Are There Other Ways To Ease The Pain
Most people with postherpetic neuralgia use medication to control their symptoms. But there are other ways to control the pain, too. They include:
TENS : You use a device that shoots tiny electrical currents into the area of pain on the skin. This helps block the pain.
Cold packs: Try a gel-filled one to numb the area unless cooler objects make your neuralgia worse.
Comfortable clothes: Go for looser fits and fabrics such as cotton and silk.
Shingles On The Face: Complications And Treatment
Potential for serious complications is very real.
The red rash and lesions associated with shingles can erupt anywhere on the human body. It all depends on which nerves are affected by the reactivation of the varicella zoster virus that remained in the body after an earlier case of chickenpox.
Although the front and back of the torso are the usual sites of the rash, the face will be affected when the virus reactivates in the trigeminal nerve, which handles face and motor functions. When this happens, the patient is at risk for potentially serious complications like facial pain, numbness, tingling, or paralysis damage to the eyes, and hair loss.
The shingles rash generally appears on just 1 side of the affected body part, and the face is no exception. The fluid-filled blisters can extend to cover the mouth, eye, ear, forehead, nose, and scalp. Early diagnosis and treatment can help limit the length of the infection and its complications, including postherpetic neuralgia.
Two of the most serious threats from shingles on the face are herpes zoster ophthalmicus and herpes zoster oticus, which involves the ear.
Herpes zoster ophthalmicus , or ocular shingles, is a growing health risk in the United States, according to an article published in the American Academy of Ophthalmologys EyeNet Magazine.1 It reports that cases are on the rise and account for approximately 10% of all shingles cases.1
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.
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If You Have Shingles Symptoms Get Treatment Now And You May Avoid Permanent Nerve Pain
Shingles, a viral infection of the nerve roots, affects 1 million people in the U.S each year. Most people recover from their bout, but for as many as 50% of those over age 60 who have not been treated, the pain doesn’t go away. It can last for months, years, or even the rest of their lives.
These people have what’s called postherpetic neuralgia , the result of the shingles virus damaging the nerves of the skin. In some cases, the pain is mild. In others, even the slightest touch — from clothing or even a breeze — can be excruciating.
“PHN causes a great deal of suffering and high social costs,” says Robert H. Dworkin, PhD, a professor in the department of anesthesiology at the University of Rochester Medical Center in Rochester, N.Y. “It can severely disrupt people’s lives.”
But the good news is that there are drugs that can help treat and even prevent PHN, and doctors are learning more about who is at greatest risk of developing this debilitating condition.
Soak In A Colloidal Oatmeal Bath
This DYI option hasnt been tested for shingles specifically but experts say it may provide some skin relief while your rash is still acting up. Colloidal oatmeal is made by grinding oats into a fine powder . A study in the Journal of Drugs in Dermatology found that this natural remedy has antioxidant and anti-inflammatory properties which can make it helpful in treating irritated skin. Add colloidal oatmeal to a bath of cool or lukewarm water and soak for about 10 minutes, once per day, for as long as your rash lasts.
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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.
Shingles And Postherpetic Neuralgia
After you have had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. Postherpetic neuralgia is the most common complication of shingles. PHN is pain resulting from a herpes zoster outbreak along the trigeminal nerve. Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles.
Damaged fibers cannot send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic pain. The most common area to have PHN is along the torso, but pain in the face can also occur. The sensation may be of intense burning or stabbing, and it may feel as if it is shooting along the course of the affected nerve.
PHN typically starts during the shingles outbreak, but lasts after the rash and blisters have healed. Chicken pox causes shingles later in life. People over the age of 60 have an increased risk of shingles. Treatment for PHN does not cure it, but aims to minimize its symptoms.
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Risk Factors For Nerve Pain After Shingles
Researchers have long known that older people are more likely to get PHN, the nerve pain after shingles, but recent studies have found other factors that increase risks.
In one study published in the journal Neurology, researchers including Dworkin looked at data from 965 people with shingles. The researchers identified five risk factors for developing PHN in people who had been recently diagnosed with shingles:
- Presence of symptoms before the rash appeared, like numbness, tingling, itching, or pain
- Severe pain during the illnesss initial stages
Importantly, the researchers found the more risk factors you have, the greater the risk of developing PHN.
For instance, 17% of women with shingles and 26% of those who had severe pain went on to get PHN. But 50% of women who were over age 60 and had symptoms before the rash, severe rash, and acute pain went on to get PHN.
Have Shingles Get Treatment Take Action
If you have shingles, it’s important to talk to your doctor about your risk for developing PHN. Ask whether preventative treatment with antiviral drugs makes sense. If your doctor says it’s not necessary, ask why.
The full implications of the psychological risk factors for PHN aren’t clear yet, says Dworkin. But he suggests that people with shingles should try to stay active and connected.
“If psychological distress is a risk factor for PHN,” he says, “then we think that people who have shingles might benefit from getting out and not being isolated and homebound.”
You might make an effort to stay connected to family and friends and not to dwell on your symptoms. Also, keep in mind that even if you do develop PHN, there are treatments that can help.
“We have about a half dozen types of drugs that are used as first-line treatments for PHN,” says Dworkin. They include lidocaine patch , pregabalin , gabapentin , capsaicin , carbamazepine , tricyclic antidepressants, and painkillers.
The most important thing is to get prompt medical attention if you think you might have shingles.
“If you have a one-sided rash — especially if you’re over 50 — see your doctor right away,” says Dworkin. “It could be shingles. And we know that prompt treatment can dramatically reduce the likelihood of developing long-term pain.”
