Postherpetic neuralgia

By Medically reviewed by Hello Doktor Medical Panel


What is postherpetic neuralgia?

Postherpetic neuralgia is a complication of shingles, which is caused by the chickenpox (herpes zoster) virus. Postherpetic neuralgia affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.

How common is postherpetic neuralgia?

It’s estimated up to one in every five people with shingles will go on to develop post-herpetic neuralgia, and older people are particularly at risk. Please discuss with your doctor for further information.


What are the symptoms of postherpetic neuralgia?

The common symptoms of postherpetic neuralgia are:

  • Pain that lasts 3 months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.
  • Sensitivity to light touch. People with the condition often can’t bear even the touch of clothing on the affected skin (allodynia).
  • Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • The first sign of shingles
  • Persistent pain after having shingles

Often the pain starts before you notice a rash. Your risk of developing postherpetic neuralgia is lessened if you begin taking antiviral medications within 72 hours of developing the shingles rash.


What causes postherpetic neuralgia?

Once you’ve had chickenpox, the virus remains in your body for the rest of your life. As you age or if your immune system is suppressed, such as from medications or chemotherapy, the virus can reactivate, causing shingles.

Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers can’t send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that can last months — or even years.

Risk factors

What increases my risk for postherpetic neuralgia?

There are many risk factors for postherpetic neuralgia, such as:

  • You’re older than 50.
  • Severity of shingles. You had a severe rash and severe pain.
  • Other illness. You have a chronic disease, such as diabetes.

You had shingles on your face or torso.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is postherpetic neuralgia diagnosed?

Your doctor will examine your skin, possibly touching it in places to determine the borders of the affected area.

In most cases, no tests are necessary.

How is postherpetic neuralgia treated?

Many people with post-herpetic neuralgia make a full recovery within a year of developing the condition. But occasionally the nerves do not heal completely and symptoms last for several years or permanently.

Medication can ease the symptoms of post-herpetic neuralgia, although they may not relieve the pain completely.

As post-herpetic neuralgia generally doesn’t respond to standard painkillers such as paracetamol and ibuprofen, alternative medications will need to be prescribed.

These will often be medications originally intended to treat depression (antidepressants) or epilepsy (anticonvulsants), but have since been found to also be effective in relieving nerve pain.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage postherpetic neuralgia?

The following lifestyles and home remedies might help you cope with postherpetic neuralgia:

  • Capsaicin cream, made from the seeds of hot chili peppers, may relieve pain from postherpetic neuralgia. Capsaicin (Capzasin-P, Zostrix) can cause a burning sensation and irritate your skin, but these side effects usually disappear over time. Because capsaicin cream can irritate your skin, avoid getting it on unaffected parts of your body. Follow instructions, including wearing gloves for application and washing your hands thoroughly after applying.
  • Topical analgesics and anesthetics. Aspirin mixed into an absorbing cream or nonprescription-strength lidocaine cream may reduce skin hypersensitivity.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Review Date: September 11, 2017 | Last Modified: December 6, 2019

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