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Postherpetic neuralgia - aftercare

Herpes zoster - postherpetic neuralgia; Varicella-zoster - postherpetic neuralgia; Shingles - pain; PHN

Description

Postherpetic neuralgia is pain that continues after a bout of shingles. This pain may last from months to years.

Shingles is a painful, blistering skin rash that is caused by the varicella-zoster virus. This is the same virus that causes chickenpox. Shingles is also called herpes zoster.

What to Expect

Postherpetic neuralgia can:

Taking Pain Medicines

Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort.

You can take a type of medicine called NSAIDs. You do not need a prescription for these.

You may also take acetaminophen (such as Tylenol) for pain relief. If you have liver disease, talk with your provider before using it.

Your provider may prescribe a narcotic pain reliever. You may be advised to take them:

A narcotic pain reliever can:

Other Medicines for Postherpetic Neuralgia

Your provider may recommend skin patches that contain lidocaine (a numbing medicine). Some are prescribed and some you can buy on your own at the pharmacy. These may relieve some of your pain for a short time. Lidocaine also comes as a cream that can be applied to areas where a patch is not easily applied.

Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain.

Two other types of prescription drugs may help reduce your pain:

You must take the medicines every day. They may take several weeks before they begin to help. Both of these types of drugs have side effects. If you have uncomfortable side effects, do not stop taking your medicine without talking with your provider first. Your provider may change your dosage or prescribe a different medicine.

Sometimes, a nerve block can be used to temporarily reduce pain. Your provider will tell you if this is right for you.

What Else can Help?

Many non-medical techniques can help you relax and reduce the stress of chronic pain, such as:

A common type of talk therapy for people with chronic pain is called cognitive behavioral therapy. It may help you learn how to cope with and manage your responses to pain.

When to Call the Doctor

Call your provider if:

References

Dinulos JGH. Warts, herpes simplex, and other viral infections. In: Dinulos JGH. Habif's Clinical Dermatology: A Color Guide in Diagnosis and Therapy. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Whitley RJ. Chickenpox and herpes zoster (varicella-zoster virus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 136.

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Review Date: 4/9/2020  

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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