Shingles Rash on Neck: Pain Causes, Diagnosis, Symptoms and Pictures

Symptoms of shingles present much like those of a skin infection or a rash. In reality, shingles is actually a disease of the nervous system. It occurs when herpes zoster is triggered. The herpes zoster virus hides in nerve fibers after a patient recovers from chicken pox. When certain factors are present, the virus can become active, causing shingles.

Anyone can get shingles. Most cases are reported in people above the age of 50 years. It is estimated that 1 in 3 people will get shingles at some point in their life.

Commonly affected areas are the face, chest and torso. The main difference between chicken pox and shingles is that the latter appears on localized body areas. For example, signs can appear on one arm, one side of the face or one side of the neck. This article investigates shingles rash on the neck, how it presents, its causes and how it is treated. Shingles on neck pictures and pictures of shingles on face are available to help with illustrations.

Can you get shingles on your neck?

Herpes zoster virus hides in the dorsal root ganglia. These are nerve fibers that branch out from the spinal cord and connect the skin to the brain. Every part of the skin contains these nerve fibers. When nerve fibers that serve the neck region are affected, rash around neck shingles symptoms can occur.

It is possible to have shingles on several body areas at the same time. For example, signs can appear in the neck region and face. It is not uncommon for instance to experience a rash on the neck region accompanied by ear pain.

The common scenario is shingles on the neck appearing on one side and sparing the other. This goes back to the roots of how shingles occurs. Note that shingles is not contagious and doesn’t spread. If you have signs on the neck, they will not spread to adjacent or distant areas. “Spread” in this context is used cautiously. For instance, the shingles rash can start on the neck and extend to the hairline, face or ear. Shingles in multiple dermatomes is another good example. It is possible however for the varicella virus to be passed from one person to another. In fact, patients are advised to cover their rash or stay at home until blisters crust over. See CDC guidelines for shingles for more.

Symptoms of shingles on neck

Symptoms of shingles on neck may start with tingling or itching. This happens as the activated virus reaches for the skin from the nerve fibers. After about 2 days, lesions appear and may continue forming for the next several days. The lesions soon develop into blisters which may burst and ooze before scabbing over. This whole process can take about 5 days. Over the next 2-5 weeks, the blisters will follow the normal process of healing. How long does shingles last untreated? Signs can last for up to 5 weeks.

Not all patients experience the same symptoms. For example, shingles neck pain can occur without a materialized rash. Fever, malaise and fatigue may accompany the above mentioned signs. These internal shingles symptoms sometimes appear before rash.

Most symptoms will improve by the fourth week. Pain may persist for several months and in some cases years. In that case, medical treatment is necessary.

What can be said to be a controversial symptom of shingles is a headache. Headache is very common and can be caused by an array of things. It also is not always present but can be a sign of post-herpetic neuralgia when it is present. See shingles headache a comprehensive review to get the whole idea.

What causes shingles neck pain?

You may have noticed that shingles neck pain is not necessarily being caused by the rash or blisters. Experts theorize that nerve fibers that have recovered from damage sometimes become too sensitive, thus causing prolonged pain. It could also be that inflammation on affected nerves is to blame. If either is the cause, it means the pain will be there for a long time.

Pain can also occur inside the ear if the shingles rash has extended to the facial region. A disorder known as Ramsay Hunt Syndrome occurs when shingles affects a nerve that services the facial region around the ear. It is characterized by muscle weakness or paralysis on one side on the face with signs of shingles. Ramsay Hunt Syndrome can be quite painful and can lead to complications such as eye damage and loss of hearing.

When inflammation occurs inside the ear, it may cause problems in hearing and balance. These symptoms may happen along with pain that is most intolerable inside the ear.

Prolonged shingles pain is known as post-herpetic neuralgia. Normally, pain goes away with other symptoms like rash and blisters. When it persists for more than 18 months, extensive damage to nerve fibers is a likely cause. Post-herpetic neuralgia is a common sign of recurring shingles.

Causes of shingles neck rash

It has been made clear that shingles is caused by herpes zoster virus. But why then does the reactivated virus not cause chicken pox? The cause can better be explained with how vaccines work. Vaccines introduce weakened or nonliving disease-causing organisms into the body. As immune cells move to fight off the introduced pathogens, they become familiar with the molecular structures of the pathogens. Next time these pathogens attack, the immune system will be ready to fight them back.

Our bodies develop a kind of immunity against chicken pox after the first attack. When the causative virus is activated, it is kept from causing widespread signs, which then results in shingles. And why do some people get more outbreaks than others? It mostly is an issue of weakened immunity. When body defense mechanism is down, pathogens like herpes zoster have nothing to keep them from being active. This is why more than half of all shingles cases are reported in individuals above the age of 50 years. Other risk factors include being an infant, being pregnant and being stressful. Does stress cause shingles? Stress is a risk factor but not a cause.

How is shingles on neck area treated?

Before treatment, diagnosis is usually necessary. Doctors are often able to identify shingles during a physical examination. Patients will be required to provide details on their symptoms and medical history.

Treatment is mostly done with antiviral medications like acyclovir. These don’t have the power to eradicate the herpes zoster virus completely from the body but will keep the virus under control. Painkillers are also commonly prescribed.

Other options to consider include tricyclic antidepressants and opioids. Corticosteroids may be used especially if symptoms involve the ears. All these medications should be used with the consent of a doctor, especially medication for shingles nerve pain.

Treatment at home

Shingles can keep coming back although some patients only experience it once. Home treatments seek to improve symptoms, mainly pain and itching. An itchy neck can, for example, be treated with essential oils.

To reduce the risk of bacterial infections on shingles blisters, tea tree oil or apple cider vinegar can be used. Capsaicin can also be used for nerve pain. It is a substance contained in red peppers. Ointments that contain this substance are sometimes very relieving to nerve pain due to shingles.

At home, cold compressing on rash affected areas will not only relieve pain but also keep blisters clean and therefore free from bacterial infections. Foods rich in vitamin C, zinc and omega 3s boost the immune system and may therefore help during outbreaks. If not available in foods, they vitamins and minerals can be taken in supplements. Lysine for shingles is a good example.  Avoid foods products rich in processed sugar and carbonated or caffeine containing drinks.


Prevention can be done with vaccines. There are two types of shingles vaccine that have been approved by FDA. Vaccines do not keep shingles from occurring but reduces the severity. Patients are advised to start treatment as early as possible.