Shingles In The Throat: Everything You Need To Know

Herpes zoster, also known as shingles, is a viral infection caused by the reactivation of the varicella-zoster virus (VZV), the same virus that's responsible for chickenpox.

After chickenpox runs its course, VZV moves into the nerve tissues near the spinal cord and brain, where it remains in a state of latency.

The virus may reactivate years later and travel along nerve fibers to your skin, causing a painful rash of small blisters anywhere on the body. While it commonly affects the skin, the rash can also appear in your mouth, particularly on the roof of your mouth or the top of your throat — also called oral shingles. 

Individuals with a weakened immune system due to aging, illness, and certain drugs have an increased risk of the virus becoming active again, causing shingles in the throat. Keep reading for more information about shingles in the throat, including prevention and treatment. 

What are the symptoms of shingles in the throat?

Although not as common as shingles of the skin, oral shingles can be debilitating. Outbreaks may be rare or happen when you're stressed or immune-compromised, but they can be quite worrying and painful. 

Therefore, it's important to know how to spot an oral shingles outbreak to seek treatment quickly. 

The most common symptoms of oral shingles include:

• Sensitivity or tenderness in the mouth or face

• Burning or tingling in the upper or lower mouth or top of your throat

• A burning sensation that turns into small red blisters a few days later

• Teeth or mouth pain

• Fever

• Fatigue

Other common symptoms associated with shingles in the throat may include intense pain, difficulty chewing, loss of appetite, sensitivity to light, and overall body aches. 

The symptoms of oral shingles can vary depending on the stage of infection. The stages include:

• Prodromal phase. The prodromal or pre-eruptive phase precedes the appearance of shingles rash by about 48 hours and comprises symptoms such as headaches, fatigue, and tooth pain. The prodromal phase can last for 48 hours or more. 

• Acute eruptive phase. The pre-eruptive phase is followed by the acute eruptive phase, where clusters of tiny blisters erupt in the upper or lower mouth and the top of the throat. The acute eruptive phase can last 2–4 weeks.

• Postherpetic neuralgia phase. Postherpetic neuralgia (PHN) is the final — or chronic — phase of oral shingles. It's the most common complication of oral shingles. The PHN phase of oral shingles is marked by recurrent nerve pain that lasts more than four weeks after the blisters have healed.

What causes shingles in your throat?

Shingles, herpes zoster, is caused by the same virus that causes chickenpox. When the outbreak of chickenpox runs its course, and the symptoms resolve, the varicella-zoster virus (VZV) remains in your system and can reactivate later as shingles. Therefore, shingles only affect people who have had chickenpox. 

Oral shingles develop when your immune system becomes compromised. The varicella-zoster virus (VZV) can spontaneously reactivate and cause shingles in the throat for any of the following reasons: 

• Aging — the normal gradual decline of immune function as we get older

• Acute or chronic illness 

• Compromised immunity due to cancer or advanced HIV

• Medications that suppress the immune system

• Psychological stress 

However, older age is arguably one of the greatest risk factors for oral shingles. Even so, it's still possible for people under 50 to develop shingles in the throat. 

How are shingles in the throat treated?

There is no cure for oral shingles, but it can be managed. Treatment can mitigate your symptoms and cut the duration of your infection. A treatment plan for oral shingles will typically include the following: 

• Antiviral medication. Antiviral medications such as Zovirax (acyclovir), Valtrex (valacyclovir), and Famvir (famciclovir) can help. However, antiviral drugs are most effective if administered within 72 hours of an outbreak. 

• Pain medication. Shingles in the throat can be very painful. Your doctor may recommend analgesics and other pain medications to support the treatment of oral shingles. Depending on the severity of the pain, medication may include over-the-counter (OTC) painkillers or stronger prescription drugs.

• At-home care. In addition to pharmacologic therapies, you can take other measures at home to help with oral shingles and reduce the risk of complications. These include a healthy diet, soft foods, and alcohol-free mouthwash. 

Early treatment is key to reducing the severity and duration of an outbreak. Talk to your doctor as soon as you notice the symptoms of an oral shingles outbreak. Be sure to follow your healthcare provider's treatment plan carefully.

The lowdown

A shingle is a viral infection that causes a painful rash. It's caused by the reactivation of the varicella-zoster virus (VZV), the virus that causes chickenpox. Any person who has had chickenpox has the potential to develop shingles. 

Since the virus resides on the sensory nerves, it can appear on any part of the body, including the throat. While there's no cure for shingles, your doctor may recommend antiviral medications to reduce the duration and severity of shingles in the throat. 

Like all cases of herpes zoster, seeking early treatment for shingles often leads to better outcomes. Antiviral medications are most effective when administered within 72 hours of the onset of the rash.