Shingles is a disease that is characterized by a painful rash and blisters. It is caused by varicella-zoster virus, the same virus responsible for chicken pox in children and young adults. Anyone who has ever had chicken pox is at risk of getting shingles.
Commonly affected areas are the back, chest and face. Shingles rash on face often appears on the forehead and around the eye, sometimes in the ear or the tip of the nose. Signs only involve one side of the face.
People with weakened immunity are at the highest risk of becoming affected. This is why the disease is mostly diagnosed in people above 50 years of age.
What causes shingles rash on face?
After recovery from chicken pox, complete eradication of varicella-zoster virus does not occur. For some reason, the virus hides in nerve fibers where it stays dormant and keeps from being destroyed by immune cells. How exactly this happens is yet to be fully understood.
As long as immune cells are doing their job efficiently, the virus stays dormant, making very few viral proteins, which do not really cause any trouble. It is to be expected that like other body systems, our immune system becomes weaker as we grow older. This allows the dormant virus to become reactivated. It then travels from nerve fibers to skin where it causes shingles.
But why cause shingles rather than chicken pox? Well, our bodies develop a form of resistance to chicken pox after initial attack. As a result, recurring invasions are only localized to areas supplied by the sensory nerve in which herpes zoster virus hides.
Signals from facial skin are carried towards the brain by sensory nerves, the trigeminal nerve in particular. Trigeminal nerve is the largest cranial nerve. It branches into:
- Ophthalmic nerve – this is the branch of trigeminal nerve most commonly affected by shingles. It branches into three terminals which innervate the forehead, nose, upper eyelid and cornea.
- Maxillary nerve – this nerve branches into 14 terminals. It innervates the lower eyelid, cheeks, upper lip, roof of mouth and nasal cavity.
- Mandibular nerve – this nerve branches into 4 terminals. It innervates the floor of mouth, chin, lower lip and exterior parts of the ear.
Any of these branches of trigeminal nerve can host dormant herpes zoster virus. Once activated, signs of shingles will appear on areas innervated by affected nerve. But as mentioned earlier, the ophthalmic nerve is most commonly affected. Shingles on the face therefore mostly appear on the forehead, tip of nose, upper eyelid and inside the eye. Shingles in mouth symptoms may occur when either maxillary or mandibular nerve is affected.
Does stress cause shingles? Stress is not necessarily a cause but a risk factor. Risk factors make it more likely that a certain disease will occur.
Signs and symptoms of shingles on face; what does it look like?
What are the symptoms of shingles on face? What does it feel like? Before any signs appear, patients usually experience flu-like symptoms. These include fever, headache and vomiting. They are the early shingles symptoms. Shingles does not cause a runny nose however.
Other defining symptoms start before the signs are excruciating pain, tingling, burning or stinging. The latter three are somewhat predecessors to shingles pain. They are caused by migration of herpes zoster virus from nerve fibers towards the skin. These symptoms can linger for 2-3 days before the signs appear.
How can you recognize shingles on the face? What does it look like? Typical shingles signs are red painful rash and blisters. These indicate shingles rash early stages. Blisters start as lesions which may continue to appear for several days. After sometime, the blisters may burst, ooze and start to scab over. Scabbing over also takes several days and marks the final stages of shingles. It is when blisters have broken open and are oozing that herpes zoster virus is most contagious. Once they have crusted over, the disease stops being potentially contagious. The whole process takes about 2-5 weeks. These are the general signs. They will not change much in such cases as shingles rash on leg.
While signs appear in localized areas, it is possible to have shingles on multiple dermatomes. This is caused by continuous multiplication of shingles virus and subsequent invasion on adjacent nerve fibers. You can compare with pictures of shingles rash on chest.
Shingles in the eye may cause the following signs and symptoms:
- Tearing eyes
- Watery eyes
- Eye reddening
- Throbbing pain inside eye
- Blistering on upper eyelid
- Blurry vision
- Sensitivity to light
Is facial shingles contagious?
Healthy individuals cannot get shingles from an infected person. The possible scenario, however, is the herpes zoster virus getting transmitted from a patient to a healthy person. Touching shingles blisters when they have ruptured or oozing is a classic means of transmission. Virus particles can also be picked up from the air after breathing them in.
If you have never had chicken pox, first contact with varicella-zoster virus will result in chicken pox. It is possible to never suffer from shingles even after having been diagnosed with chicken pox. When this is not the case, it may be decades after the chicken pox that shingles occur.
