Postherpetic Neuralgia Is a Real Pain
Last updated: November 2022
Postherpetic neuralgia (PHN) is one of the most common complications of shingles. Nearly 20 percent of people who get shingles will develop PHN.1
PHN causes severe pain that can last for months and even years. For people with PHN, chronic, sometimes excruciating pain makes it hard to work, have a social life, exercise, sleep, and more. The pain can be disabling on a physical and emotional level. Often, people cope by taking prescription pain medicines for years.2-4
Why does PHN occur?
When a person has shingles, the reactivation of the varicella-zoster virus triggers a rash with blisters. It also causes skin sensitivity and pain in the nerve fibers around the rash. Sometimes, those nerve fibers get damaged during a shingles outbreak.2,3
When nerve fibers are damaged, they do not function as they should. They send the wrong, or too strong, messages to the brain. This can cause chronic, severe pain that lasts 3 months or more after the shingles rash has healed.2,3
What are the symptoms?
PHN typically occurs wherever the shingles rash was located on the body. There is a higher risk for PHN when the rash was on the face or torso.2,3
People with PHN have described the symptoms as:2-4
- Burning, shooting pain
- Deep, aching pain
- Itching, tingling, and numbness
- Extreme sensitivity to touch and temperature
Who does it affect?
Certain risk factors increase the chances of PHN with shingles, including:2-4
- Age. PHN is more common in people over age 50.
- Gender. Women tend to develop PHN more than men.
- Other health conditions. Chronic health issues like congestive heart failure, diabetes, and COPD can increase your risk.
- The severity of the shingles outbreak. The more severe the case of shingles, the greater the risk for PHN.
- Delayed shingles treatment. If treatment was delayed, it may affect whether a person gets PHN.
- Immunosuppression. People who are immunocompromised because of an existing illness like HIV/AIDS, a transplant, or cancer treatment are at a higher risk of developing shingles and PHN.
How to treat PHN
Unfortunately, there is no cure for PHN. But there are ways to reduce the pain. Over-the-counter medicines like ibuprofen can help relieve some of the ache and discomfort. Talk with your doctor if the pain is unmanageable or interfering with your daily life.5
Ways to manage and treat PHN include:5
- Lidocaine and capsaicin skin patches. These patches deliver medicine directly through the skin and provide temporary pain relief.
- Anticonvulsants. These prescription drugs manage nerve activity and can help lessen nerve pain.
- Antidepressants. These drugs affect the chemicals in your brain and how your body interprets pain.
- Prescription painkillers. Also called opioids, these prescription drugs help reduce pain. Because they can be addictive and habit-forming, they should be closely monitored by your doctor.
Can PHN be prevented?
Getting vaccinated with the shingles vaccine can greatly reduce your chances of getting shingles and PHN. In fact, the Shingrix vaccine is more than 90 percent effective at preventing shingles and PHN.2-4
The shingles vaccine is recommended if you are:2-4
- Over the age of 50
- Have had shingles in the past
- Are immunocompromised
Early shingles treatment with antiviral drugs can also reduce your risk of PHN. Antiviral drugs are prescribed to help your body fight the virus. These drugs help reduce the chances of severe or prolonged symptoms like PHN.3
When to see a doctor
If you have any signs or symptoms that you think might be shingles, see your doctor as soon as possible. If you do not have shingles but are interested in getting the vaccine, talk with your doctor about whether it is right for you. All vaccines, even though safe, can cause side effects.
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