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Treatment of Herpes Pain

one in 5 people with shingles will get Post- Herpetic Neuralgia. PHN is the most common complication of shingles infection.  Shingle is caused by reactivation of the Varicella-Zoster Virus. It appears after the rash and blister of shingles disappear.

The chickenpox ( herpes zoster) virus causes shingles. The risk of PHN increases with age, more than 60 year. Post-herpetic neuralgia means, nerve pain after herpes.

Symptoms:

  • It occurs in area of skin, where the shingles, outbreak first occurred. Most commonly a band pattern around your trunk, usually one side of your body.
  • As rash or blisters go away, pain may remain
  • Pain that lasts 3 month or longer, after the shingle rash has healed. This pain is burning, sharp deep aching pain.
  • Increase sensitivity to light, touch. People can not bear the touch of clothing on the affected area. (allodynia)
  • Itching and numbness in the area of rash.
  • Pain that is constant or comes and goes
  • Pain gets worse at night or in heat or cold temperature.

Causes:

  • Once you have chickenpox, the virus remains in your body for rest of your life,.
  • As you become elder, or when your immune system is suppressed, such as from medication, the virus reactivate causing shingle
  • If your nerve fibers are damaged during the outbreak of shingle, post-herpetic neuralgia occurs.
  • The nerve fibers at the skin in the affected area send exaggerated pain signal to your brain..

 

Risk factor: 

  • You are older than 50
  • Severity of shingles: if you have severe rash and intense pain
  • Associated illness like diabetes
  • Shingles location – shingle on face and torso
  • Delayed anti-viral  treatment: if treatment is delayed more than 76 hours, after your rash appeared.

Complication:

  • It depends on how long PHN lasts and how painful it.
  • Other symptoms might be associated with chronic pain
  • Depression, fatique
  • Difficulty sleeping, lack of appetite
  • Difficulty in concentrating
  •  

Prevention;

  • The centre of disease control and prevention recommend shingrix for adult,, and more than 50.
  • 2 dose of shingrix is more than 90% effective in preventing shingles and post-herpetic neuralgia

How PHN is treated?

  • Start anti-viral medication( Acyclovir) as soon as the rash appear.. These medications help the radh heal faster, decrease pain and itching.
  • Lignocaine 5%, topical application plays a great role in healing.
  • Neuropathic medications like, pregabalin, gabapentin for burning pain.
  • Anti-depressants medications like Amitryptiline or Escitalopram
  • Botulinum Toxin( botox) injection in the area, where you have pain.
  • There is no clear cut superior treatment for PHN.
  • You may need more than 1 medications for pain relief.