How long does shingles rash last? Without treatment, shingles can persist for up to five weeks. The first one or two weeks are usually the worst. With medications, the disease may clear up in about 2 weeks. Going without treatment also increases the risk of recurring shingles and post-herpetic neuralgia.
Can shingles cause breast cancer? It has been mentioned that shingles is most common and more severe in people with weakened immune systems. For this reason, patients may experience recurring shingles before being diagnosed with breast cancer. Such correlation is however not evidence that either causes the other. Cancer cells will also find it easy to grow in people with weak immune systems and thus may appear together with not only shingles but other common infections and diseases.
Shingles on face treatment
Before treatment, diagnosis will be done. Doctors are usually able to identify shingles during a physical examination. You may be referred to an ophthalmologist if the eye is involved. To confirm diagnosis, a scraping of your skin rash may be taken for examination in the lab.
Treatment can be done with:
- Antiviral medications – antiviral medications do not cure shingles. They however make symptoms less severe and shorten recovery period. The medications also reduce risk of spread.
- Pain relievers – pain relievers can be prescribed or be purchased over the counter. The former option is a better choice.
- Antidepressants – shingles can prove very stressful, especially when dealing with post-herpetic neuralgia or recurrent shingles. Your doctor may prescribe tricyclic antidepressants to combat such effects.
- Corticosteroids – corticosteroids help reduce inflammation. They are options to consider when dealing with shingles in the eye. This is because inflammation inside the eye can cause permanent scarring on cornea or glaucoma.
In most cases, a combination of several treatment options is used. This is why medical attention is recommended.
Shingles on face treatment at home
At home, pain caused by shingles can be eased with cool compress. Soak a piece of cloth or towel in cool water and compress it on blistered areas for 20 minutes. This natural cure for shingles may also discourage bacterial infections.
Calamine lotion can be used to treat itchiness and skin irritation. Itchiness often leads to scratching which in turn increases risk of scarring. Calamine is very effective on shingles on scalp symptoms.
Essential oils are also potential home remedies to use against shingles. They soothe irritated skin, reduce the risk of infection and restore skin integrity to avoid scarring. Always remember to dilute with carrier oil before applying essential oils.
Other considerable home remedies include capsaicin ointments, apple cider vinegar, oatmeal baths and baking soda. Oatmeal baths are particularly effective for shingles on buttocks symptoms.
How to prevent shingles rash on face
Anyone who has ever been diagnosed with chicken pox is at risk of getting shingles. Not much can be done to avoid a potential outbreak.
People who have never been vaccinated against chicken pox are advised to get the shot. As for shingles, a vaccine (Zostavax) is available and indicated for those above the age of 50 years. The problem is that the vaccine stops being effective after about 5 years. This is not good news, bearing in mind that it is after the 60th birthday that complications of shingles are most probable.
Patients should avoid public places during outbreaks to avoid spread to other people. If possible, shingles blisters are best kept covered.
Complications of shingles on face
Shingles on the face can result in several complications depending on where the outbreak occurs.
Shingles in and around the eyes is perhaps the form with most potential complications. The first complication is pain. While pain is always among the symptoms of shingles, it can prove intolerable when eyes are involved. Worse episodes come when post-neuralgia develops.
- Scarring – scarring causes more problems when it occurs in the cornea. There, permanent vision problems can develop.
- Glaucoma – glaucoma occurs when swelling in the retina results in excess pressure so that images are no longer formed as they should be in the eye.
- Post-herpetic neuralgia – people with compromised immune systems can develop post-herpetic neuralgia. It is a very painful disorder that can linger for years.
- Scarring – it is not common for shingles to cause scarring. However, scratching and not treating blisters encourage this complication.
- Hearing issues – the first obvious potential complication of shingles in the ears is hearing problems. Inflammation in internal ear structures that play important roles in hearing can cause complications.
- Facial paralysis – facial muscles near the ear usually become weakened or paralyzed during an episode of shingles in the ears. This can cause problems with how the lower eyelid opens and closes.
- Balance problems – other than hearing, the ear also aids in maintaining balance. Inflammation inside the ear can cause vertigo.
Can you die from shingles? Shingles is not fatal and in fact clears up even without treatment. Very rarely will complications include death. Inflammation in sensory facial nerves can extend to the brain. Brain inflammation is always a bad sign and can lead to death. But as mentioned, this is very rare.
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