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Shingles is a disease caused by the herpes zoster virus, the same virus that causes chickenpox. Sometimes after a person contracts chickenpox, the virus may lie dormant in the nerves and reappear years later as a painful, blistering rash called shingles. When the virus infects the facial nerve and causes symptoms in the face, it’s called facial shingles, or Ramsay Hunt Syndrome. Although there is no cure, there are numerous effective treatments available to shorten the duration of facial shingles and relieve symptoms.
Facial shingles may begin with flu-like symptoms and a fever. Blisters develop a short time later in a stripe or band across one side of the face. Symptoms may be present in facial shingles that are not present in shingles infections in other parts of the body. These symptoms can include impaired speech, pain in the ear, neck, or head, altered sense of taste, sensitivity to sound, vertigo, dry mouth, and facial weakness or paralysis. It usually is important to see a doctor as soon as facial shingles are suspected to minimize the duration of the illness and treat symptoms.
Once facial shingles is diagnosed, a doctor may prescribe medication. Since patients with facial shingles are at a higher risk for some complications than patients with shingles in other parts of the body, a doctor may prescribe an antiviral medication. Pain can be treated with prescription pain medication, skin creams, antidepressants, and antihistamines. Doctors may treat facial weakness with physical therapy. If the eyelid has difficulty closing, the doctor may inject botulinum toxin type A (Botox®) into the upper eyelid.
At home, patients can relieve discomfort by applying cold compresses to the blisters and keeping them covered with gauze. An oatmeal bath may relieve pain and itching. Patients typically should rest until the fever is gone and apply skin creams, such as lidocaine or calamine lotion, as needed.
Shingles most commonly affects the elderly, people under stress, and people with weakened immune systems. Anyone suffering from shingles generally should avoid anyone whose immune system may be compromised. This includes anyone who has never had chickenpox, the elderly, pregnant women, and newborn babies. The virus that causes shingles will not spread shingles, but it can cause chickenpox in someone who has never had chickenpox or had the vaccine.
Patients with facial shingles are at a greater risk of some shingles complications. In some patients, the shingles virus may infect the nerve in the eye, or ophthalmic nerve, causing painful swelling and temporary loss of vision. Although shingles usually heals on its own within 3 to 5 weeks, sometimes complications, such as postherpetic neuralgia, may cause pain and headaches for months or years.