How Is Postherpetic Neuralgia Treated
If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.
If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.
If your pain is mild, your healthcare provider may recommend:
- Acetaminophen or NSAIDs such as ibuprofen .
- Creams and patches include lidocaine and capsaicin .
If your pain is more severe, your healthcare may prescribe:
- Antiseizure drugs gabapentin and pregabalin .
- Antidepressants, such as escitalopram , quetiapine or amitriptyline.
- Botulinum toxin injections in the area where you are having pain.
Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.
Who Gets Postherpetic Neuralgia
About 1 out of 5 people who have shingles will have these sharp, ongoing pains afterward. Certain things can increase your chances of getting it:
- Age: Most people who get postherpetic neuralgia are older than 60.
- Gender: Women seem to get it more than men.
- Early symptoms: People who have numbness, tingling, or itching before a shingles rash even appears tend to get the lingering pain later.
- Pain at the start: If you had severe pain or a rash during the beginning of your outbreak, you have a greater chance of the neuralgia later.
- Other health problems: People with ongoing conditions that can weaken the immune system, like HIV and cancer, seem more likely to get it.
Shingles On The Face: Symptoms Treatments And More
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Shingles on the face
Shingles, or zoster, is a common infection that occurs due to a herpes virus.
Shingles is a rash that usually appears on one side of the chest and back. It can also develop on one side of the face and around the eye.
The condition can be very painful and can sometimes have long-term side effects. No cure for shingles is available, but early treatment can lower your risk of serious complications.
second most common rash site is the face. It can spread from the ear to the nose and forehead. It can also spread around one eye, which can cause redness and swelling of the eye and surrounding area. The shingles rash occasionally develops in the mouth.
Many people feel a tingling or burning sensation days before the first red bumps appear.
The rash starts out as blisters filled with fluid, or lesions. Some people have a few clusters of blisters scattered about, and others have so many that it looks like a burn. The blisters eventually break, ooze, and crust over. After a few days, the scabs start to fall off.
Other symptoms of shingles are:
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How Long Does Postherpetic Neuralgia Last
Postherpetic neuralgia can last for weeks, months, or in some people, years after the shingles rash goes away. In most people, shingles pain goes away in one to three months. However, in one in five people, pain lasts more than one year.
The pain from PHN can be so severe in some people that it disrupts their life. Researchers dont know why some people have severe or long-lasting pain and others do not.
What Is Shingles And Postherpetic Neuralgia
Shingles is caused by the varicella-zoster virus, the virus that also causes chickenpox. In a person who has been exposed to chickenpox — or its vaccine — the virus never really goes away. It can lie dormant in the body’s nerves.
In most cases, it stays that way. But in some — especially people with immune systems weakened by disease or treatment — the virus can reappear. This is likely to happen years or decades after the person had chickenpox.
When it comes back, the virus can cause shingles, a rash that often appears as a band on one side of the body. Early shingles symptoms can include:
- Flu-like symptoms
Itching, tingling, or extreme pain where the rash is developing may come next, and the pain can be moderate to severe.
Are you contagious? Though people who haven’t had chickenpox can catch that condition from you, the shingles itself isn’t contagious.
For reasons that experts don’t really understand, the pain of shingles lingers for some. If the pain lasts for at least 3 months after the shingles rash has healed, a person is diagnosed with PHN. In some people, the pain will subside. In others, it won’t.
“We don’t have any idea why the pain goes away in some people and not others,” says Dworkin. But the longer you have PHN — especially after a year — the less likely it is to resolve, he says.
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How Dangerous Is Shingles
Shingles isnt considered a dangerous health condition.
Each year about 1 million new cases of shingles are reported in the United States. Most people recover and resume their normal activities once theyre no longer infectious.
However, if shingles isnt treated, particularly severe cases can lead to death.
People with autoimmune conditions and people over the age of 65 are at a higher risk for shingles complications.
Women who are pregnant may also be concerned if they develop shingles. You and your baby will most likely be safe. However, talk with your healthcare provider if youre pregnant and suspect you have shingles.
What Should I Do To Avoid/deal With Shingles
With about one million cases of shingles in the U.S. every year, effective prevention and treatment methods are highly valuable.
- The only way to reduce the risk of developing shingles and PHN is get vaccinated against. Two doses of the shingles vaccine is recommended for healthy adults 50 years of age and older. You can visit your local Passport Health clinic for the necessary series of vaccinations. Remember, the shingles shot is different from the chickenpox immunization.
- If you are sick with a bout of shingles and wish to avoid spreading the varicella-zoster virus to others, follow CDC guidelines. Cover the rash, wash your hands often, avoid touching the rash and avoid interaction with people at particular risk. To learn more about how contagious herpes zoster is, you can read more here.
