Postherpetic neuralgia

Postherpetic neuralgia is a commonly experienced complication from herpes zoster, or shingles. Shingles is a skin rash that can be mildly itchy or severely painful. Postherpetic neuralgia is a chronic condition in which pain is felt in the same area as the shingles rash, resulting from damage to the nerve fibers during the shingles infection. Learn more about shingles and the symptoms, diagnosis, and treatment for postherpetic neuralgia in this article.

As mentioned above, shingles, also referred to as herpes zoster, is a skin rash that can range in severity. It is caused by a reactivation of the varicella-zoster virus, which is the same virus that causes chicken pox. Anyone who has had chicken pox can get shingles. When chicken pox disappears, the varicella-zoster virus lays dormant in the nerves near the spine; when the immune system is weakened, the virus can get reactivated. Shingles is essentially a viral infection of the nerves. Shingles appear as a rash, patch, or line of painful blisters on the skin over a nerve inside the body; the band of blisters follows the nerve path, but is seen on the skin. These nerves can continue to cause severe pain after the rash of shingles has disappeared, hence postherpetic neuralgia.

Symptoms of Postherpetic Neuralgia

Postherpetic neuralgia (PHN) pain can be very intense. It is often described as a stabbing, burning, or gnawing. The areas that are affected by the pain may be hypersensitive (extremely tender to touch) or they can be hyposensitive (decreased sensitivity). The areas that were once affected by shingles may also have scars. There may be itching or numbness after the shingles rash has disappeared. The pain can actually last for months or years.

Diagnosis of Postherpetic Neuralgia
Postherpetic neuralgia is defined as pain residing from shingles for 4 or more months after an acute shingles attack, or when the pain perseveres more than 90 days after the skin lesions from shingles have healed.

Treatment for Postherpetic Neuralgia
For most people, a combination of treatments will be needed to relieve postherpetic neuralgia, but everyone is different. Below are some common treatments used.

Lidocaine skin patches
These small, bandage-like patches contain a topical pain-reliever called lidocaine. They can be cut to fit the exact area that needs pain relief. The patches are available by prescription only.

Certain anticonvulsants
Anti-seizure medications have also been successful in relieving the pain associated with postherpetic neuralgia. They stabilize abnormal electric activity in the nervous system. There are different types: gabapentin, pregabalin, and more.

Tricyclic antidepressants
There are certain antidepressants that affect chemicals in the brain that help interpret how your body perceives pain. Examples are nortriptyline and amitriptyline.

Opioid painkillers
Some people might need prescription-strength pain medications to relieve the pain associated with postherpetic neuralgia. These medications contain one of the following: tramadol, oxycodone, or morphine. Drugs like this, however, can be highly addictive and there is usually serious consideration before they are prescribed.

Home remedies
In addition to what your doctor can do for you, there are certain things you can do on your own. Some individuals might discover that over-the-counter medications or topical creams may relieve the pain from postherpetic neuralgia just fine. One, capsaicin cream, which is made from the seeds of hot chili peppers, is one such over-the-counter cream. Be careful with this one because it can cause an itching or burning sensation, but should subside over time. Another thing to try is a topical analgesic and anesthetic; for example, mixing aspirin into a nonprescription-strength lidocaine cream and applying it to the affected area may reduce pain. It is a good idea to speak with your doctor about trying any home remedies.

Last updated on Dec 4th, 2010 and filed under Other Conditions & Diseases. Both comments and pings are currently closed.

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