What Are The Symptoms Of Shingles In The Head

Managing Shingles On The Scalp

Pay special attention to prevent permanent hair loss.

Herpes zoster, also commonly known as shingles, is a viral infection that occurs when the dormant varicella-zoster virus reactivates in the body after causing an earlier case of chickenpox. Once a person recovers from chickenpox, VZV travels deep into nerve tissues and remains dormant for decades. When it reawakens, it travels back up the same nerve to the skin where it reemerges as shingles.

Any individual that has had chickenpox can develop shingles unless they have been vaccinated against it, which greatly decreases their risk. Approximately 60% of all shingles cases occur in people over the age of 60.

One of the most common symptoms of shingles is a painful and blistering raised rash that erupts most often along one side of the torso, waist, chest, neck, or back. Other sites include around an eye, ear, or scalp.

Shingles on the scalp is particularly tricky to treat because the skin there is very sensitive. Simple pressure from washing or brushing the hair can result in broken and bleeding blisters.

Besides pain, shingles on the scalp can cause headaches and weakness on one side of the face that makes it appear to droop. It can also cause hair loss from combing or scratching, or even permanent baldness from cicatricial alopecia, which destroys the hair follicles that generate hair growth and replaces them with scar tissue.

Is Shingles On The Scalp Contagious

The answer isnt exactly straightforward. Whether or not its contagious depends on who you come into contact with.

• Fact: Shingles is triggered when the varicella-zoster virus becomes active after an extended period of hibernation. What this means is that you cant directly pass shingles from one person to another, like you would the flu or an STI. If you come into contact with someone when you have shingles, theyre not at risk of catching it from you.

If you pass the virus on to someone who hasnt been exposed to it, you might give them chickenpox. When the varicella-zoster virus first infects a person, it comes out as chickenpox. Most people develop chickenpox in childhood, so its unlikely that youd give it to an adult. If the person does develop chickenpox from exposure to your virus, they may go on to develop shingles later in life. They wont get it directly from you, though.

If the person has already had chickenpox before, theyre not usually at risk. This is because their body will have developed antibodies against chickenpox. Although it is technically possible for someone to catch chickenpox a second time, it is very rare.

Its also worth noting that youre only contagious when your blisters are open and oozing fluid. Once they scab over again, its almost impossible to pass the virus on.

What Are Vaccine Side Effects

There are two vaccinations for shingles to prevent an outbreak: Zoster vaccine live and Recombinant zoster vaccine are both legitimate shots to protect the at-risk population. Brand name Shingrix is one of the latter and the top recommendation from the CDC for shingles vaccines. The CDC recommends the vaccine for adults over the age of 50 that have had chickenpox at some time in their lifetime. The organization estimates that 99% of elderly adults have had a chickenpox outbreak in their childhood, even if they dont remember.

The vaccine side effects are mild for most patients and include:

• Soreness and redness at the injection site

For most people, the after-effects of the vaccine cleared up in 2 to 3 days from the booster. The formula does not include the preservative thimerosal, for those concerned with mercury poisoning.

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How Is Shingles Prevented

The best protection against shingles is vaccination. Chickenpox vaccine should prevent you from getting the virus, and so decrease the risk of both chickenpox and shingles. Shingles vaccine reduces the risk of getting shingles and its complications you may still get shingles, but the symptoms are usually less severe and post-herpetic neuralgia is less likely. In New Zealand there are 2 brands of vaccines that protect against shingles Shingrix and Zostavax. These vaccines differ in the way they work, their cost and how they are given. Read more about the differences between Shingrix and Zostavax.

Dont Shrug Off Shingles

• By Matthew Solan, Executive Editor, Harvard Mens Health Watch

ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

If you had chickenpox as a kid, there is a good chance you may develop shingles later in life. In fact, one in three is predicted to get shingles during their lifetime, says Dr. Anne Louise Oaklander, director of the Nerve Unit at Harvard-affiliated Massachusetts General Hospital.

The same varicella-zoster virus that causes chickenpox also causes shingles. After the telltale spots of chickenpox vanish, the virus lies dormant in your nerve cells near the spinal cord and brain. When your immunity weakens from normal aging or from illnesses or medications, the virus can re-emerge. It then travels along a nerve to trigger a rash in the skin connected to that nerve. The rash often appears on only one side of your body. The most common locations are the chest, back, or stomach, or above one eye.

