The Truth About Shingles On The Scalp: Everything You Need To Know

Herpes zoster, popularly known as shingles, is one of the most common conditions. According to the Centers for Disease Control and Prevention (CDC), one out of three people will get shingles at some point. While young people are susceptible to shingles, it's more common in people 50 and above.¹

Shingles can be a severe condition and, left untreated, can cause long-term damage. So, if you are experiencing any symptoms of shingles on the scalp, you should see a doctor immediately. 

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What are shingles?

Shingles are a viral infection that causes a painful rash on the skin. It is caused by the varicella-zoster virus, which also causes chickenpox. 

As such, for you to get shingles, you must have had chickenpox previously, something that usually occurs during childhood. 

How do shingles occur?

As mentioned, the critical determinant of whether you can develop shingles is if you have had chickenpox. This is because the virus remains in your body even after recovering from chickenpox. It moves deep down to the roots of your nerve cells by the spinal cord and becomes dormant.

While in that state, the virus does not pose any threat to you. However, if it becomes active, it causes the symptoms responsible for shingles. To date, it's unknown what exactly causes the virus to become active again.

Some factors attributed to it include aging, a weakened immune system, surgeries, and immune-suppressing drugs. Other causes of shingles include:

  • Injuries to the skin or sunburn

  • Emotional stress

  • Long-term use of steroid medication

Signs and symptoms of shingles

The most prominent symptom of shingles is a painful rash that can form on any part of your body, though it most commonly appears on the trunk, back or side. Also known as postherpetic neuralgia (PHN), 10–18% of shingles patients experience this pain.²

This rash typically starts as a cluster of small bumps that turn into blisters. The rash can be itchy and painful, usually followed by a burning sensation. 

Other symptoms of shingles include: 

  • Fever 

  • Chills 

  • Headache 

  • Fatigue 

  • Sensitivity to light 

  • Tingling

  • Burning sensation

  • Numbness of skin

After the pain begins, it may take 1–14 days for skin redness and blisters to appear. In most cases, shingles will appear on your chest or stomach. But the rashes may also appear on other body parts, including your eyes, face, and genitals.

Generally, the rashes will appear as patches on your skin, but only on one side of the body. If the rashes appear on both sides of the body, then it's likely not shingles. 

When it comes to shingles on the head, you will also experience weakness on one side of the face. 

It is also possible to experience these symptoms without necessarily developing the rash — this is referred to as zoster sine herpete and can make it challenging to diagnose shingles. 

If the rash forms near your eyes, it can lead to severe complications such as blindness. This is why it is essential to see a doctor as soon as you experience any symptoms. 

How are shingles diagnosed? 

To diagnose shingles, your doctor will examine your rash and ask about your medical history. 

They might also perform a nerve conduction study or skin biopsy to rule out other conditions with similar symptoms. 

How are shingles treated? 

There is no cure for shingles, but there are treatments that can help ease the symptoms. Here are some of your options:

1. Medication

It is best to start treatment with prescription antiviral medication from the moment shingles blisters appear. In addition, your doctor may also recommend the following:

  • Pain relievers 

  • Corticosteroids 

  • Antidepressants 

  • Anti-itch drugs 

  • Topical treatments 

  • Nerve blocks 

  • Oral corticosteroids 

While self-care is a key part of shingles treatment, medication also plays a vital role. It helps slow down its progress and shorten the severity and length of the illness. Medication is especially effective if you begin the dosage within three days of having the condition. 

2. Self-care

Self-care is an integral part of treating shingles. However, it should not be mistaken as an alternative to seeing the doctor or taking medication. Self-care aims to accelerate the healing process and enhance your comfort during the recovery period.

Some of the steps you should take include:

  • Getting necessary bed rest during the early stages if symptoms such as fever persist

  • Placing a cool, moist cloth on the affected area

  • Preventing bed linens and clothing from rubbing against the blisters

If you take these steps, you'll notice some improvement in a few days. However, if you don't see any improvement or your symptoms worsen, seek medical assistance immediately. Here are some of the signs you should look out for: 

  • The pain and fever are worsening

  • Headaches become severe

  • Changes in your ability to think

  • You develop hearing loss, or the neck becomes stiff

  • Signs of bacterial infection, such as milky yellow discharge or increasing redness or pain in the affected area

  • You experience trouble walking

  • The emergence of blisters in your eyes, trouble seeing, or pain in the eyes

  • Severe cough or breathing difficulties

  • Your fever is higher than 101.5° F (38.6° C.)

  • Sensitivity to bright light

  • The affected area becomes sensitive to touch

Shingle blisters on the scalp

Treating shingles can be challenging due to the nature of the blisters. And this is especially so for shingles on the scalp. While they're no different from shingles on your stomach, they come with the added complexity of brushing or combing hair.

