Postherpetic Neuralgia (PHN)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

Read about home remedies used in the treatment of shingles, a painful skin condition.

Home Treatments for Shingles

What are medications for shingles?

Antiviral medications like acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir) can reduce the severity and duration of the rash if started within 72 hours of the development of the skin rash, and pain medications like acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve), and even narcotic pain-control medications may be useful in symptom control. In addition to medications, many people find that home care remedies can also provide relief for the pain of shingles.

Keeping the inflamed skin clean is essential, so wash the affected area with cool water and mild soap. Taking a bath or shower is fine. The blisters of shingles will crust over and fall off on their own, and it's important to avoid picking at the blisters to prevent the development of a secondary skin infection at the inflamed site. Cool compresses applied to the painful area after washing may be helpful. In the first few days of an attack, you can apply ice packs for 10 minutes at a time several times throughout the day.

Quick GuideShingles Rash Pictures, Symptoms, Vaccine Facts

Shingles Rash Pictures, Symptoms, Vaccine Facts

Postherpetic neuralgia (PHN) facts

  • PHN is a painful complication that occurs after a shingles infection.
  • PHN is caused by viral damage to nerve cells.
  • PHN is diagnosed by the patient's history and physical exam.
  • Treatment often requires more than one agent to reduce pain.
  • PHN may last one to two months, but some patients have PHN for longer than a year.
  • Older people and people with relatives who get shingles are at a higher risk for PHN.
  • Complications of PHN may include severe pain, pain-medicine addiction, diminished lifestyle, and in a few patients, paralysis of the affected area.
  • The prognosis of PHN ranges from good to poor, depending on the length of time the disease lingers and on the development of complications.
  • PHN can be prevented in many people by a vaccine designed to prevent shingles (Zostavax).

What is postherpetic neuralgia (PHN)?

Postherpetic neuralgia (also termed PHN) is a condition of recurring or persistent pain in an area of the body that has undergone an outbreak of herpes zoster virus (HZ), also known as the varicella zoster virus, commonly termed shingles. It usually begins after shingles lesions (blisters) begin to crust over and heal but may occur in some patients who do not produce lesions. Some investigators suggest the pain has to be present for three months to be termed PHN.

What causes postherpetic neuralgia?

Postherpetic neuralgia is thought to be caused by the damage or alteration of nerves that register pain, pressure, and other sensory nerves (for example, touch) that occur when the reactivated HZ viruses travel down nerves to the skin. This process first begins when the virus causes chickenpox in an individual; the viruses can infect various dorsal root ganglia (nerve cells) as the chickenpox subsides. These viruses then can be reactivated, usually decades later, and produce shingles lesions. The reactivation of HZ is thought to be due to a stress on the body from either another infection or a immunocompromised state (for example, some patients undergoing treatments for leukemia) that allows the HZ to escape the dorsal root cells. PHN does not occur in everyone who gets shingles; about 9%-14% have symptoms after one month post-shingles and about 5% have PHN three months post-shingles.

Medically Reviewed by a Doctor on 8/23/2016

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