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What Should You Expect If You Get Shingles

Shingles can be a very painful condition. If you think you have the symptoms of shingles, see your healthcare provider right away. Starting antiviral medications early can ease your discomfort and end symptoms earlier.

A better approach to shingles is to take action and do what you can to lessen your risk of getting it. If youve never had shingles in the past, talk to your healthcare provider about getting the shingles vaccine. If youve never had chickenpox, talk with your healthcare provider about getting the chickenpox vaccine.

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First Signs And Symptoms Of Shingles

Among the systemic symptoms that may appear in the first few days of the prodromal stage of shingles are:

• Pain in a specific, localized area of the body
• Sensitivity to light

The most telling first symptom of shingles typically is the pain. Often excruciating, the discomfort has been described as burning, stinging, tingly, prickly, itchy, numbing, achy, or shooting. It can be persistent or intermittent, but will always be limited to one side of the body.

Because the pain from shingles is localized, it can be mistaken for other conditions depending on where it’s focused.

For example, a stabbing or persistent pain on one side of the lower back may mistakenly be attributed to sciatica or a kidney problem. Shingles pain around the lips could suggest a cold sore coming on, while pain focused on the eye or ear might seem like the start of a migraine.

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Am I At Risk For Shingles

Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:

• Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
• Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.

Most people only have shingles one time. However, it is possible to have it more than once.

How Is Internal Shingles Treated

Even though shingles is a virus, this is a case where there are antiviral medications available by prescription. Thats why its important to see your doctor right away if you suspect you have shingles. Early treatment may reduce the risk of complications, like PHN. Serious complications require hospitalization.

Common antiviral medications for shingles include:

Depending on the location and severity of the shingles infection, steroids may also help. Anti-inflammatory medications like ibuprofen and pain-relieving medication such as acetaminophen or other prescription pain medication can help in easing pain experienced from shingles.

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Who Is At Risk From Shingles

Anyone who has had chickenpox is at risk of getting shingles later in life. About one in three people who have not been immunised against chickenpox or shingles will get shingles in their lifetime.

Shingles usually affects older people. The older you are if you get shingles, the higher your risk of getting serious disease. People who have a weakened immune system are also at risk of getting more severe disease, even if they are young.

How Is Postherpetic Neuralgia Treated

If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.

If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.

If your pain is mild, your healthcare provider may recommend:

• Acetaminophen or NSAIDs such as ibuprofen .
• Creams and patches include lidocaine and capsaicin .

If your pain is more severe, your healthcare may prescribe:

• Antiseizure drugs gabapentin and pregabalin .
• Antidepressants, such as escitalopram , quetiapine or amitriptyline.
• Botulinum toxin injections in the area where you are having pain.

Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.

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S Of The Shingles Rash

If you have a rash of blisters on your skin or a rash that looks like any shown below, see your doctor immediately for a diagnosis. If you have shingles, its important to get treatment, preferably within 2 to 3 days.

If youve had the rash for longer than 2 to 3 days, its still important to see your doctor.

A typical shingles rash

Doctors often refer to this rash as the shingles band because it looks like a band that appears on one area of your body, as shown here.

A rash on one side of the body

A key that you have shingles is that the rash only develops on one side of your body.

Close-up of a shingles rash

The shingles rash often causes a cluster of tiny blisters. You may notice that the skin beneath the blisters is red and inflamed, as shown here.

The rash will also feel painful.

Blistering shingles rash on a man’s chest

Although the rash can begin in one area, you may notice that a few scattered blisters develop in other areas, as shown here.

Shingles rash on the palm of a man’s hand

While shingles tends to develop on your body or face, it can appear anywhere on your skin.

Study Explains Why Patients With Shingles Feel Pain

by FAPESP

In most cases, chickenpox is a benign childhood infection with symptoms that disappear within 10 days. However, the Varicella zoster virus that causes it remains dormant in the patient forever. In some cases, the virus can be reactivated years later, causing a different disease known as herpes zoster, or shingles.

