Shingles is a skin condition caused due to reactivation of the varicella zoster virus which causes chickenpox. The viral migrates to the body’s nerve tissues after recovery from chickenpox and remains there dormant for many years. Reactivation of the virus and its subsequent migration to the nerve paths and the skin surface leads to development of shingles rash.
Shingles can trigger formation of itchy, blistery, and painful rashes on any area of the body, but shingles on scalp can be specially difficult and unbearable. It can cause increased sensitivity of scalp which can result in combing and grooming problems. Non-treatment of shingles on scalp can trigger formation of bald patches on head.
Shingles rash on scalp typically resolves on its own in 2 to 4 weeks. Doctors will suggest varied medications for faster healing, pain alleviation, and prevention of scalp damage and other health complications.
Symptoms
It may be noted that shingles affects just one side of the body. Hence shingles on scalp will also affect just one side of the scalp. Some of the common signs and symptoms of shingles on scalp are listed below:
- An outbreak of shingles begins with pain in the nerve pathways where the virus has reactivated. The pain can be mild or extreme and varies between patients. Depending on the nerve that the virus affects, shingles pain in scalp may trigger pain in different facial parts like the ears, mouth, eyes, etc.
- After pain, patients will experience formation of reddish rash along with blistering. The rash typically forms 2 days after pain, but it may also take nearly 3 weeks to develop. Shingles rash on scalp can adversely affect other areas of the face.
- Shingles on scalp may sometimes trigger facial weakness and headache on the side of the body that is affected by the viral infection. Facial weakness may cause the face muscles to droop.
- Pain and itchiness of the shingles rash can make the scalp very tender and sensitive to the mildest of touches or pressure. This can make combing an arduous task and the comb bristles can sometimes rupture the blisters.
- Avoid scratching the head to alleviate itching as it can increase the risk to a condition called scarring alopecia which is marked by hair loss. Scarring associated with shingles on scalp does permanent damage to the hair follicle stem cells which are responsible for growth of new hair. Destruction of the stem cells does not allow regeneration of hair and thus there is permanent hair loss.
- Shingles can trigger onset of severe medical conditions like Bell’s palsy and Ramsay Hunt syndrome.
Causes
Shingles on scalp is a viral disease caused by herpes zoster virus. The initial VZV or varicella zoster virus infection causes the short-lived, acute illness called chickenpox which typically affects kids and young adults. Even though the names sound similar, herpes zoster infection is different from herpes simplex disease.
After successful resolution of an episode of chickenpox, the virus does not get eliminated from the body. It remains dormant in nerve cells, and sometimes in non-neuronal satellite cells of autonomic ganglia, cranial nerve or the dorsal root, without causing symptoms.
Several years after the chickenpox infection, the virus may migrate from the nerve body cells to the nerve axons and cause skin infection in the area of the affected nerve. This skin infection is shingles and its symptoms are different from chickenpox. The virus may travel from 1 or more ganglia across nerves of an affected part and cause infection of the associated dermatome thereby resulting in a painful itchy rash.
Shingles on scalp typically resolves in 2 to 4 weeks. Some patients may however suffer from residual nerve pain for many months or even years; this condition of residual pain is known as postherpetic neuralgia.
Medical experts are not aware of how the virus stays dormant in the body and why and how it gets reactivated.
Treatment of shingles on scalp
Treatment of shingles on scalp involves the following:
- Antiviral drugs to kill the advancement of herpes zoster virus
- Doctor may prescribe creams or emollients to reduce itchiness and soothe the blisters and rash
- Lidocaine topical patches for relief from pain and itching
- Tricyclic antidepressants, NSAIDs, and other OTC pain killers for pain relief
- Topical anesthetics like nerve blockers which are directly injected into the shingles rash
Home remedies include:
- Eye drops made from green or black tea can be used on the eyes to clear the infection
- Application of aloe vera gel on the shingles rash on scalp can help ease the symptoms
- Use eye drops made from black or green tea every 2 hours in both eyes to help clear up the infection.
- Boost the immune system so that it can fight the virus more efficiently. This means a healthy diet, regular exercise, quitting smoking, getting sufficient rest and sleep, and intake of multivitamin supplements.
The below listed scalp and hair care measures can help alleviate symptoms and prevent hair loss and permanent damage to scalp:
- Menthol or calamine lotion can be used on scalp to soothe the rash
- Wash hair with warm or lukewarm water and never hot water
- Do not use scented shampoos or harsh soaps to wash hair. Opt for unscented gentle hair cleanser.
- Do not scrub when washing hair. Wash hair with gentle movements of fingers; do not use your nails to wash scalp/hair
- Do not rub hair but pat it dry with a towel after washing head
- Avoid using pomade, hair spray, mouse or other hair care products till shingles on scalp is present
- Take extra care when combing so as to avoid scraping the rash
