Shingles, otherwise known as herpes zoster, can affect the throat. However, this is typically not very common. Doctors may face some challenges when diagnosing shingles in the throat.

Shingles can affect various systems in the body, including the brain and spinal cord, as well as the organs, skin, and bones. The cause of the condition is usually the reactivation of the varicella-zoster virus.

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 3 people will develop shingles. However, very few cases of shingles in the throat are reported in the medical literature.

Keep reading to learn more about shingles in the throat, including symptoms, causes, treatment, and some answers to frequently asked questions on the topic.

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Cases of shingles in the head and neck can result in a range of signs and symptoms, possibly due to the potential for damage in various nerves or a combination of nerves.

For example, one case report of an 80-year-old male with shingles of the larynx notes that he had experienced the following symptoms:

In another case report, this time including a 67-year-old female, the authors note the following symptoms:

  • severe sore throat
  • pain on swallowing
  • redness of the throat
  • pain extending to the left jaw and ear
  • blisters spreading from the soft palate to the tonsils and down the throat
  • tenderness on physical examination
  • sensitivity to cold water
  • altered sense of taste
  • enlarged lymph nodes in the neck

Shingles in the throat can happen when the dormant varicella-zoster virus reactivates in the body. People of advanced age and those with weakened immune function are at increased risk of having the virus become active again.

Research from 2020 proposes that UV radiation from sunlight exposure could increase a person’s risk of developing shingles.

However, the findings indicate an association between typical sun exposure and shingles in males but not females. There was also a slight increase in the risk of shingles in both males and females with a history of severe sunburn.

Other potential risk factors for shingles include having the following:

Additionally, a 2021 study using data from the Korean National Sample cohort found people with herpes zoster infection are more likely to have laryngitis than those without herpes zoster infection. Laryngitis refers to inflammation of the larynx (voice box).

Learn more about the cause of shingles.

Treatment of shingles in the throat is similar to treating shingles anywhere in the body and largely involves antiviral medication. These can help shorten the duration of symptoms and decrease their severity.

Antiviral medications can also help with:

  • treating the lesion in the throat
  • pain management
  • prevent postherpetic neuralgia, a type of complication

Typically, doctors may prescribe the following medications at specific doses:

Drug nameDosageRegimen length
Acyclovir800 milligrams (mg), 5 times per day5 days
Valacyclovir 1 gram (g), 3 times per day5 days
Famciclovir 500 mg, 3 times per day7 days

Other medications along with the antiviral can help with symptom management, including:

  • analgesics, such as ibuprofen (Advil)
  • opioid medications for more severe cases
  • anti-inflammatory drugs, such as corticosteroids
  • gabapentin for nerve-related pain

Researchers of the previously mentioned case report note that treatment approaches should be individualized, especially with pain management. This is likely due to how differently the condition appears in people. For example, they prescribed pregabalin (Lyrica) in this case, which helps with nerve pain.

The CDC estimates that 10-18% of people who get shingles are left with postherpetic neuralgia (PHN). This condition causes pain in the area where the lesion was. The pain can last months or years and may be debilitating.

Additionally, some people can develop eye problems, which may lead to blindness. Other possible but very rare complications of shingles include:

PHN can sometimes be fatal.

Learn more about PHN.

Doctors may diagnose shingles in the throat by taking a medical history and performing a physical examination. An endoscopy, where the doctor inserts a thin tube with a camera on it, may help them assess the throat in more detail.

The lesion may be distinctive enough but if someone has an atypical presentation — such is the case with shingles in the throat — diagnosis may be challenging.

Laboratory tests may be beneficial. One effective choice is using the polymerase chain reaction (PCR) test, which detects the virus from samples taken from the lesion. PCR tests provide rapid and accurate results. Also, they are particularly helpful in diagnosing atypical cases.

Doctors can often misdiagnose shingles in the throat as a rash if blisters are not necessarily visible.

Therefore, it is important to see a doctor if people have throat pain. Sometimes, the blisters may be visible at the top of the throat.

Early diagnosis and treatment with antiviral medications help to clear up the blisters quickly and can help prevent long-term or severe pain.

Below are some commonly asked questions and their answers about shingles in the throat:

How serious is shingles in the throat?

Children and young people usually get milder symptoms, and most adults only get shingles once.

The course of the disease can be serious for those with advanced age or weakened immunity. While there is no cure, vaccination can prevent shingles in both groups.

Very rarely, the blisters can spread to nearby areas and sometimes affect the whole body. For example, when shingles affect the facial nerve, the condition is called Ramsey Hunt syndrome.

How long does recovery take?

Most cases of shingles in adults without complications go away after 2 to 4 weeks. However, some people experience PHN that can last months or even years after the initial infection.

Is it contagious?

The blisters that develop when a person has shingles contain the live virus. If a person has never had chickenpox or shingles and comes into contact with blister fluid, they can contract the virus and develop chickenpox.

Shingles is a common viral infection caused by the varicella-zoster virus. However, shingles in the throat is an atypical presentation.

Shingles in the throat mostly affect older people and those with reduced immune function. Shingles in the throat can cause similar symptoms as a typical case of shingles, such as blisters and pain.

Complications include postherpetic pain lasting months or years. In very rare cases, this can be fatal. Getting antiviral and pain management treatment as soon as possible can help limit the symptoms.