Shingles in the face can occur when the varicella-zoster virus (which also causes chickenpox) reactivates in the body along nerves connected to the face. It can affect the eyes and, in severe cases, may even cause vision loss.
For most people, symptoms typically get better within 2–4 weeks, which may be shortened with the use of antiviral medications.
Seeing a doctor quickly and receiving treatment can help prevent long-term complications like nerve pain and vision loss.
Symptoms of shingles in the face
Shingles can cause a rash to form on the face that can sometimes blister and cause severe pain. A shingles rash usually affects only one side of the face. Some areas where shingles in the face might occur include:
- forehead and scalp
- upper eyelid
- inside the eye (zoster ophthalmicus)
- side of the nose
- cheek and ears
- inside the mouth (oral shingles)
There are three phases of shingles in the face, each with distinct symptoms:
- Before the rash: You might feel pain, burning, or electrical sensations on your face for a few days before you notice the rash. You might also experience a headache, light sensitivity, or generally feel unwell.
- As the rash starts: You might develop a painful rash on one side of your face. The rash may cause blisters and color changes. This can also lead to further blisters before the rash starts to heal. Typically, this phase lasts 2–4 weeks.
- As the rash goes away: As the shingles rash starts to clear up, the blisters on your face might open, bleed, and scab over.
If you have shingles in the eye, you might also have:
- vision problems
- eye redness
- tearing
- eye pressure
- skin lesions at the tip, side, or root of your nose
Some people also experience a chronic shingles infection. This is where symptoms such as pain last longer than 4 weeks. This is called postherpetic neuralgia.
Postherpetic neuralgia can significantly affect your life, causing severe pain, shock-like sensations, burning, prickling, tingling, or numbness in the area of the face where you had the shingles rash.
Causes of shingles in the face
The varicella-zoster virus causes shingles. It’s the same virus that causes chickenpox. After someone has chickenpox, the virus stays dormant in the body. If it reactivates, it’s called shingles.
No one knows why the virus reactivates in some people, but researchers think it has to do with the immune system. As the immune system naturally weakens with age, it’s less able to keep the virus in check. You’re at greater risk of shingles if you:
- are age 50 years or older
- have had a bone marrow or organ transplant
- have had human immunodeficiency virus (HIV)
- take immunosuppressive medications
Shingles appears on the face when the varicella-zoster virus reactivates in a nerve root, which is connected to areas of skin called dermatomes. The location of the rash is the dermatome connected to where the virus became active.
One possible cause for shingles in the face is the reactivation of the varicella-zoster virus in the trigeminal nerve, which is responsible for sensory information to the eyes, nose, and mouth.
Treatment options for shingles
Shingles treatment typically includes antiviral medications and home remedies. A healthcare professional can recommend a treatment plan that’s suited to your needs.
Medication options
The antivirals used for shingles treatment are:
- acyclovir (Zovirax)
- valacyclovir (Valtrex)
- famciclovir (Famvir)
Need a refill for valacyclovir (Valtrex)? You may be able to get an online prescription through Optum Perks in as little as 15 minutes with no video or appointment needed. Learn more here.