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Best Treatments For Lasting Shingles Pain
Postherpetic Neuralgia Pain: What Works, What Doesnt
Doctors call it postherpetic neuralgia or PHN. Its caused by nerve damage left behind by a case of shingles. Shingles itself comes from reactivation of a chickenpox virus, varicella zoster. The virus travels down nerve fibers to cause a painful skin rash.
When the rash goes away, the pain usually goes with it. But for 12% to 15% of people the pain remains. If your shingles pain lasts eight to 12 weeks after the rash goes away, youre part of an unfortunate minority, says pain researcher Andrew S.C. Rice, MD, of Imperial College, London.
Among people with PHN, some have their pain resolve in the first year to 18 months after the shingles rash goes away, Rice tells WebMD. But if they have pain longer than that, it is not going to go away on its own. In either case, a person must deal with the pain.
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Peripheral Electrical Nerve Stimulation
PENS is a potentially ground breaking advance in the treatment of post-herpetic neuralgia, as it can be used to treat its severe symptoms of pain in an effective way without the use of strong medication or invasive surgery. Using PENS in the treatment of post-herpetic neuralgia is an effective method without the use of strong medication or invasive surgery.
PENS is actually a fusion of the benefits of TENS , with electro-acupuncture. In essence it harnesses the benefits of both into a very effective way of treating pain. TENS is a more familiar treatment, whereby electrical impulses, without needles are passed through the skin to treat the nerve endings and stop them from feeling pain. PENS is slightly different in the sense that the electrical impulses are delivered through the skin.
This fundamental difference in the two applications is actually quite an important one because PENS can directly target the nerve endings that are causing the nerve pain. When a TENS procedure is used, the skin can often act as a barrier and some of the electrical stimulation is lost through the skins natural defenses, so a PENS system can get straight to the root of the problem and none of the potency of the electrodes is lost.
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Lasting Pain After Shingles
Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. Its still not clear how it can be prevented or what the best treatment is.
Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word “post-herpetic” means “post-herpes” because the pain arises after infection by the herpes zoster virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.
The main symptom of post-herpetic neuralgia is pain in the nerves . The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.
Nerve Blocks For Shingles Pain
The same virus responsible for chicken pox during childhood causes shingles pain as an adult. The virus becomes active in nerve tissue causing severe pain usually on one side of the body. This occurs more frequently in people older than 60, but can occur in younger individuals. Shingles usually presents in sharp pain followed by a rash. The more likely areas to be affected include the chest or abdomen, and less frequently, the face, the arms, or the legs.
Reasons for treatment
A shingles infection causes a very severe nerve inflammation that if left untreated can evolve into a more severe form of the disease called post-herpetic neuralgia. This disease is a complication of shingles where nerves and their blood supply have been severely damaged from inflammation. Typically. the older you are and the more pain you have during your shingles episode, the more likely it is for you to develop permanent pain. Blocking the pain in the affected nerves using strong numbing medicines and anti-inflammatories will shorten the actual shingles pain and may decrease the chance of developing severe nerve damage and chronic pain.
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What Is Postherpetic Neuralgia
Postherpetic neuralgia is a condition of recurring or persistent pain in an area of the body that has undergone an outbreak shingles .
When the shingles virus damages nerve cells of an infected area, it often causes a painful skin rash that appears as a patch or line of painful blisters on the skin in the shape of a band. The band of blisters follows the distribution of the nerve where the virus was present before it spread to the skin.
Postherpetic neuralgia is a painful condition that often begins after shingles lesions begin to crust over and heal, but it may occur when lesions are not produced by the virus.
Who Is At Risk Of Getting Shingles
Shingles typically affects older people, but it can also occur in healthy younger persons and even in children. Those whose immune systems have been weakened by cancer, HIV infection, AIDS, or treatment with certain medicines are also at increased risk of getting shingles.
- Anyone who has had chickenpox is at risk of getting shingles later in life. About 1 in 3 people who have not been immunised against chickenpox or shingles will get shingles in their lifetime.
- Shingles usually affects older people. The older you are if you get shingles, the higher your risk of getting serious disease. People who have a weakened immune system are also at risk of getting more severe disease, even if they are young.
- Women have a higher risk of getting shingles than men.
- Most people who develop shingles have only 1 episode during their lifetime. However, you can have shingles more than once.
An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.
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Help Is Available For Phn
Fortunately,early treatment for shingles can lower your chances of getting PHN.
For some people, the pain becomes refractory, or resistant to treatment, explains Dr. Rosenquist. So we want to treat shingles as fast as we can ideally as soon as somebody feels a tingling or burning sensation, even before a rash develops.
Sheadds that whenever nerve pain is involved, some people respond to treatment andsome dont.
However,medications taken orally or injected that can target the affected nerves may beable to stun the nervous system into behaving properly. That meanstransmitting the appropriate signal to the brain.
The Emotional Toll Of Nerve Pain After Shingles
Researchers are not just looking at biological and neurological risk factors for PHN. Dworkin was also a co-author of a study looking at psychological risk factors, too. The results were published in the Journal of Pain in 2005.
“It certainly looks like psychological stress can be a potent risk factor for PHN,” Dworkin tells WebMD.
The study showed that people with shingles who went on to develop PHN were more likely to have had symptoms of personality disorders, hypochondria, intense worry about their disease, and other bodily complaints.
Dworkin says previous studies have already shown a connection between stress and shingles development.
“One study even found that the risk of developing PHN was higher in people who were living alone when they developed shingles than people living with others,” Dworkin says, perhaps indicating that social isolation increases the risks of PHN.
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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.
Types Of Facial Nerve Paralysis
Facial nerve paralysis is often described as central or peripheral. Central facial nerve paralysis is caused by a problem affecting the brain. It causes weakness in the lower part of the face. Peripheral facial nerve paralysis is caused by a problem affecting the nerve. It causes weakness in the whole face, including the forehead.
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