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General Practice 2023

Neuralgia pós-herpética: what é, symptoms and treatment

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Neuralgia pós-herpética: what é, symptoms and treatment
Neuralgia pós-herpética: what é, 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 a constant burning sensation to appear in the body, even after the lesions caused by the herpes zoster virus have disappeared.

Typically, postherpetic neuralgia is more common in people over 60, but it can start at any age, as long as you caught the chickenpox virus during adulthood.

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

Main symptoms

The most common symptoms of postherpetic neuralgia include:

  • Burning-like pain that lasts for 3 months or more;
  • Extreme sensitivity to touch;
  • Itchy or tingling sensation.

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

The burning sensation may appear before shingles lesions on the skin and, in some people, it may also be accompanied by stabbing 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 postherpetic neuralgia arises

When you catch the chickenpox virus during adulthood, the virus causes stronger symptoms and can damage the nerve fibers that are in the skin. When this happens, the electrical stimuli that go to 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 alleviate the symptoms through various forms of treatment such as:

  • Lidocaine patches: these are small patches that can be stuck to the pain site and release lidocaine, a substance that anesthetizes the nerve fibers of the skin, relieving pain;
  • Application of Capsaicin: This is a very strong analgesic substance that can reduce pain for up to 3 months with just one application. However, its application should always be done in the doctor's office;
  • Anticonvulsant drugs, such as Gabapentin or Pregabalin: these are drugs that stabilize electrical signals in nerve fibers, decreasing 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: alter the way the brain interprets pain, relieving chronic pain situations such as post-herpetic neuralgia.

Furthermore, in more severe cases, where none of these forms of treatment seem to improve pain, the doctor may still prescribe opioid medications such as Tramadol or Morphine.

There are treatments that work better for some people than others, so you may need to try different forms of treatment before finding the best one, or even combine two or more treatments.

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