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What Are the Symptoms of Postherpetic Neuralgia?

Medically Reviewed by Carmelita Swiner, MD on August 28, 2020

For most people, shingles lasts about a month, and the symptoms fade with their rash. But some people -- usually older folks -- can feel pain long after their blisters heal.

This condition is called postherpetic neuralgia.

It happens if your nerve fibers become inflamed or damaged during a shingles outbreak. This will send the sensation of tingling or pain to your brain. It can cause ongoing pain, and sometimes it can be severe.

Call your doctor if you’ve had shingles and continue to feel pain in the areas where the blisters were. They may be able to give you treatments to ease your symptoms.

What Does It Feel Like?

You usually feel the pain on one side of your body, where the blisters appeared. The feeling is described as shooting, sharp, or stabbing. Other signs you have neuralgia include:

It hurts to be touched: Sometimes, you can’t bear clothing rubbing on your skin. You might feel discomfort from a light breeze.

Long-lasting pain: This condition can last 3 months or longer after the shingles rash has healed. In some people, it’s permanent. For most, it gets better over time.

Other sensations: Sometimes, you might feel burning, itching, tingling, or aching along with the shooting feelings. Some people feel numb or get headaches.

You may also get a fever and generally feel worn out. If you had blisters on your face, you’re more likely to get the neuralgia.

Should I Call My Doctor?

If you think you have shingles, call your doctor right away. Early treatment can lower your chances of getting postherpetic neuralgia.

Make an appointment if you have pain that is severe or lasts longer than one week after your shingles has run its course. This is especially true for people older than age 60, who are more likely to have this condition afterward.

Your doctor can talk to you about a mix of medications and other treatments to make you feel better.

What About a Vaccine?

Two FDA-approved vaccines, Zostavax and Shingrix, are available.

A vaccine is recommended if you’re age 60 or older and may even be helpful for those as young as age 50 in certain medical situations. The vaccines cut the chance of shingles by at least by 50% in people between ages 50 and 59. Even if you still get it, the vaccines can shorten the period of pain and reduce your risk of developing postherpetic neuralgia. Once you’ve gotten shingles, though, getting the vaccines won’t do anything to stop postherpetic neuralgia.

Talk to your doctor about the vaccines if you’ve had chickenpox but haven’t gotten shingles. The same virus causes both, and chickenpox always comes first.

WebMD Medical Reference

Sources

SOURCES:

Columbia University Department of Neurosurgery, “Postherpetic Neuralgia,” “Postherpetic Neuralgia: Signs and Symptoms.”

Mayo Clinic, “Postherpetic neuralgia; Causes.”

National Health Services UK, “Post-herpetic neuralgia: Signs and Symptoms.”

UCLA, “Postherpetic Neuralgia: Symptoms.”

CDC: “Shingles (Herpes Zoster): Overview.”

American Academy of Family Physicians:“Shingles.”
Center for Shingles and Postherpetic Neuralgia: "Surgical options for treating postherpetic neuralgia," "Treating shingles with tricyclic antidepressants to lessen the risk of PHN."

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