- Antiviral medicines can help treat shingles, and they should be taken as soon as possible. To soothe the herpes zoster rash, try wet compresses, calamine lotion, colloidal oatmeal baths and pain medication.
Did you know that shingles could have so many painful effects? Does someone you know deal with the illness? Will you be getting a shingles vaccine to prevent herpes zoster? Let us know in the comments below, or via and .
Written for Passport Health by Katherine Meikle. Katherine is a freelance writer and proud first-generation British-American living in Florida, where she was born and raised. She has a passion for travel and a love of writing, which go hand-in-hand.
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Causes Of Shingles Pain
Causes of Shingles Pain
The main cause of shingles pain is a viral infection of the nerve root. If you ever had chickenpox, the virus will remain dormant in your body for the rest of your life. As you grow older, your immune system becomes weaker and suppressed from medications or other procedures such as chemotherapy. When your immune system gets weak, the virus can reactivate, causing shingles pain.
Who Should Get The Shingrix Vaccine
The Shringrix vaccine is recommended in healthy adults age 50 and older. There is no maximum age. You should get the vaccine even if:
- Youve had shingles.
- Youre not sure if youd had chickenpox .
- Youve already had the Zostavax vaccine. This vaccine for shingles is no longer available in the U.S. Ask your healthcare provider about the best time to get the Shingrix vaccine.
If you currently have shingles, you need to wait until the shingles rash has gone away. Talk with your provider about the proper time to begin vaccination with Shingrix.
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Who Is At Risk Of Developing Phn
- Up to 1 in 6 shingles sufferers aged 70-79 may develop PHN. 4
- Risk and severity increases with age.
- For more information about shingles and PHN please talk to your doctor.
References:
Week One: Stroke And Heart Attack Risk
While the risk of a post-shingles stroke is highest amongst those whose shingles outbreak impacted their eyes, overall, people with shingles have a 2.4-fold increased risk of stroke and 1.7-fold increased chance of heart attack during the first week after getting diagnosed, found a report featured in the journal PLOS Medicine. While ones risk gradually lessened after that, it takes about 27 weeks to completely roll the risk back to baseline. Its thought that shingles-induced inflammation may lead to blood clots that could then, in turn, cause a stroke or heart attack. Adding to the risk: A spike in blood pressure due to pain and stress associated with shingles.
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Can Shingles Cause Nerve Damage
October 31, 2018 By Will Sowards
When you picture harmful infections, shingles is probably not the first one that comes to mind.
Yet, while the illness may seem to just cause an irritating rash, pain, itching and tingling, it can also cause permanent damage. Some patients may even deal with constant pain for years after infection.
Considering almost one in every three people in the United States will develop shingles in their lifetime, understanding how it works is necessary for millions.
What Are The Pain Complications Of Shingles
Pain, itching, and tingling may continue for several months after the rash healing. At the same time, the pain that remains after the rash has healed may be the most severe complication of shingles. Itching, burning, and pain along the nerves that affect the eyes, nose, mouth, and throat can cause temporary and permanent problems.
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How Is Postherpetic Neuralgia Diagnosed
Postherpetic neuralgia is usually diagnosed based on your symptoms, history of having shingles and physical exam. If youve had a recent case of shingles and have pain in the area where the shingles rash once was, you likely have PHN. Your provider may want to make sure your pain is not caused by something else, but in most cases, no other tests are needed.
Diagnosis Of Shingles In The Eye
Your doctor should be able to diagnose shingles just by looking at the rash on your eyelids, scalp, and body. Your doctor might take a sample of fluid from the blisters and send it out to a lab to test for the varicella-zoster virus.
An eye doctor will examine:
- help the rash fade more quickly
Starting the medicine within three days after your rash appears can help you avoid long-term shingles complications.
To reduce swelling in your eye, your doctor might also give you a steroid medicine in the form of a pill or eye drops. If you develop postherpetic neuralgia, pain medicine and antidepressants can help relieve the nerve pain.
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Month Two To Three: Lingering Itch
The lasting itch one can experience once the shingles rash clears is called postherpetic itch and it most commonly develops on the face and on skin thats already suffered sensory loss. Translations: Your skin is likely already feeling numb there. And since individuals are more likely to scratch numb skin too long and too vigorously, its important to turn to your healthcare provider for advice. He or she will likely suggest topical local anesthetics to help quell the urge to itch.
Reducing Nerve Pain From Shingles
Pharmaceuticals and vaccination for herpes zoster.
Shingles is virtually synonymous with pain, whether it be from the rash itself, from postherpetic neuralgia , or postherpetic itch . Additionally, it can lead to serious complications involving the eye, including vision loss and blindness, as well as pneumonia, hearing problems, brain inflammation, and even death.
