Anon

I'm currently being treated for shingles....

I'm currently being treated for shingles. It has affected the right side of my face, especially my right ear where I have suffered quite a lot of pain and discomfort, and some loss of hearing. The course of anti-virals will complete in a few days, but next week I am due to go away on holiday. I am concerned that flying might badly affect my ear if it is not completely better by that time. Should I be concerned? Also is there, with or without flying, a risk that shingles could affect my hearing permanently?

13 December 2016

You can usually travel with shingles as long as you’re not infectious and there’s no risk to you or your fellow passengers. 

If your inner ear is affected by the infection, this can be painful as pressure within the ear increases during flight.

Airlines can refuse to let passengers fly if their condition could worsen or be affected by the journey, and if they pose a threat to passengers or crew. Each of their regulations differ, however, so it is worth checking with their medical department and website before you travel.

How can shingles affect your ear and hearing?

As shingles is a viral infection, there are various ways it can cause a hearing problem.

The two most common are:

1. Ramsay Hunt Syndrome - This condition, also known as herpes zoster oticus, occurs when the varicella zoster virus spreads into the facial nerve near the inner ear. This causes nerve damage that affects your hearing.

2. Labyrinthitis - This term refers to infection and swelling in the inner ear structures that affect balance and hearing. Shingles can cause labyrinthitis either through direct viral infection or by subsequent bacterial infection that occurs as the blisters crust over and heal.

Symptoms for ear shingles

Ear shingles usually only affects one ear, the one surrounded by the rash.

Symptoms include:

  • Decreased hearing or deafness
  • Intense and severe ear pain
  • Tinnitus, which is ringing or other strange noises in your ear
  • Vertigo, which creates the sensation of the room spinning around you
  • Nausea or vomiting.

Patients with Ramsay Hunt Syndrome also might have other symptoms due to the nerve damage caused by the varicella zoster virus. These include partial facial paralysis, loss of taste sensation, and dry mouth and eyes. 

Treatment for shingles in the ear

Receiving prompt treatment can help prevent hearing problems. The best treatments include:

  • Antiviral medications - These attack the varicella zoster virus and prevent its spread. Antiviral drugs are usually taken for 7 to 10 days.
  • Corticosteroid therapy - This treatment can reduce the pain and swelling associated with shingles. Patients usually receive these powerful anti-inflammatories for three to five days.

You’re more likely to recover from shingles if you begin receiving treatment within three days of your first symptoms. About 70% of those with shingles make a full recovery if they're treated early. If you delay getting to the doctor, your chances of complete recovery decrease. In some cases, hearing loss will be permanent due to damage to nerves or to the structures of the inner ear, so don’t wait to seek medical attention.

What can go wrong after the initial rash is gone?

One of the most common complications of shingles is postherpetic neuralgia. This condition causes pain where you had the rash, even after it has healed.  It can last weeks, months or in some cases years and may be treated using specific pain management.

In rare cases, shingles causes a small increase in the risk of stroke for a few weeks to a few months. That risk is higher if you have shingles on the face, as in your case, but the symptoms are easy to spot. You’ll need to monitor your eyes. If you experience any changes in your vision or inflammation around the eye area you should seek medical attention immediately. 

Next steps

I suggest you see your GP to confirm you’re fit to fly and that there’s no risk to you or your fellow passengers. It’s also really important to contact your travel insurance provider to inform them about any condition you’re currently being treated for, as your cover may be affected.

Answered by the Health at Hand nurses  

Sources and further reading

How do you catch shingles? – AXA PPP healthcare

Can I fly with labyrinthitis – AXA PPP healthcare

Shingles – NHS factsheet

Labyrinthitis – NHS factsheet

Neuralgia – NHS factsheet

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