Postherpetic neuralgia is the commonest complication of shingles.
What Leads To Postherpetic Neuralgia?
If you get affected by chickenpox, the virus stays in your body all through your life. Once you start aging or if your immune system gets suppressed, this virus- the herpes zoster virus – can activate again. This leads to shingles. When during shingles, your nerve fibers get damaged; they cannot send or transmit messages from the skin to the brain in a normal way. Instead, they send signals in a confused and exaggerated way, which leads to agonizing and chronic pain. This pain may last for months or even years.(1)
If you are exposed to shingles and any of the following factors as well, you are at an increased risk of developing postherpetic neuralgia-
Being older than 50 years of age makes you more susceptible to shingles
If you have had shingles, the severity of the rash and pain will also be responsible for the development of postherpetic neuralgia
Other Medical Conditions-
If you suffer from any other medical conditions like diabetes, you may be more prone to developing postherpetic neuralgia
Site Of Shingles-
If you were affected by shingles on your face or torso, you are at an increased risk of developing postherpetic neuralgia
If the shingles treatment wasn’t started soon, or within 72 hours max after the shingles rash developed, it may increase the risk.(1)
Can Postherpetic Neuralgia Be Cured?
Postherpetic neuralgia cannot be cured, but symptoms, especially pain, can be relieved with treatment. In most cases, postherpetic neuralgia gets better with time. For treating postherpetic neuralgia, more than one treatment methods are usually required, as it is seen that only one of the methods fails to give promising results. The treatment options may include-
Lidocaine Skin Patches-
- These are topical pain-alleviating patches of medicine lidocaine
- These are to be applied at the site of pain directly to ease the pain
Capsaicin Skin Patch-
- These are patches of extract capsaicin, derived from chili peppers
- It is available by the name Qutenza
- This is to be applied at the site of pain, but only by a trained professional and after the application of a numbing medication at the site first
- These medicines help in normalizing the electrical activity in the nervous system
- However, these may cause side effects like sleepiness, hallucinations, imbalance, etc.
- These may help in changing the way the brain interprets pain
- As a result, you may feel less pain
- These are given in a low dosage as compared to what is given for depression
Opioid Pain Relievers –
- These are extremely strong pain killers, made out of opioid derivatives
- However, these may cause many dangerous side effects, and hence, their use is discouraged
Injectable steroids may be sometimes given, however, there have been mixed results with this.(2)
Complications Of Postherpetic Neuralgia
The complications of postherpetic neuralgia depend upon the severity and the duration for which it lasts. It also depends upon how painful the neuralgia is. Complications may include many other common conditions that are associated with pain. These may include-
- Sleeping difficulties
- Fatigue or extreme tiredness
- Anxiety and depression
- Loss of appetite
- Concentration difficulties(1)
Prevention Of Postherpetic Neuralgia
- It is suggested that people older than 50 years of age should get themselves vaccinated with Shingrix, which helps in preventing shingles
- It is recommended that this vaccine be taken even if you have had shingles in the past or have taken Zostavax
- Shingrix is considered to be better than Zostavax in terms of effectiveness and period of sustainability of the effectiveness(1)
Postherpetic neuralgia occurs as a complication of shingles. There is no cure for this condition, but the symptoms can be reduced with treatment and most times it gets better on its own.