Postherpetic Neuralgia: Finding The Right Treatment For You
Experts agree that for everyone at risk, prevention is the best treatment. Although it’s too early to see a benefit from vaccination in the community, Ralph believes that it shows promise.
For those who have postherpetic neuralgia, treatment needs vary widely. “Some people may only need a few months of a topical anesthetic,” Rumbaugh tells WebMD. “Others — not many, thank goodness — take multiple medicines for the rest of their lives and still have pain.”
Finding the right treatment for persistent postherpetic neuralgia can be a long and frustrating process. “It can take several weeks to really give a medicine a chance to work,” Rumbaugh says. “If it’s not working, you have to start all over again.”
The important thing is not to give up. People with severe postherpetic neuralgia should see a neurologist or pain expert, says Rumbaugh. “There are people who think their pain isn’t treatable, who simply haven’t been tried on the right doses of the right medicines. There’s usually something more we can try.”
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Treating Pain After Shingles
ROCHESTER, Minn. Many older adults who develop shinglesface a second whammy: severe pain caused by postherpetic neuralgia.
The October issue of Mayo Clinic Health Letter explains this painful and common complication of shingles. Some studies have shown that half of the people 60 years and older who develop shingles experience this complication.
Shingles occurs when the chickenpox virus, present and dormant in those who had chickenpox, becomes reactivated. Age, illness, stress or medications that suppress the immune system can contribute to reactivation. The virus travels along nerve fibers that extend to the skin and typically shows up as a trail of rash and blisters. They most often present as a band around the trunk, usually just on one side. Postherpetic neuralgia occurs if nerve fibers are damaged during the shingles outbreak. The result is excruciating pain that may persist for months or even years after the disappearance of the shingles rash and blisters.
Signs and symptoms of postherpetic neuralgia generally occur in the same area as the shingles outbreak. The pain may be sharp, burning, or deep and aching. Sensitivity to light touch, even the touch of clothing, can be extreme.
There is no single treatment to manage postherpetic neuralgia. Usually, a combination of strategies will be used. They may include:
- Skin patches for topical pain relief
- Anti-seizure medications that stabilize abnormal activity in the nervous system
- Opioids and other pain medications
For Some Pain From Shingles May Linger And Become Long
Dear Mayo Clinic:
I have been diagnosed with shingles of the trigeminal nerve affecting my face. How do I reduce the pain in my head and eye after having shingles?
Answer:For most people, the pain from a case of shingles usually fades as the rash disappears. But for some, the pain may linger and become a long-term condition. A variety of treatments may lessen this pain, but the condition can be challenging to treat.
Shingles is a localized form of chickenpox. Once you’ve had chickenpox, the varicella-zoster virus that caused it remains in your body for the rest of your life. As you grow older, the virus can reactivate. Sometimes this occurs when your body is stressed because of another infection or due to medications that suppress your immune system, for example. The result is shingles. Because you have some immunity against the virus, rather than getting a full body rash, the rash occurs in areas of skin supplied by the nerve where the virus is reactivated.
Shingles typically involves a bandlike rash on the chest, abdomen or face that is usually quite painful. Most people recover from shingles in a few weeks without other problems, but a small number continue to have severe pain in the same distribution that was irritated when the virus returned. Pain that lasts for three months or more is called postherpetic neuralgia.
If medications aren’t enough, procedures such as nerve blocks or steroid injections may help lessen postherpetic neuralgia.
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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.
How Long Does Shingles Last Untreated
You may want to allow the shingles to heal on their own. However, you must be ready to bear the pain for long period of up to five weeks. Most doctors advise you to get treatment as soon as you can as allowing it to heal on its own may lead to complications.
Dr Wheeler encourages people to visit their health care as soon as the symptoms of shingles appear. He further explains that prompt intervention curtails chances of infection consequently decreasing chances of complications.
As much as shingles is nothing to scare you, you should not leave it untreated and in the open. This is so as to avoid any possible spread. Apart from that, if shingles will prevent you from going to work, just get treated because leaving it untreated will force you to spend so much time away from what you love doing for a longer period.
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How I Avoided Shingles Horror
Let me tell you how Julissa Clays program achieves what it does and youll see for yourself.
Youre possibly aware that shingles are caused by the varicella-zoster virus.
Remember chickenpox? The varicella-zoster virus has been with you since you got rid of that illness which was possible decades ago.
Our immune systems beat and then suppress the virus so that it no longer harms us. However, the virus still lies dormant in our nerve cells. Our immune system keeps it in check so that it does us no further harm.
However, if the immune system falters the varicella-zoster virus reactivates. And shingles are the result.
Most people had chickenpox when they were young. They, therefore, carry the varicella-zoster virus. Many never go on to get shingles. Their immune system wins out and varicella-zoster remains dormant for life, never getting the chance to resurface.
Many others do get the illness. Millions every year, in fact. Im one of those people. You are too. Basically, our immune system fought a losing battle and the virus has run rampant throughout the nervous system.
If youre suffering right now I dont need to describe the consequences of this.
But, as you now realize, its not only the suffering we go through in the first 4 6 weeks that causes problems. The mix of a weakened immune system and a system-wide attack on nerves is very dangerous.
Shingles lead to complications with intensely painful PHN its most common complication.
