What does the initial stage look like? | Shingles on the face

What does the initial stage look like?

The reason for the activation of the triggering virus is often a slight weakening of the immune system. This can be caused by stress, other diseases or other factors. An exact trigger cannot be determined in most cases.

At first, the affected persons notice small blisters that form on the face. These hurt to varying degrees and are often ignored in the first few days. This is accompanied by increasing fatigue, a feeling of illness and fever.

At this stage the blisters are often confused with a common rash. After about three days, the typical shingles blisters appear. These are arranged in a specific line on the face, as they follow the supply areas of the affected nerve.

In particular, contact with pregnant women should be avoided if shingles or chickenpox is present. If the pregnant woman is not vaccinated or does not have sufficient antibodies against the varicella zoster virus in her body despite having been infected, infection with the pregnant woman’s virus can lead to developmental disorders in the child. If the pregnant woman becomes infected with the varicella zoster virus shortly before or shortly after giving birth, this also poses a risk to the newborn child.

Shingles on the eye

If the virus spreads along the first branch of the trigeminal nerve, the ophthalmic nevus, it can infect the forehead, the eye and the cornea. In this case it is called “Zoster ophthalmicus”, a complication of shingles in the face. The first symptoms can be photophobia, lacrimation, redness and swelling of the eye. As the disease progresses, painful blisters may form on the cornea. After these blisters have healed, irreversible scarring can occur, which can lead to reduced vision and even blindness.

Late effects of shingles

Because of the acute inflammation of the nerves (neuritis), shingles can be very painful. But even after the zoster has healed, severe pain in the area of the affected nerve can continue for a long time – in some cases even for life. When the zoster heals, the pain-conducting fibers are likely to become hypersensitive due to remodelling processes of the nervous system.

This pain is called post-herpetic neuralgia. Typically, it is a dull, burning permanent pain. It occurs more frequently in shingles on the face than in other parts of the body.

Moreover, the probability of suffering from the persistent pain increases with age. To prevent post-herpetic neuralgia, early treatment of shingles with antiviral therapy (e.g. acyclovir) is extremely important. There is a vaccination against herpes zoster for persons over 50 years of age.

It reduces the probability of developing shingles. If a vaccinated person falls ill anyway, the vaccination at least reduces the probability of suffering from post-herpetic neuralgia later on, compared to non-vaccinated persons. Although shingles on the face is less common than on the chest or abdominal skin, it is accompanied by numerous serious complications.

The cause is often a reactivation of the viruses in the trigeminal nerve, which sensitively supplies the entire face. The eye, ear and facial motor nerve (facial nerve) can be particularly affected. In this case, blindness, facial paralysis or loss of sense of taste can be the result of the infection.

Due to the serious complications, a doctor should be consulted at the first signs of infection in the face. If the eye is affected, an ophthalmologist should also be contacted. Through early treatment with virus-inhibiting drugs, as well as pain and itch-relieving agents, facial erysipelas can usually be treated well. Permanent paralysis or pain can still occur, however, and may then require lifelong pain-relieving therapy.