Post-herpetic Neuralgia
Even people who appear to recover completely from a shingles attack can have something called post-post-herpetic neuralgia. According to the Mayo Clinic, this is the most common complication of shingles, and the risk of getting it increases with age. [i]
Post-herpetic neuralgia is pain that lingers for months or even years to decades after the shingles rash has resolved. This pain can be deep and aching and feel like it burns and stabs. It can make your skin so hypersensitive to touch that even the weight of clothing or a sheet feels too much. Itching and numbness can also persist for many years in the affected area.
Who fares the worst from shingles?
There are two groups of people that have worst-case shingles scenarios but they have a common condition – immunodeficiency or a weakened immune system.
In the elderly, this is called immunosenescence, which relates to the general decline in immune function found in people as they age. The older you are, the more likely it is you will get shingles, and the more likely it is that shingles will result in complications.
The other group is made up of those who have a compromised immune system due to things like AIDS, cancer, chemotherapy and radiation treatment, an organ transplant, or the ingestion of drugs that affect the immune system. In these circumstances, shingles can be life-threatening.
Other complications
There is a slew of other complications involved with shingles:
- Bacterial skin infections: “A secondary bacterial infection of the skin blisters can sometimes develop, leading to cellulitis or impetigo. These skin infections may be characterized by increasing redness, tenderness, and warmth in and around the area of the rash.”[ii]
- “Herpes zoster ophthalmicus, which occurs in 10% to 20% of HZ episodes, can involve the entire eye, causing keratitis, scarring, and vision loss.”[iii] It can also cause glaucoma, conjunctivitis, cataracts, and debilitating pain.
- Ramsay Hunt Syndrome, also known as herpes zoster oticus, is the name given to the cluster of symptoms that can develop when shingles affect the facial nerve. Besides ear, head, and face pain, other symptoms include rash or blisters in and around the ear, scalp, and mouth, hearing loss, vertigo, tinnitus, and loss of expression due to weakness or paralysis in the facial muscles on the affected side (Bells palsy).
- Brain inflammation (meningitis)
- Lung infection (pneumonia)
- Liver inflammation (hepatitis)
- Bladder impairment (urinary frequency, urgency, and leakage)
Shingles also have psychological effects. It can make you feel anxious, depressed, and self-conscious, especially if it is visible on your face. This can interfere with your social life and contribute to sleeplessness.
The pain from active shingles and from postherpetic neuralgia can be so agonizing that some people feel suicidal. The pain can become a permanent, life-altering reality if nerves have been damaged. According to an article in the New York Times: “At least 50 percent of postherpetic neuralgia patients develop clinical depression”.[iv]
[i] https://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/symptoms-causes/syc-20376588
[ii] https://www.medicinenet.com/shingles_herpes_zoster/article.htm#what_are_complications_of_shingles_part_3
[iii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664599/
[iv] https://www.nytimes.com/2005/06/07/health/for-some-patients-shingles-is-just-the-beginning.html