There are some effects that may occur and may last longer after an outbreak of shingles. These include scarring after deep blisters that tend to destroy the superficial skin layers or cause post-inflammatory hyperpigmentation, muscle weakness or a facial nerve palsy may occur after zoster of the face, including Ramsay Hunt syndrome. Internal organs may be affected by zoster, including the brain, causing encephalitis, lungs and GI tract. Eye complications may occur if the ophthalmic division of the cranial nerve five is affected. And possible fetal harm if zoster occurs in the early months of pregnancy. In addition, post-herpetic neuralgia may occur, which describes the persistence or recurrence of pain in an area more than one month after the onset of zoster. Post-herpetic neuralgia is more common with age and affects about one third of patients over the age of 40. It is more likely if there is a facial infection. It may occur as a continuous burning sensation with hypersensitivity in affected areas and spasms of shooting pains. Oftentimes overlying skin is numb or very sensitive to palpation. Instead of pain, sometimes post-herpetic neuralgia results as persistent itching or neuropathic puritis.
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