If you're not careful when doing your hair, you may scratch and burst the blisters, which can cause the virus to spread and lead to more blisters. 

To avoid this: 

  • Wash your hair with a mild shampoo

  • Tie back your hair 

  • Be extra careful when brushing or combing your hair 

  • Use a soft-bristled brush 

Treating shingles on the head requires extra caution and a proactive approach. Having an aggressive hair routine or delaying care could lead to bald spots. This is caused by damage to the cells from which new hair follicles grow.

In addition, shingles on the scalp can quickly spread to the eyes. Therefore, if you have shingles on your scalp, you should see the doctor immediately. 

How long do shingles last? 

Shingles typically last for 2–4 weeks. However, some people may experience lingering pain for months or even years after the rash disappears. 

This is known as postherpetic neuralgia (PHN). It occurs when the shingles virus damages the nerve fibers. 

The good news is that there are treatments available for PHN. These include: 

  • Medication 

  • Nerve blocks 

  • Neurostimulation 

  • Physical therapy 

  • Occupational therapy 

Health complications caused by shingles 

In addition to causing pain and discomfort, shingles can also lead to serious health complications. 

Some of the more common complications include: 

  • Pneumonia 

  • Encephalitis 

  • Hearing loss 

  • Bacterial skin infections 

  • Vision loss

Are shingles contagious?

You can only get shingles if you have the chickenpox virus in your body. 

The virus can lie dormant (inactive) for many years before it's triggered and causes shingles. Once you have shingles, however, the virus is no longer inactive. 

As a result, you can spread the virus to someone who hasn't had chickenpox, and they will go on to develop chickenpox, not shingles.  

It's also possible to spread the virus when the rash is in the blister phase. The blisters are filled with fluid that contains the virus. Anyone who comes into direct contact with this fluid can develop chickenpox. 

You're most contagious when the blisters first appear. Once they crust over, you're no longer contagious. 

It's important to note that you can't spread shingles through casual contact. The virus can only be spread through direct contact with the fluid from the blisters. 

How to prevent spreading shingles

If you have shingles, it's important to take measures to prevent the spread of the virus. By doing so, you can protect vulnerable individuals and help them avoid potentially serious health complications.

Here are some tips to help prevent the spread of shingles: 

  • Cover the rash 

  • Avoid touching or scratching the rash 

  • Wash your hands often 

  • Stay home from work or school 

In addition, you should also avoid contact with the following groups of people:

  • Individuals with weak immune systems

  • Pregnant people 

  • Newborns

Shingles and pregnancy

Pregnant women who have never had chickenpox before are at risk of developing the disease if they come into contact with the shingles virus. 

Chickenpox can cause serious health complications for the mother and the developing baby. 

If you're pregnant and have never had chickenpox, avoiding contact with anyone who has shingles is crucial. 

If you've had chickenpox before, you're not at risk of developing the disease again. However, you can still get shingles. If so, visit your healthcare provider for antiviral treatment.

Shingles and newborns 

Newborns are also at risk of developing chickenpox if they come into contact with the shingles virus, as they still need to build up immunity to it. 

Chickenpox can be especially dangerous for newborns. It can lead to serious health complications, such as pneumonia and encephalitis. 

Shingles prevention

There is no guaranteed way to prevent shingles. However, there are some measures you can take to lower your risk of developing the disease. 

These include getting the chickenpox vaccine and managing stress. 

The chickenpox vaccine 

The chickenpox vaccine is very effective at preventing the disease. It's recommended for all children and adults who have never had chickenpox. 

The vaccine is given in two doses. Your child will receive the first dose at ages 12–15 months and the second one at ages 4–6 years. 

Adults who have never had chickenpox or the chickenpox vaccine can get the vaccine as well. 

Managing stress 

There's no definitive evidence that stress can cause shingles. However, some experts believe that it may play a role in reactivating the virus. 

If you're under a lot of stress, take steps to manage it. This may help lower your risk of developing shingles. 

These steps include regularly exercising, eating a healthy diet, and getting enough sleep. 

The lowdown

While it may seem like an ordinary rash, shingles can result in severe health complications. 

If you think you have shingles, ensure you see your healthcare provider for an accurate diagnosis and treatment. 

You should also take measures to prevent the spread of the virus, especially if you're pregnant or have a weak immune system. 

With the right care, most people with shingles make a full recovery. 

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  1. Shingles (Herpes zoster) | Centers for Disease Control and Prevention

  2. Shingles burden and trends | Centers for Disease Control and Prevention

Other sources:

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