Ask the expert

Anon

Can I fly with 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'm worried 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?

17 March 2021

Shingles is a viral infection that is caused by the herpes zoster virus, the same family of viruses that causes chicken pox (British Skin Foundation, 2021). 

Shingles is characterised by a red skin rash that causes pain and burning. Shingles generally presents at first with flu like symptoms, headaches, fever and nerve pain; pustules will then form after a few days that gradually crust over, usually over a 5 to 7-day period. The blisters will usually begin on the abdomen or torso and will be limited to one side of the body. The virus can persist for a couple of weeks and while it is more common to see the blisters on some areas of the body, as above, they can also be apparent on other areas such as the face, eyes and genitals (NHS, 2021). 

Although you cannot infect another person with shingles, if you have shingles you may pass on the chickenpox virus (as the conditions are in the same group of viruses) if they have not previously had this (NHS, 2021).

You will usually be able to fly with shingles, but if you are concerned you may want to speak with your GP to receive a 'fit to fly' notice prior to your holiday. You may also want to get in touch with the airline you are flying with to check their guidelines on this, as some airlines may request this to ensure that flying is not likely to worsen your medical condition; each company may have slight variations in their regulations regarding this.

When we fly, the change in pressure, especially during take-off and landing, can cause changes in our hearing, and existing hearing difficulties may be exacerbated by this (British Tinnitus Association, 2021). Your GP or specialist should be able to advise on this further, and how this might affect you personally.

How can shingles affect your hearing?

As shingles is a viral infection, there are various ways it may affect our hearing.

The two most common are:

1. Ramsay Hunt Syndrome - This condition (herpes zoster oticus) is a rare type of facial neuropathy; it occurs when the varicella zoster virus spreads into the facial nerve near the inner ear; a complication that can come about from the shingles virus. Along with other symptoms, this condition can cause hearing loss or tinnitus on the affected side (Facial Palsy UK, 2021).

2. Labyrinthitis - This term refers to infection and swelling in the inner ear structures that affect balance and hearing. Labyrinthitis is usually caused by viral infections like cold or flu, but could also be due to shingles. Shingles can cause labyrinthitis either through direct viral infection or by subsequent bacterial infection that occurs as the blisters crust over and heal (NHS Inform, 2021).

Shingles of the ear

When shingles affects the inner ear, this can irritate the facial nerve leading to complications, also known as the herpes zoster oticus as above, and can be caused by a reactivation of the childhood chicken pox infection (Richmond ENT, 2021). Symptoms of this condition (relating to the ear) include (Patient UK, 2021):

  • Deep pain within the affected ear
  • Tinnitus
  • Facial weakness or facial drop
  • Vertigo
  • Rash or blisters affecting the skin of the ear canal
  • Hearing changes
  • Nausea or vomiting

Treatment for shingles of the ear

Receiving prompt treatment can help prevent hearing problems. The best treatments include (Patient UK, 2021):

  • 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. 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 (Patient UK, 2021).

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 team. 

Sources and further reading

How do you catch shingles? – AXA Health

Can I fly with labyrinthitis – AXA Health

Shingles – NHS factsheet

Labyrinthitis – NHS factsheet

Got a health question?

We’re here to help you take care of your health - whenever you need us, wherever you are, whether you're an AXA Health member or not.

Our Ask the Expert service allows you to ask our team of friendly and experienced nurses, midwives, counsellors and pharmacists about any health topic. So if there's something on your mind, why not get in touch now.