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Post-Herpetic Neuralgia

Overview

Post-herpetic neuralgia (PHN) is caused by damage that occurs to the peripheral nerve fibers during a shingles infection. On average, one out of every five patients with shingles develops PHN. However, the risk of having the condition increases with age. People over age 60 who have had shingles have as much as a 50 percent chance of developing PHN.

Our Approach to Post-Herpetic Neuralgia

Post-herpetic neuralgia (PHN) can cause intense pain that may linger for months. At UCSF, we specialize in treating patients whose pain hasn't responded to more common treatments for PHN. We offer many pain relief options, including skin patches with high levels of capsaicin, a compound found in jalapeño peppers that can alleviate PHN pain.

Our team of experts reviews each patient's case thoroughly to determine the best treatment or combination of treatments for that individual. Our goal is to reduce or eliminate pain, allowing our patients to return to the activities they enjoy.

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    Among the top hospitals in the nation

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    Best in California and No. 2 in the nation for neurology & neurosurgery

Signs & symptoms

Pain associated with post-herpetic neuralgia (PHN) can be very intense, often described by patients as deep, aching and unbearable. In some cases, even a light touch, like the pressure of a shirt or gust of wind, can cause intense pain.

Because of the intensity of pain, it can interfere with daily life, including sleep and appetite. Depression is common because of the severe pain and social isolation that can occur.

Some PHN patients have to stop their normal activities for months. And for some, the pain can last for several years.

Diagnosis

There are no specific tests available to test for post-herpetic neuralgia (PHN). However, people who have recovered from shingles and experience an ongoing pain in the region affected by the initial shingles rash, should contact their doctor to determine if they have developed PHN.

Treatments

There are a variety of effective pain relief medications, but unfortunately no cure for post-herpetic neuralgia (PHN). In most cases, the pain of PHN subsides with time.

Treatment options that provide pain relief include:

  • Skin patches
  • Anti-seizure medication
  • Narcotic analgesics
  • Antidepressants

At UCSF Medical Center, pain management specialists also use a skin patch with capsaicin, a hot-pepper compound that's found in jalapenos, that has been effective in treating this pain/

The effectiveness of treatment varies widely among patients. The Food and Drug Administration (FDA) has approved a lidocaine skin patch for PHN pain and an anti-seizure drug, called gabapentin. Narcotic analgesics and antidepressant medications also have been effective.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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