The presence of hearing loss can lead to a difficult experience affecting everyday interaction, communication and participation in social activities. The causes of a hearing loss vary and can include things such as an infection, genetic disorders, stroke, and exposure to extremely loud noise, or damage to inner ear hair cells resulting from injury or old age. Hearing difficulties associated with these causes can be present in one or both ears. Most people are not aware of the common occurrence of hearing loss in Shingles. In this article, it’s important that we take a closer look into this kind of Shingles as it can lead to serious hearing difficulties.

What is Shingles?

Shingles is defined as being a viral infection that manifests as a painful rash. The rash can appear on any part of the body but it is most commonly seen around the side of the torso area (left/right) as a row of blisters.
Shingles is associated with the same kind of virus that causes chickenpox. This means that if you’ve had chickenpox before, the “remains” of the virus from recovery may reactivate (years later) and come in the form of shingles. This means that only people who have been infected with the chickenpox virus can get Shingles. In simpler terms, if you have never had chickenpox, you can not get Shingles. Also please keep in mind that Shingles cannot be passed from one person to the next.

The Centres for Disease Control and Prevention (CDC) have estimated that in the United States, 1 in 3 people develop shingles in their lifetime. There is no clear connection between shingles and who it affects; however, the infection is common amongst older adults (over the age of 50). The older you get, the more at risk you are of getting it; bearing in mind the association with chickenpox. Other risk factors include the presence of diseases that weaken the immune system (i.e. HIV/AIDS, cancer) and the administration of certain medications.

In addition to the rash and blisters, there may be continuous burning or aching pain. Most individuals who display early signs and symptoms of shingles usually focus on relieving the pain and discomfort that they experience at the time. This is a short–term resolution that may require more treatment and management options. Shingles is NOT a death sentence, even though it can be an agonizing experience. There are vaccines available to help reduce the risk, as well as treatment options to shorten the infection and minimize the chance of complications (i.e. vision loss, skin problems).

Treatment options for shingles mainly include medication to speed up the healing process. Some people may find that their symptoms subside after a certain period of time (weeks, months). Others find that they persist. Experts have suggested that the sooner the treatment begins, the greater the chance of patient recovery.

Hearing loss in Shingles

Our hearing system comprises different parts that each play an essential role in how we detect, process, and respond to sound. The system houses the vestibulocochlear nerve, which is responsible for the special sense of hearing and balance. The Shingles virus emerges in the hearing system and settles within numerous paths of the vestibulocochlear nerve. This can have different outcomes for an individual’s hearing and balance. In almost all cases, only one ear is affected. Apart from the obvious pain within the affected ear, symptoms such as decreased hearing, vertigo, tinnitus, as well as nausea/vomiting may occur.

Shingles can cause one of two pathologies, Labyrinthitis or Ramsay Hunt Syndrome. The former refers to an infection of the inner ear structures that affects hearing and balance. The latter refers to when the virus spreads to the facial nerve close to the inner ear – which can further damage your hearing. Any kind of infection affecting the inner, middle, and external ear is termed Herpes zoster oticus. From a hearing healthcare professional perspective, one study found that patients with Herpes zoster oticus presented with a severe high-frequency hearing loss; and that a hearing loss was more severe in both the low and high frequencies, in patients with vertigo as compared to those without vertigo.

It is important to keep in mind that not everyone who has Shingles will have the same type of hearing difficulties. Each case is person-specific and should be treated in that way. It is not guaranteed that your hearing will get better as the virus has reached the level of the nerve, which is an essential and delicate part of the hearing system.

Take note

It is important that you consult with your doctor at the first sight of the signs and symptoms associated with Shingles. Look out for pain, burning, tingling, red rash, a row of blisters, itching, fever, headache, vertigo, and fatigue.

Once you have been diagnosed, further consultation with a hearing healthcare professional for a hearing assessment to identify the type and severity of the hearing loss and recommendation of management options (i.e. hearing aids).

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