Overview
Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. It causes a burning pain in nerves and skin. The pain lasts long after the rash and blisters of shingles have gone away.
Postherpetic neuralgia mainly affects people older than 60. There's no cure, but treatments can ease symptoms. For many people, postherpetic neuralgia gets better over time.
Symptoms
Postherpetic neuralgia symptoms usually happen in the same area of skin where you had a shingles breakout. Often, a shingles rash looks like a band on one side of the body, typically on the torso.
Postherpetic neuralgia symptoms might include:
- Pain that lasts three months or longer after the shingles rash has healed. The pain may feel like sharp burning or jabbing. Or it may feel deep and aching.
- Being bothered when skin is touched. People with postherpetic neuralgia often can't bear even the touch of clothing on the area of skin that had the rash.
- Itching or loss of feeling. Less often, postherpetic neuralgia can cause an itchy feeling or numbness.
When to see a doctor
See a healthcare professional at the first sign of shingles. The pain of postherpetic neuralgia may start before you notice a rash. If you start taking virus-fighting medicines called antivirals within 72 hours of getting the shingles rash, the risk of having postherpetic neuralgia is lower.
Causes
The chickenpox virus causes shingles. If you've had chickenpox, the virus stays in your body for the rest of your life. The virus can become active again and cause shingles. This risk goes up with age. The risk also rises if something weakens the body's immune system, such as chemotherapy medicines to treat cancer.
Postherpetic neuralgia happens if nerve fibers are damaged during a breakout of shingles. Damaged fibers can't send messages from the skin to the brain as they usually do. As a result, the messages become confused, and the body cannot manage pain signals and pain levels. Pain can last months or even years.
Risk factors
With shingles, things that can raise the risk of postherpetic neuralgia are:
- Age 60 or older.
- Health conditions, treatments for an illness or medicines that make the immune system weak.
- Severe shingles rash that kept you from doing daily activities.
- Other long-term health issues, such as diabetes or lung or heart conditions.
- Shingles rash on the face or torso.
- Not taking antiviral medicine within 72 hours of the rash appearing.
- Not being vaccinated for shingles.
Complications
People with postherpetic neuralgia can develop other concerns that are common with long-term pain. It depends on how long postherpetic neuralgia lasts and how painful it becomes. Concerns may include:
- Depression.
- Trouble sleeping.
- Tiredness.
- Not feeling as hungry as usual.
Prevention
Shingles vaccines can help prevent shingles. You can only get postherpetic neuralgia if you've had shingles.
In the U.S., people age 50 and older can get a shingles vaccine called Shingrix. Adults who have weakened immune systems due to disease or treatment also may get the shingles vaccine.
Shingrix is given in two doses, typically 2 to 6 months apart. With two doses, Shingrix is more than 90% effective in preventing shingles and postherpetic neuralgia.
Even if you've had shingles, being vaccinated can help prevent future breakouts.
If you've had the older shingles vaccine, Zostavax, you should still get the Shingrix vaccination. Zostavax is no longer available in the United States. Other shingles vaccines also are offered outside of the United States.
Ask your healthcare professional when you should get a vaccine and for more information on how to prevent shingles and postherpetic neuralgia.