Shingles - Complications 

Complications of shingles 

A number of complications can occur as a result of shingles. They are more likely if you have a weakened immune system (the body’s natural defence system) or are elderly.

Possible complications include:

  • an infected rash that becomes red and tender, which may need to be treated with a course of antibiotics (medicine to treat infections caused by bacteria)
  • white patches (a loss of pigment) in the area of the rash
  • scarring, although this is unusual
  • encephalitis (inflammation of the brain), which only occurs in rare cases and causes a high temperature (fever) and confusion
  • transverse myelitis (inflammation of the spinal cord), which is also rare and may cause pain in your neck and back

Ophthalmic shingles complications

Ophthalmic shingles is where shingles affects part of the trigeminal nerve (the nerve that controls sensation and movement in your face). This can cause complications that affect your eye, including:

  • ulceration (sores) and permanent scarring of the surface of your eye (cornea)
  • uveitis, which is inflammation (redness and swelling) of some parts of the inner eye, such as the iris (the coloured part) and ciliary body (the ring of muscle behind the iris)

Ophthalmic shingles may cause vision loss if not treated.

Ramsay Hunt syndrome

Ramsay Hunt syndrome is a complication that can occur if shingles affects certain nerves in your head. In America, Ramsay Hunt syndrome is estimated to affect 5 in 100,000 people every year and it may affect a similar number of people in the UK.

Ramsay Hunt syndrome can cause:

  • earache 
  • hearing loss 
  • dizziness
  • vertigo (the sensation that you or the environment around you is moving or spinning)
  • tinnitus (the perception of noise in one ear, both ears, or inside your head, where the noise comes from inside your body rather than from an outside source) 
  • a rash around the ear
  • loss of taste
  • paralysis (weakness) of your face, known as Bell's palsy

Ramsay Hunt syndrome is usually treated with the following medications:

  • antiviral medication (medication to treat viruses)
  • corticosteroids (medication that contains steroids)

The earlier treatment is started, the better the outcome. Around three-quarters of people given antiviral medication within 72 hours (three days) of the start of their symptoms usually make a complete recovery. If treatment is delayed, half of those treated will recover completely. 

You may be more likely to have some permanent facial palsy (paralysis) if:

  • your face was completely paralysed before you started treatment
  • you are over 50 years of age

Around 1 in 20 people with Ramsay Hunt syndrome may experience some degree of permanent hearing loss. 

Postherpetic neuralgia

Postherpetic neuralgia is the most common complication of shingles. Estimates vary, but postherpetic neuralgia is thought to affect one or two people in every 10 who have shingles. The condition becomes more common with age, and affects one-third of people over 80.

Postherpetic neuralgia can cause severe nerve pain (neuralgia) that persists after the rash and any other symptoms of shingles have gone. If you have pain for more than three months after your shingles rash has gone, you may have postherpetic neuralgia.

Types of pain experienced by people with postherpetic neuralgia include:

  • burning, aching or throbbing pain
  • stabbing or shooting pain
  • allodynia, where you feel pain from something that should not be painful, such as a very light touch
  • hyperalgesia, where you are very sensitive to pain

Postherpetic neuralgia may be treated with a number of different painkilling medicines.

Read more information about neuralgia.

Peripheral motor neuropathy

Peripheral motor neuropathy is a complication that affects one or two people in every 20 who have shingles. It is more common in elderly people.

Neuropathy means nerve damage. In this case, it is damage to a peripheral motor nerve (a nerve that controls movement). Peripheral motor neuropathy usually affects a single limb, such as an arm or leg, causing paralysis in that limb. It is usually possible to make a full recovery.

Read more information about peripheral neuropathy


Page last reviewed: 21/06/2012

Next review due: 21/06/2014

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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Sugar daddy said on 27 September 2013

I was diagnosed with Ramsey Hunt syndrome nearly 2 years ago and I am still suffering side-effects with balance on occasions. I also had to have two hearing aids fitted because of hearing loss

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vintage said on 05 February 2012

Hi Ii all started over a week ago.with areally low back ache my husband was in hospital so i was running around like a headless chicken thought i was just tired.Then had terrible cramp pains in my stomache ,id been feeling hot and felt i was walking through treacle. then felt tearful thought just tired,but then 2 sores appeared under my rib cage and on my back where like 3 lumps odd i though so i googled oh forgot to say i was numb for a couple of days on my tummy just though a bit odd, to busy to really care. went to docs he gave me 400g of the antiviral drug, it was then 2 dys later and i was in agong felt id been kicked by a horse,so pain ful the skin to touch and my ribs and back omg so ive now got 800 strengh of the anti viral but its now sunday and 5 days in to this im really tearful, but the pain is terrible ive had a hysterectomy 2 children but this is Horrid i dont know what to do for the pain.im worried about work and when i will be feeling better can anyone give me some advice Pleeaasseee xx

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SCARFACE48 said on 23 March 2010

I had shingles years ago that effected my right optic nerve and was told by my mother by the family doctor if it had effected the left optic side i could have gone blind. I was only 9years old at the time and remember the severe pain at the time.i had spots on my forehead and above my eye and in my hair and of course on the right side of my face. I missed about 3 months schooling. To this day i have the pure white scarring by my hairline as i was in such a bad way. To this day i still get the discomfort especially when i feel tired or run down.
I remember the doctor prescribing phenobarbitone, i was on these for years and never questioned my mother how long i needed to be on these and weaned myself off them as i got older. This type of condition together with tn and suicide was discussed on gmtv./this morning where a woman had been suffering extreme pain and had an operation to ease her symptoms which was very informative and intresting as doctor chris mentioned the pain shingles can leave . Just thiught i would share my experience with you

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