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Postherpetic Neuralgia


The Manual's Editorial Staff

Full review/revision Mar 2022 | Modified Sep 2022
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What is postherpetic neuralgia?

In some people who've had shingles, pain continues after the rash is gone. Because chickenpox and shingles are caused by the herpes zoster virus, problems that happen after you've had shingles are called "postherpetic." Neuralgia is nerve pain. So pain that continues after you've had shingles is called postherpetic neuralgia.

  • The pain is usually in the spot where you had the shingles rash

  • Doctors don’t know why some people get postherpetic neuralgia

  • Most people who have postherpetic neuralgia are older than 50

  • Pain medicine and creams can help lessen your pain

  • The chickenpox and shingles vaccines can help prevent shingles and postherpetic neuralgia

Go to a doctor right away if you still have pain after shingles has gone away. Treatment works better if you start as soon as possible.

What causes postherpetic neuralgia?

After you've had chickenpox, the virus stays in your nerve roots, near your spine. Sometimes the virus becomes active again and causes a very painful rash (shingles Shingles After you've had chickenpox, the virus that caused it stays in your body all your life. If the virus becomes active again, you get shingles. Shingles is a viral infection that causes a painful... read more Shingles ) on the part of your skin connected to the infected nerve root.

The shingles rash goes away on its own. But a few people continue to have severe pain where the rash was. Doctors don't know why this happens in some people and not others.

What are the symptoms of postherpetic neuralgia?

You’ll have burning pain in the area of your skin where you had shingles. The pain may:

  • Be constant or come and go

  • Get worse at night or in the heat or cold

  • Last 3 months or longer—about 1 in 5 people will have pain that lasts for more than a year

How can doctors tell if I have postherpetic neuralgia?

Doctors will know based on your symptoms and because you recently had shingles. They'll also examine you to be sure the pain isn't from something else.

How do doctors treat postherpetic neuralgia?

If you only have mild pain, doctors will tell you to use an over-the-counter pain medicine (such as acetaminophen) or cream (such as capsaicin or lidocaine) to lessen your pain.

There's no cure for postherpetic neuralgia. For most people it goes away by itself in 1 to 3 months.

If you're in a great deal of pain, doctors may treat you with:

  • Prescription medicines that affect how your nerves work

  • Prescription painkillers

  • Sometimes, botox injections in the areas where you have pain

How can I prevent postherpetic neuralgia?

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