How To Prevent Transmission
You cant catch shingles, and you cant give shingles to someone else. But you can give others chickenpox.
After you have chickenpox, the varicella-zoster virus stays dormant in your body. If this virus reactivates, shingles occurs. Its possible to transmit this virus to others who arent immune while the shingles rash is still active. You are contagious to others until all areas of the rash are dried up and crusted over.
To catch the varicella-zoster virus from you, a person has to have direct contact with your rash blisters.
You can help prevent your transmission of the varicella-zoster virus by:
- keeping the rash loosely covered
- practicing frequent handwashing
- avoiding contact with people who may not have had chickenpox or who havent been vaccinated against chickenpox
Last medically reviewed on August 24, 2017
10 sourcescollapsed
- Cohen KR, et al. . Presentation and management of herpes zoster in the geriatric population.
Also Check: How Does One Catch Shingles
What Shingles Rash Looks Like
With shingles, the first thing you may notice is a tingling sensation or pain on one side of your body or face. Painful skin blisters then erupt on only one side of your face or body along the .
How long do shingles rash last A 30-year-old member asked: I have recurring skin rashes in different areas that appear like fever blisters or shingles and itch. i never had chicken pox. it lasts a couple wks. ?
Shingles causes a painful rash, itching, and burning skin, and lasts for 3 to 5 weeks in most cases. People usually only experience shingles once, but the infection can recur.
Treatment For Shingles On Scalp
Shingles is most commonly diagnosed and treated by a primary-care physician or an emergency-room physician. For certain individuals who develop complications of shingles, a specialist in ophthalmology, neurology, or infectious disease may also be involved.
The treatment for shingles is aimed at diminishing the effects of the virus, as well as pain management. There are several medications that can be used, and your doctor will discuss the best treatment options for your particular situation.
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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.
How Long Does Shingles On The Scalp Last
Not every case of scalp shingles lasts for the same amount of time. It will depend on your immune health. Even in people with healthy immune systems, shingles can last for weeks.
Lets examine the different stages of shingles, and how long each lasts:
So, from start to finish, shingles usually lasts anywhere from two to six weeks.
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Is It Possible To Avoid Shingles
Most people get shingles only once, but it is possible to get it two or more times.
Anyone who has had chickenpox can get shingles later in life. There is a shingles vaccine that may help prevent shingles, or make it less painful. The vaccine is recommended for adults ages 60 and older, even if theyve previous had shingles.
For children and adults who never had chickenpox, there is a vaccine that can help avoid getting the virus that causes both chickenpox and shingles.
For anyone who has never had chickenpox and has not received the chickenpox vaccine, it is best to avoid contact with people who have shingles or chickenpox. Fluid from shingles blisters is contagious and can cause chickenpox, but not shingles.
What The Shingles Solution Did For Me
The program did four things for me. These are essential for anybody suffering shingles right now. They were crucial to my quick and full recovery:
I had shingles for less than half the time most other people have it. And I suffered zero after-effects.
If you have to have shingles this is the way you want to have it!
And do be clear about this: there is nothing unusual about the outcome I enjoyed. I wasnt some rare, lucky person.
Put plainly, thousands of people with shingles take this natural, evidence-based approach to their illness and get well quickly with minimal pain and no after-effects.
Others trust drugs and pharmaceuticals only and take their chances. That as my brother found out can end very badly.
Recommended Reading: What Is Shingles And How Do You Get It
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.
What Outcome Can I Expect If I Have Postherpetic Pain
Theres no standard treatment for the symptoms of postherpetic pain . Depending on the severity of your pain, you may start with over-the-counter products. If your pain is more severe, one or more prescription medications may be tried. PHN is difficult to treat. Achieving a complete symptom-free state was achieved in less than half the patients with PHN, according to one study.
PHN tends to happen in older individuals who may have other health conditions, which can complicate treatment and results. Pain can last weeks, months and even longer than a year. In some people, the pain can be debilitating. In most people, PHN lessens with time.
A note from Cleveland ClinicThe best way to not get postherpetic neuralgia is to prevent it from happening in the first place. Varicella-zoster virus causes both chickenpox and shingles. Vaccines are available to protect against developing both of these viral infections.
Once you develop chickenpox, the varicella-zoster virus remains in your body for life. If the virus reactivates and causes shingles, you have a few days around the rash outbreak to see your provider and get an antiviral medication, which can significantly lessen your symptoms. Still, if you develop PHN, your provider has many medications available to manage your symptoms.
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Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later
After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.
Can I Get Shingles More Than Once
You may have heard that if youve already had chickenpox once, you cant get it again. It might make sense, then, to assume that the same goes for shingles. After all, its the same virus, right?
However, its a misconception. First of all, you can develop chickenpox a second time if youve already had it once. Its quite rare, but it is indeed possible.
Secondly, shingles arent the same as chickenpox. Even though the same virus is responsible for both conditions, they are entirely different. Getting shingles a second time isnt as rare as getting chickenpox twice. When your bout of shingles goes away, the virus goes back into hibernation. This means that it has the potential to become active again later in your life.
In the first few years after your first bout of shingles, the chances of getting it again are slim. In fact, the chance of developing shingles again is lower than it is for someone who has never had it. As the years go on, the odds go up again. Eventually, you have about the same chance of developing shingles as everyone else.
Luckily though, it is extremely rare to develop shingles a third time.
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