Treatment of the virus typically begins with antiviralsand the sooner the better. Acyclovir, valacyclovir, and famciclovir are most commonly used to treat shingles. They should be administered as quickly as possible after the onset of symptoms to shorten the severity and length of the illness.
Additionally, there are simple self-care steps that can be followed to help reduce the pain and discomfort of shingles.
Long-term nerve pain from PHN is the most common complication of shingles and is experienced by up to 20% of patients with shingles The risk of PHN increases with age, as does the severity and length of pain, which can persist for months or even years.
The FDA has approved the use of analgesics, anticonvulsants, and lidocaine and capsaicin topical patches for treating PHN.
PHI, which can occur in conjunction with PHN, is caused by sensory fibers in the nerves that were damaged or died during the shingles infection. The remaining isolated nerve fibers fire when they shouldn’t, generating false sensations that fool the central nervous system.
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What Can I Take To Feel Better
Your doctor has a host of ways to treat your pain after shingles, including a variety of medications. They include:
Anticonvulsants: These medications were developed to control seizures, but they can also help reduce the pain of postherpetic neuralgia. Examples are:
Talk to your doctor or pharmacist about side effects of any new prescription or over-the-counter medication.
Your Good Health: Nerve
Dear Dr. Roach: I am a 78-year-old woman, and I am in my 10th week of shingles. I have them on my left chest and back and on my upper arm. I cant go anywhere because I cant stand when my clothes or bra touches me. I now have severe shooting pains on my arm area, mostly at night but also during the day. The rash on my chest, although mostly healed, is still very painful. Im desperate for help. I use lidocaine, which helps for an hour or so. This is my second bout of shingles. I had them 10 years ago. I was advised by my internist not to get the shingles vaccine after that last bout. Is there anything I can do?
P.C.
Shingles, also called herpes zoster, is caused by the recurrence of the chickenpox virus after years or decades of the virus being dormant. The herpes virus can escape the immune system during times of stress or simply as we age.
Pain around the time of shingles is nearly universal, but the duration of time is variable. The type of pain you have now is caused by damage to the nerve and is called acute neuritis.
Once the pain has lasted more than four months, the diagnosis of postherpetic neuralgia is made. Unfortunately, postherpetic neuralgia can last a very long time for people over 65 with persistent, active PHN, the average duration of symptoms was about three and a half years.
Treatment of acute zoster, preferably within 24 hours of the onset of rash, but certainly within 72 hours, with antiviral medications can also help prevent PHN.
K.J.
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Spinal Cord Or Peripheral Nerve Stimulation
These are often used to treat several different types of neuropathic pain. Electrodes are placed underneath the skin along the affected peripheral nerves. Before using this technique, doctors will do a test using a wire electrode to get a sense of how the patient will respond.
After the electrodes have been placed above the peripheral nerve, a weak electrical current is sent to the nerve. By stimulating a sensory pathway that doesnt cause pain, experts believe that this electrical signal to the brain can trick the brain into turning off the painful signal, bringing relief to the patient.
How Is Shingles Diagnosed
If you have symptoms of shingles, especially if they involve your face, see your doctor or ophthalmologist right away.
Doctors can usually diagnose a shingles rash by performing a physical exam. Your doctor can also take a scraping of your skin rash and send it to a lab for examination under a microscope.
Its particularly important to seek treatment if you have a compromised immune system. Early treatment can help cut down on your chances for serious complications.
Shingles will have to run its course, but quite a few treatment options are available. These include:
- antiviral drugs
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Shingles And Nerve Paths
Shingles is caused by a reactivation of the virus that causes chickenpox. Only people whove had chickenpox or chickenpox vaccines can develop shingles. Having a chickenpox vaccine can lead to shingles because the vaccine contains the virus that causes chickenpox.
Shingles isnt contagious, but people who have not had chickenpox can develop chickenpox if they come in contact with open blisters of somebody with shingles.
After your body fights off a chickenpox infection, the herpes zoster virus remains dormant in your cranial nerves and spinal ganglia until it becomes reactivated. Spinal ganglia are nerve cells that connect your spinal cord to nerves in your body and limbs.
The virus reactivates when your immune system is no longer able to suppress it. Reactivation most commonly occurs in older adults because the immune system tends to get weaker with age, as well as in people with suppressed immune systems.
Once the virus is active, it usually spreads down sensory nerve fibers that lead from your spinal cord to your skin. These nerves carry sensory information like feelings of pain, itchiness, or pressure from your skin to your spinal cord and brain.
Once the virus gets to the end of these sensory nerves, it reaches your skin and usually leads to a rash. This rash often shows up in one or two nearby areas of skin called dermatomes.
A dermatome is an area of your skin where the sensation is supplied by one spinal nerve.