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.

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Shingles Pictures Slideshow: A Collection of Photos on Shingles

How long does postherpetic neuralgia last?

Only approximately 9%-15% of patients who get shingles develop PHN. For those few patients who develop PHN, the length of time that PHN lasts is variable; the majority of PHN patients have discomfort lasting one to two months. About one-third of PHN patients have symptoms that last about three months, and about one-fifth last a year or longer.

What are the complications of postherpetic neuralgia?

PHN itself is a complication of shingles. A serious complication of PHN is addiction to pain medications. Some patients may have an inability to live a normal lifestyle (unable to exercise) because of constant pain, while others have sleep and activities limited or even prohibited by touching the affected area, including just having contact with their own clothing. Patients taking opioids may become very constipated. In a few cases of PHN, muscle weakness can be an additional complication.

What is the prognosis for postherpetic neuralgia?

For the majority of patients who develop PHN, the prognosis is good although they may have to take pain medications for about one to three months. For others, the prognosis is fair to poor if the pain is severe, lasts longer than three months, or markedly reduces their quality of life. PHN occasionally results in permanent nerve damage; however, the disease is not fatal.

Can postherpetic neuralgia be prevented?

If shingles can be prevented, then PHN can be prevented. Fortunately, the vaccine Zostavax is about 70% effective in preventing shingles. The CDC recommends that everyone older than 60 years of age get the vaccine; in 2011, the FDA approved the vaccine for people aged 50 and above. The CDC states, "Zostavax should not be given to pregnant women, persons with a primary or acquired immunodeficiency, or to persons with a history of anaphylactic reaction to gelatin, neomycin, or any other component of the vaccine. Herpes zoster vaccine can be administered simultaneously with other indicated vaccines."

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCES:

Levine, Norman, ed. "Understanding Postherpetic Neuralgia -- Treatment." WebMD.com. Apr. 7, 2012. <http://www.webmd.com/skin-problems-and-treatments/shingles/understanding-postherpetic-neuralgia-treatment>.

McElveen, W. Alvin. "Postherpetic Neuralgia." Medscape.com. July 3, 2012. <http://emedicine.medscape.com/article/1143066-overview>.

Stone, Jennifer A.M., Gettelfinger, Gary L., and Johnstone, Peter A.S. "Treatment of 13 Patients With Post-Herpetic Neuralgia Using Acupuncture." Journal of the Society for Integrative Oncology 8.4 Fall 2010: 125-130.

United States. Centers for Disease Control and Prevention. "Update on Herpes Zoster Vaccine: Licensure for Persons Aged 50 Through 59 Years." MMWR 60.44 Nov. 11, 2011: 1528. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a5.htm>.

Medically Reviewed by a Doctor on 4/15/2015
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