Managing the Pain of Postherpetic Neuralgia

Medically Reviewed by Minesh Khatri, MD on August 19, 2021
2 min read

Postherpetic neuralgia (PHN) is a painful, chronic condition that can occur following shingles, a viral infection that causes a mildly itchy to intensely painful rash.

PHN occurs most often in elderly people and in people whose immune systems have been compromised.

The pain of PHN, which occurs in the same area as the pain and rash of shingles, results from damage to nerve fibers during the shingles infection. Shingles is caused by a reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Anyone who has had chickenpox can get shingles, but the disorder is most common in people over age 60.

In PHN, pain is intense and may be described as burning, stabbing, or gnawing. Affected areas of the body may be hypersensitive or may have decreased sensation. In addition, areas previously affected by shingles may show evidence of scarring.

PHN usually is diagnosed when pain lasts three months or more after an acute attack of shingles or appears after the skin lesions of shingles have healed.

PHN is treated with medications including over-the-counter lidocaine patches, prescription pain relievers, anticonvulsants, antidepressants, or topical capsaicin. For many people, PHN may improve over time without treatment.