One of the first and most unpleasant symptoms of shingles is neuralgia, or constant intense pain affecting mainly the nerves of the chest and neck, the trigeminal nerve in the face, and the lower back. The pain may be accompanied by paresthesia, a feeling of pins and needles, tingling, prickling, itching, numbness, burning and/or cold). A painful blistering skin rash often develops.

Researchers affiliated with the University of São Paulo have published a study in The Journal of Neuroscience describing how the immune mechanisms triggered by the reactivated virus change the way that sensory neurons work. The authors say that their discoveries lay a foundation for novel treatments not only to combat acute pain but also to prevent it from becoming chronic, a condition known as post-herpetic neuralgia.

Almost all adult humans carry VZV, he added. VZV usually lies dormant in the ganglia, clusters of sensory neurons that project to different parts of the body. An unexplained decrease in immunity leads to VZV reactivation in some people, causing inflammation of the ganglia. Shingles usually affects people over 60.

Explore further

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What Are The Risk Factors For Internal Shingles

Many of the risk factors for internal shingles are the same as those for the skin rash of shingles. They include:

• Having a weakened immune system. Diseases and conditions such as HIV/AIDS, organ transplant, and autoimmune conditions like lupus, rheumatoid arthritis, or inflammatory bowel disease can make you more susceptible to shingles.
• Undergoing cancer treatment. Cancer, along with radiation and chemotherapy, also weaken your immune system and can increase your risk of a herpes zoster infection.
• Being older than 60. Shingles can occur in people of any age. However, its more common in older adults. About half the cases of shingles develop in people over 60 .
• Taking certain medications. Drugs that lower your chance of rejecting an organ transplant or treat autoimmune diseases will increase your risk of shingles. Examples include cyclosporine and tacrolimus . Extended use of steroids will also increase your risk. These medications suppress your immune system, making your body more vulnerable to infection.

Not receiving the shingles vaccine will also increase your chances of getting the condition. Even if you dont remember ever having chickenpox, you should get the shingles vaccine. Studies have shown that 99 percent of people over 40 have had chickenpox. According to the

The Stages Before And After Rash Development

• If You’ve Had Chickenpox, You Could Be At Risk of Shingles

The most well-known symptom of shingles is a severe skin rash. However, before any signs of blisters, you may feel as if you’re only coming down with the flu.

You may experience chills and fever, as well as intense pain. It’s not until a few days later that a rash finally joins these shingles symptoms, with clusters of tiny, pimple-like blisters progressing quickly once they appear.

If you’re familiar with the signs and symptoms of shingles, you’ll be able to recognize what’s going on, get a diagnosis quickly, and deal with it without delay. Doing so makes you less likely to develop complications, such as nerve issues or bacterial skin infections.

This article reviews the symptoms of shingles and what you need to know about potential complications.

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What Shingles Symptoms Come Next

After about 1 to 5 days, a shingles rash will appear on one side of the body, often in a single characteristic band around one side of the torso or face.

The painful rash will then form itchy or burning blister-like sores filled with a clear fluid. The blisters will scab over in 7 to 10 days. Theyll gradually grow smaller before disappearing.

Shingles rash symptoms commonly last between 2 to 4 weeks.

How Is Shingles Diagnosed And Treated

If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.

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When To See A Doctor

If you suspect you have shingles, you should see a doctor right away. You can then begin appropriate treatment that will help relieve your symptoms, speed your recovery, and lower your risk of complications. This is especially important if you:

• Are over age 60
• Have a condition that has caused you to have a weakened immune system, such as HIV
• Take medication that may diminish your body’s immune response
• You share a home with someone who has a weakened immune system
• The rash is on your face: Blisters near your eye could lead to serious eye damage or even cause you to lose sight in that eye.

Shingles Doctor Discussion Guide

If while you’re dealing with shingles you experience any of the following, let the doctor who’s treating you know right away:

• You aren’t getting relief from the pain with treatment.
• The pain doesn’t go away after three to four weeks.
• The rash spreads beyond the initial area.
• You begin to have symptoms of a secondary infection, such as a very high fever, chills, and severe headache.

Your healthcare provider will help you determine the right treatment for you. This may include antiviral drugs, antidepressant medications, and pain medications.