How Shingles May Cause a Headache

Treating and Preventing Shingles in This Simple Question and Answer Style Format

Shinges – A Painful Rash. Joel Carillet/Getty Images

Shingles is a painful and common skin disorder that affects approximately one million Americans every year, according to the Centers for Disease Control and Prevention, or CDC. Shingles may cause head and face pain if it affects a large nerve that innervates the face, known as the trigeminal nerve

What is Shingles?

Shingles is a painful rash that develops along a nerve line—called a dermatome. The rash forms as a result of reactivation of the chickenpox virus, which normally lies dormant in our bodies.

Is Shingles the Same as Herpes?

No. The medical term for shingles is herpes zoster.  This has nothing to do with herpes, which is a sexually transmitted disease.

Who Gets Shingles?

Anyone who has had chickenpox can develop shingles. But it becomes more common as people age over 50 and is more common in people with a weak immune system like people taking corticosteroids or people with lymphoma, leukemia, or human immunodeficiency virus (HIV).

How Can Shingles Cause Head or Face Pain?

Shingles can affect you anywhere on your body. It affects the trigeminal ganglion in about ten to fifteen percent of cases, and this is what causes a person to have head or face pain. The medical term for this head pain is "painful trigeminal neuropathy attributed to herpes zoster."

What is the Trigeminal Ganglion?

The trigeminal ganglion is where cell bodies of the trigeminal nerve converge to provide sensation to the face, mouth, and head.

The trigeminal nerve consists of three major branches:

  • ophthalmic (near the eye)
  • maxillary (cheek-area)
  • mandibular (jaw-area)

The branch of the trigeminal nerve most commonly affected by herpes zoster is the ophthalmic branch.

What Does Trigeminal Neuropathy Attributed to Herpes Zoster Feel Like?

People usually describe a burning, tingling, itching, stabbing, or aching feeling in the head or face, along the tract of the affected trigeminal branch.

People also describe skin sensitivity to touch. Prior to developing the painful rash, some people have several days of malaise, headache, sensitivity to light, unusual sensory disturbances (for example, itching or burning) and/or occasionally a fever.

What Does the Rash Look Like and How is it Treated?

The rash starts off as red bumps that then turn into clear fluid-filled bumps, called vesicles. The vesicles scab within 7 to 10 days. The scabs fall out in about two to four weeks. Sometimes the rash can leave a scar.

Shingles is treated with an antiviral prescribed by your doctor. If the rash is around or near your eye, you will need to also urgently see an eye specialist called an ophthalmologist for an eye examination. Finally, in addition to an antiviral, your doctor may prescribe pain medication to ease discomfort, which can range from mild to severe. Examples of pain medication your doctor may recommend or prescribe include:

  • Tylenol (acetaminophen)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids 
  • Anti-seizure medications like Neurontin (gabapentin) or Lyrica (pregabalin).

Is Shingles Contagious?

You cannot transmit shingles to another person That being said, there is an exception.

If a person has never had chickenpox (and never had the chickenpox vaccine) and comes into contact with the rash (when the rash is at the blister or vesicle stage), they may contract it.

Shingles are not contagious prior to the rash forming or when the rash crusts. Even so, according to the Centers for Disease Control and Prevention, the risk of transmitting chickenpox from a shingles rash is low if the rash is covered.

Can Shingles Be Prevented?

Yes, a vaccine can help prevent shingles, although it is not 100 percent effective. The Advisory Committee on Immunization Practices (ACIP) recommends the herpes zoster vaccine (Zostavax) for adults 60 years or older.

In addition to helping prevent shingles, Zostavax also helps prevent postherpetic neuralgia—a painful and sometimes debilitating complication of shingles.

A Word From Verywell

When shingles affect the trigeminal ganglion, it can cause a painful rash of the head and face. Please seek immediate medical attention if you think you have shingles. If you are 60 years of age or older, please speak with your doctor too about getting the shingles vaccine. Some people may not be a candidate, as the vaccine is live, so double check with your doctor.


Centers for Disease Control and Prevention. (2014). About Shingles (Herpes Zoster)

Centers for Disease Control and Prevention. (2014). Update on Recommendations for Use of Herpes Zoster Vaccine

Fashner J, Bell AL. Herpes zoster and postherpetic neuralgia: Prevention and management. Am Fam Physician. 2011 Jun 15;83(12):1432-37.

Headache Classification Committee of the International Headache Society. (2013). "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia, 33(9):629-808.

Klasser GD, Ahmed AS. How to manage acute herpes zoster affecting trigeminal nerves.J Can Dent Assoc. 2014;80:e42.

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