Postherpetic Neuralgia

What is Postherpetic Neuralgia?

Nerve pain remaining after rashes from the shingles virus (varicella-zoster) have disappeared is referred to as Postherpetic Neuralgia (PHN). While PHN-related pain often eases in time, the initial pain can sometimes be as unbearable as what was experienced with shingles, although some people only have mild discomfort. Medication is often helpful at managing PHN until the lingering effects of the virus completely go away.

What Causes PHN Pain?

Postherpetic neuralgia is caused by nerves that have become inflamed, irritated, or damaged as a result of the shingle virus and the accompanying rash. Scar tissue next to nerves or along adjacent parts of the spinal cord may contribute to it. Discomfort is often felt in the same area previously affected by the rash. In 5 out of 10 people with PHN, symptoms last about three months.

What are the Symptoms of Postherpetic Neuralgia?

  • Difficulty sleeping
  • Burning sensations
  • Intermittent sharp, stabbing pain
  • Skin sensitivity in the affected area
  • Depression or increased anxiety

How is Postherpetic Neuralgia Treated?

Wearing loose-fitting clothing or taking cool baths may provide relief. Tricyclic antidepressants such as amitriptyline tend to work better for nerve pain. Traditional painkillers aren’t usually effective. Anti-epileptic medicines like gabapentin may also help control nerve impulses.

Treatment may also include:

  • Capsaicin cream (applied 3-4 times daily)
  • Antihistamine taken before bedtime (to minimize itching)
  • Lidocaine patches worn for 12-hour periods over the affected areas

Pain either returning or continuing more than a month after shingles has cleared is classified as PHN. Shingles can affect anyone who previously had chickenpox, which is approximately 95 percent of all adults in the United States. PHN is less common and is often mild in people under fifty. For seniors who have had shingles, however, it can be more severe, suggesting a greater chance of experiencing PHN when shingles develops later in life.

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Last Reviewed:
October 08, 2016
Last Updated:
August 29, 2017