. Shingles is caused by the varicella-zoster virus which is also responsible for chickenpox. After an individual has chickenpox, the varicella-zoster virus lies dormant in nerve tissue near the spinal cord and brain. The virus can reactivate at any time, even decades later. If it reactivates, it travels along nerve fibers to the skin. This reactivation of the varicella-zoster virus is referred to as shingles.

What are the possible complications of shingles?

Early diagnosis and prompt treatment of shingles are important not only for existing symptoms but also for prevention of long-term complications. Although older individuals are more apt to experience complications caused by shingles, they can happen at any age. Symptoms of shingles normally cease in less than a month; however, complications can last for months, years or may even become permanent.

Postherpetic neuralgia (PHN) is the most common complication of shingles. It occurs when the brain receives faulty pain signals from injured nerve fibers. PHN presents as burning pain after the rash has disappeared; however, it typically improves over time. Being age 60 or older increases the risk of developing PHN as a result of shingles. Symptoms of PHN usually begin in the area where shingles first erupted. Symptoms include, but are not limited to, the following:

• Pain lasting three months or longer
• Burning, sharp, jabbing, deep or aching pain
• Tingling feeling
• Sensitivity to touch
• Itching
• Fatigue
• Depression
• Insomnia
• Difficulty concentrating
• Loss of appetite

Ophthalmic shingles occur when the shingles virus appears on the face near the eyes, forehead or nose. It can cause scarring, swelling, glaucoma and nerve damage. Ophthalmic shingles may also lead to vision loss.

Neurological problems, such as facial paralysis, balance problems, hearing loss or inflammation of the brain may occur depending on the nerves affected by the shingles virus.

Bacterial skin infections may develop if proper treatment is not followed. The rash should be kept clean and dry and exposed to air as much as possible. The main symptom of a bacterial infection is a fever.

Ramsay Hunt syndrome is a rare condition that can occur if the shingles virus erupts near an ear. Facial paralysis and hearing loss in the affected ear may ensue. Ramsay Hunt syndrome symptoms include, but are not limited to, the following:

• Dizziness
• Balance problems
• Earaches
• Hearing loss
• Loss of facial movement
• Tinnitus (ringing in the ear)

Although extremely rare, shingles may cause swelling in the lungs, liver or brain resulting in death.