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.
