People over the age of 50 are particularly at risk for developing a shingles infection. Most of those infections clear without complications, but several problems may occur. These complications may be life-altering, cause chronic pain or disabilities, and may even be life-threatening.
Postherpetic Neuralgia After a Shingles Infection
Shingles pain that persists after the initial rash clears may result in a diagnosis of postherpetic neuralgia (PHN). The Center for Disease Control and Prevention (CDC) web site mentions that this persistent nerve pain may continue for weeks, months, or years and seems to be particularly prevalent in older adults over the age of 60, affecting this age group as much as 50% when a shingles infection occurs. Read the PHN article for more information regarding this complication of shingles.
Shingles Affects the Eye
According to Scott Fraser’s 2008 article in Pulse entitled “Chronic eye conditions,” the shingles virus may affect the upper trigeminal nerve division and cause a painful rash on one side of the face while affecting the cornea of the eye. Herpes zoster opthalmicus results from eye involvement of the shingles and may result in permanent eye damage and even blindness. Hutchinson’s sign suggests an increased likelihood of more severe ocular involvement if the rash extends down the side to the tip of the nose. Symptoms on the face, particularly in and around the eye, calling for immediate attention include:
- Reddened areas
- Drainage
- Difficulty seeing or blurred vision
- Swollen eyelid
- Pain
Shingles on the face may also cause ear pain and affect hearing, taste, or balance. The facial muscles may be affected, resulting in Ramsay Hunt syndrome.
According to a 2000 article in Opthalmology Times by Lynda Charters and Alan Palestine entitled “Famcyclovir an option for ophthalmic zoster," Famcyclovir may reduce symptoms of herpes zoster opthalmicus, particularly if started early in the progression of the infection. This article indicates that famcyclovir is more effective than acyclovir in treating herpes zoster opthalmicus.
Bacterial Infection Resulting From a Shingles Infection
According to the CDC, a superinfection of bacteria may occur at the site of the rash. Staphylococcus aureus (“staph”) infections are most common. These infections may leave open sores which may cause skin discoloration and scars. According to the National Institute of Allergy and Infectious Diseases (NIH) web article "Shingles," rare cases of bacterial infection may lead to toxic shock syndrome and necrotizing fasciitis. The NIH web site offers several pictures of shingles infections and information regarding this viral infection and its complications.
Disseminated Shingles
Disseminated shingles affects multiple body systems and generally only occurs in those whose immune system is not functioning properly due to certain conditions, including HIV infection, or because of immune-altering treatments, such as certain types of chemotherapy. The rash spreads over a much larger portion of the body and multiple internal organs, joints, the brain, spinal cord, and nerves may be affected.
The NIH web site mentions that people with disseminated shingles require more intensive hospital care and require more strict isolation procedures, including airborne in addition to standard and contact precautions. Healthcare providers entering rooms of these patients will generally wear gloves, gowns, and masks.
Hope for Lessening or Preventing Shingles Complications
The shingles vaccine offers hope to prevent or lessen cases of the shingles and possible complications, including PHN, eye involvement, bacterial infections, and severe disseminated shingles. Antiviral therapy that is initiated quickly may also minimize shingles and its complications.
Information in this article is not intended to be medical advice. Contact your healthcare provider regarding specific healthcare concerns.
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