Shingles may develop on your scalp and face if the virus that causes it travels along the trigeminal nerve. It may cause burning pain, itching, and clusters of painful blisters. Prompt medical care is advised.

Shingles (herpes zoster) is a viral infection caused by the same virus that causes chickenpox. The virus lies dormant in your body for years after chickenpox resolves. If it reactivates, the virus travels down your nerve pathways and causes shingles symptoms.

Shingles rashes typically develop on the chest, neck, forehead, and lower back, but they can also appear anywhere on the body, including the face and scalp.

Pain may peak as you notice a rash start to develop on one side of the scalp. You may first experience skin discoloration and bumps that progress into clusters of tiny fluid-filled blisters. These blisters may ooze and bleed, and then crust over forming itchy scabs.

Hair loss is possible at the site of the rash, particularly if you scratch the area. You may also experience pain or tenderness on one side of your face.

It’s not possible to spread shingles to other areas of your body by touching the rash. But an active shingles rash is highly contagious to other people until the blisters dry up and scab over.

If someone who’s never had chickenpox comes in direct contact with the rash, they may get chickenpox.

A reactivation of the varicella-zoster (chickenpox) virus causes shingles.

A shingles rash will affect the nerve pathway where the virus reactivates. The trigeminal nerve (one of the cranial nerves) supplies the scalp and the face. When the virus travels along this nerve pathway, shingles will affect these areas.

What reactivates the shingles virus is not yet clear. However, medical experts suspect it has to do with a weakened immune system. Chronic conditions, intense stress, and some medications can suppress the immune system and may facilitate the reactivation of the chickenpox virus.

Only people who have had chickenpox can develop shingles.

No cure is available for shingles. Treatment aims to reduce the severity and duration of the symptoms and prevent complications.

Medical care is advised as soon as you notice the first symptoms, even if you don’t have a rash yet. If you experience a persistent burning pain and a tingling sensation on your scalp, it’s likely shingles.

Healthcare professionals often recommend starting antiviral medications within 72 hours of the first symptoms to lower the chances of complications.

Shingles on the face is considered a medical emergency because it may affect your eyes. If you notice the rash on your scalp traveling down your forehead or along the nose, consider talking with a healthcare professional as soon as possible.

If shingles isn’t managed adequately, it may lead to permanent bald patches. If the rash extends down to your eye, it may lead to blindness.

Medications

To treat shingles, a healthcare professional may recommend:

  • prescription antiviral drugs such as acyclovir (Zovirax)
  • pain medication
  • corticosteroids to manage inflammation and hair loss

Other strategies to relieve pain may include:

  • nerve blocks in some cases
  • topical lidocaine patches if the rash is resolved
  • pain relievers such as acetaminophen (Tylenol)

Do not take aspirin if you think you have shingles because of the risk of Reye syndrome.

Self-care techniques

Self-care remedies might also help with the discomfort of shingles on your scalp. You may want to try:

  • resting cool, damp towels on the rash
  • avoiding hats, caps, and bed linens (pillowcases) made of materials that attach to the rash
  • using lukewarm water to shower
  • applying a protective ointment like Vaseline to the open sores to promote wound healing and prevent secondary bacterial infections

Anyone who’s had chickenpox may develop shingles later on. A weakened immune system facilitates the chickenpox virus to reactivate as shingles.

Reactivation of the virus may be associated with:

A shingles vaccine is available. The Food and Drug Administration (FDA) approved the vaccine Shingrix in 2017 to treat shingles and to replace the previous vaccine, Zostavax.

The Centers for Disease Control and Prevention (CDC) recommends that healthy adults ages 50 years and older get the shingles vaccine whether or not they recall having chickenpox.

You may want to ask your healthcare professional about possible side effects of the vaccine.

Shingles may appear anywhere on your body, including the scalp. Seeking the care of a healthcare professional when you first notice symptoms is highly advised to reduce the chance of complications, like vision loss and bald patches.

Starting antiviral therapy immediately prevents the chance of developing severe nerve pain called postherpetic neuralgia. It’s oftentimes debilitating with little effective treatment.

Shingles on the face is considered a medical emergency. If the shingles rash develops on the tip of the nose, get immediate medical attention. It could indicate that the virus has affected the eye. This can cause blindness if not appropriately addressed.