Shingles Complications

By Krisha McCoy, MS

Medically reviewed By Lindsey Marcellin, MD, MPH

Complications from shingles are not uncommon. Some people still feel the pain called postherpetic neuralgia after the rash is gone; some still feel the itch of the shingles rash.


A worrisome part of getting shingles is dealing with complications. For most people, shingles is a condition associated with a blistering, itchy, painful rash that heals in about three to five weeks.

But it's estimated that about one-third of those who develop shingles will have serious complications. Most shingles complications are due to nerve damage, and the risk and severity of shingles complications increases with age.

Postherpetic Neuralgia as a Complication of Shingles

About 20 percent of those with shingles will develop postherpetic neuralgia, a condition in which you continue to experience shingles-related pain even though it has been months — or in extreme cases, years — since your rash healed.

People with postherpetic neuralgia may experience pain so severe that it causes sleep problems, unintentional weight loss, depression, and disability. Four categories of medications have been shown to help treat postherpetic neuralgia, including tricyclic antidepressants, anticonvulsants, opioids, and topical anesthetics.

Other Common Shingles Complications

People with shingles may also experience:

  • Postherpetic itch. This means that itching persists after the shingles rash itself has cleared. If you have this problem, your doctor can prescribe local anesthetics to numb your skin and help relieve the itching. This complication is sometimes more difficult to treat than postherpetic neuralgia.
  • Vision problems. When the shingles rash affects your eye, it can damage it — especially the cornea — leading to vision problems or even permanent blindness. If you have shingles in your eye, it's important to see an ophthalmologist right away to help avoid vision loss, which can happen immediately or after some time.
  • Hearing difficulties. If you have shingles in or around your ear, it can affect your hearing and possibly your balance.
  • Bacterial infection. The blistering rash associated with shingles can become infected with bacteria. If you develop a bacterial infection with shingles, you could have permanent scarring, and in rare cases the infection can lead to toxic shock syndrome, or necrotizing fasciitis -- an aggressive, serious infection of soft tissue located under the skin.
  • Brain or spinal cord damage. Rarely, shingles can spread to your brain or spinal cord and lead to serious complications such as stroke or brain inflammation, (called meningitis or encephalitis, depending on the area inflamed). Seek medical help immediately if you notice neurological symptoms, while you have shingles.
  • Facial paralysis. When shingles spreads to your facial nerves, a complication known as herpes zoster oticus can lead to paralysis of facial nerves; this condition could be temporary or permanent.
  • Pneumonia. In severe cases of shingles, such as in people with immune deficiencies, pneumonia may complicate the illness.

Reducing Your Risk of Shingles Complications

You may be able to reduce your risk of developing shingles complications by:

  • Taking antiviral medications. After you're diagnosed with shingles, your doctor can prescribe antiviral medications, such as Zovirax (acyclovir) and Valtrex (valacyclovir) to shorten your illness and make it less severe. Taking antiviral medications when you have shingles can cut your risk of developing postherpetic neuralgia by about half.
  • Taking corticosteroids. Some people who have shingles take medications like prednisone, which is an anti-inflammatory corticosteroid. These medications can get your illness under control, and help control shingles that has affected your eye or facial nerves.
  • Practicing good hygiene. Staying clean can reduce your risk of bacterial infection, so bathe daily, keep your fingernails clean, limit scratching as much as possible and follow other skin care recommendations.

To prevent shingles and its complications, the best strategy is to get vaccinated. People who receive the shingles vaccine — which is recommended for people age 60 and older — cut their chances of getting shingles by half. And although some people still get shingles despite being vaccinated, the illness tends to be less severe and they're less likely to develop complications like postherpetic neuralgia than people who have not been vaccinated.