What Is Postherpetic Neuralgia?
Postherpetic neuralgia is a painful condition that affects your
nerves and skin. It is a complication of herpes zoster, commonly called
Shingles is a
painful, blistering skin rash caused by a reactivation of a virus called varicella-zoster,
which people usually get in childhood or adolescence as chicken pox. The virus
can remain dormant in your body’s nerve cells after childhood and can
reactivate years later.
When the pain caused by shingles doesn’t go away after the
rash and blisters clear up, the condition is called postherpetic neuralgia. Postherpetic neuralgia is the most common
complication of shingles, and it occurs when a person’s nerves are damaged
during a shingles outbreak. The damaged nerves can’t send messages from the
skin to the brain and the messages become confused, resulting in chronic,
severe pain that can last for months or years.
According to a study by the American Academy of Family
Physicians, about 20 percent of people who get shingles also develop
postherpetic neuralgia. Additionally, this condition is more likely to occur in
people over the age of 60.
What Are the Symptoms of Postherpetic Neuralgia?
Shingles typically causes a painful, blistering rash. Postherpetic
neuralgia is a complication that only occurs in people who already have had shingles.
Common signs and symptoms of postherpetic neuralgia include:
pain that continues for more than one to three months in the same place that
the shingles occurred, even after the rash goes away
sensation on the skin, even from the slightest pressure
to touch or temperature changes
What Are the Risk Factors for Postherpetic Neuralgia?
Age is a high risk factor for getting both shingles and postherpetic
neuralgia. People over 60 have an increased risk, and people over 70 have an
even higher risk.
Those who have acute pain and severe rash during shingles
are also at a higher risk of developing postherpetic neuralgia.
People with lowered immunity due to disorders like HIV
infection and Hodgkin’s lymphoma, a type of cancer, have an increased risk of
developing shingles. A study by the American Academy of Family
Physicians shows that the incidence of shingles is up to 15 times greater
in patients with HIV than in those who don’t have the virus.
How Is Postherpetic Neuralgia Diagnosed and Treated?
Tests are unnecessary. Most of the time, your doctor will
diagnose postherpetic neuralgia based on the duration of pain symptoms
Treatment for postherpetic neuralgia aims to control and
reduce pain until the condition goes away. Pain therapy may include the
Painkillers are also known as analgesics. Common analgesics
used for postherpetic neuralgia include:
antidepressants are normally prescribed to treat depression, but they are
also effective in treating pain caused by postherpetic neuralgia. They often
have side effects, like dry mouth and blurred vision. They do not act as
quickly as other types of painkillers. Commonly used tricyclic antidepressants
to treat postherpetic neuralgia include:
Anticonvulsants are normally used for seizures, however
clinical studies have shown that lower doses can be effective in treating pain for
postherpetic neuralgia as well. Commonly used anticonvulsants include
How Can Postherpetic Neuralgia Be Prevented?
A herpes zoster vaccine called Zostavax
reduces the risk of shingles by 50 percent, and also protects against
postherpetic neuralgia. The Centers
for Disease Control and Prevention (CDC) recommends that the vaccine be
given to all adults over the age of 60, except for people with a weakened
immune system. These people may be advised not to receive the vaccine because
it contains a live virus.
The herpes zoster vaccine, Zostavax, is different from the
chicken pox vaccine, Varivax,
that is usually given to children. Zostavax has at least 14 times more live
varicella viruses than Varivax. Zostavax can’t be used in children, and Varivax
can’t be used to prevent herpes zoster.
Painful, postherpetic neuralgia is treatable and
preventable. Most cases disappear in one to two months, and rare cases last longer
than a year.
If you’re over the age of 60, it’s wise to get vaccinated
against it. If you do develop it, there are many analgesics and even
antidepressants you can take to manage the pain. It may just take some time and