Post-herpetic neuralgia: when it arises, symptoms and treatment

Post-herpetic neuralgia is a complication of herpes zoster, also known as shingles or shingles, which affects the nerves and skin, causing the appearance of a constant burning sensation in the body, even after the lesions caused by the herpes zoster virus have gone.

Usually, post-herpetic neuralgia is more common in people over 60, but it can occur at any age, as long as you have caught the chicken pox virus during adulthood.

Although there is no cure, there are some forms of treatment that reduce symptoms, improving quality of life. In addition, post-herpetic neuralgia usually improves over time, requiring less and less treatment.

Main symptoms

The most common symptoms of post-herpetic neuralgia include:

• Pain similar to burning that lasts for 3 months or more; Extreme sensitivity to touch; Sensation of itching or tingling.

These symptoms usually appear in the region of the skin that has been affected by herpes zoster lesions, which is why it is more common on the trunk or and only on one side of the body.

The burning sensation may appear before the shingles' lesions on the skin and, in some people, it may also be accompanied by stitch pain, for example.

How to confirm the diagnosis

In most cases, the diagnosis is confirmed by a dermatologist only by observing the affected site and the symptoms reported by the person himself.

Why post-herpetic neuralgia arises

When you get the chicken pox virus during adulthood, the virus causes stronger symptoms and can cause damage to the nerve fibers in the skin. When this happens, electrical stimuli that reach the brain are affected, becoming more exaggerated and causing the onset of chronic pain that characterizes post-herpetic neuralgia.

How the treatment is done

There is no treatment capable of curing post-herpetic neuralgia, however, it is possible to relieve symptoms through various forms of treatment such as:

• Lidocaine dressings: small dressings that can be attached to the site of pain and that release lidocaine, a substance that anesthetizes the nerve fibers of the skin, relieving pain; Capsaicin application: this is a very strong analgesic substance that can reduce pain for up to 3 months with just one application. However, its application must always be done in the doctor's office; Anticonvulsant remedies, such as Gabapentin or Pregabalin: these are drugs that stabilize electrical signals in nerve fibers, reducing pain. However, these remedies can cause side effects such as dizziness, irritability and swelling of the extremities, for example; Antidepressants, such as Duloxetine or Nortriptyline: change the way the brain interprets pain, relieving chronic pain situations like post-herpetic neuralgia.

In addition, in the most severe cases, where none of these forms of treatment seem to improve pain, the doctor may also prescribe opioid medications such as Tramadol or Morphine.

There are treatments that work better for some people than others, so it may be necessary to try various forms of treatment before finding the best one, or even a combination of two or more treatments.