Post Herpes Neuralgia (PHN): Why even after Herpes treatment, the pain in Nerves does not go away?

Post Herpes Neuralgia
Post Herpes Neuralgia

Herpes Shingles, which is also called herpes zoster, can happen to anyone at any age. Herpes zoster is an infection with the varicella-zoster virus that comes back after being dormant for a long time. This is usually caused by chickenpox, which occurred at an earlier stage. The varicella-zoster virus only comes back once in a person’s life, and only 10% of people get it again. The point is what is post-herpes neuralgia, In this blog, we discuss Post Herpes Neuralgia.

What is Post Herpes Neuralgia (PHN)?

Shingle is a disease that causes a painful rash with blisters and other symptoms. Usually, the rash shows up in bands on one side of your body, usually your trunk (the central core of your body). Because of the rash, blisters start to form. Even after the rash or blisters have gone away, the pain may still be there. Post herpes neuralgia is the name for the illness when the pain doesn’t go away.

Post-herpes neuralgia, which is persistent pain after herpes zoster, is the most common and feared complication. Its definition is contested, ranging from the pain that persists after the rash has healed to pain that persists 35 days or 5 months after the onset of herpes zoster. Some physicians see the range of herpes zoster-related pain as continuous. Therefore, we recommend that pain duration and pain at a single time point (3.5 months after treatment initiation) be used as outcomes in clinical studies. Scarring of the dorsal root ganglion and atrophy of the dorsal horn on the affected side are associated with post-herpetic neuralgia, which develops as a result of the substantial inflammation caused by herpes zoster. Pain and other unpleasant symptoms of post-herpetic neuralgia, including allodynia (pain in response to generally innocuous stimuli) and hyperalgesia, are caused by these and other peripheral and central nervous system abnormalities.

What does Post Herpes Neuralgia (PHN) make you feel?

You will have discomfort at the site of the rash caused by shingles. The pain may be intermittent or continuous. Some describe the agony as burning, jabbing, or excruciating. Others (less often) describe numbness or itching in the affected area. The urge to itch the affected area will develop exponentially. Soft cotton clothes will be helpful to ease the pain by rubbing them slowly on the affected area, but the satisfaction of itching won’t go away.

Why, even after Herpes treatment, does the pain in the nerves not go away?

When a person is infected by chickenpox in their childhood days, which at the later stage of life changes to Herpes Shingles. In most cases, the virus remains dormant for a longer period of time, and some conditions (such as depression, weak immune system, or old age), reignite the dormant virus in the body and it spreads. According to the research, there is no particular cure for herpes shingles, but some treatments can ease the pain, whether that might be the vaccine or the medicines, or Ayurvedic treatments. And mostly, the pain still persists after the post-herpes treatment, because of several reasons.

  • Age: The risk of developing post-herpes neuralgia increases with age. When you’re older and have shingles, you’re more likely to develop PHN and have more severe pain than when you’re younger and have shingles. Approximately 10 to 15% of shingles patients over the age of 50 will develop PHN. PHN seldom affects anyone under the age of 35. When the person is growing old, the intensity of tolerating the pain gets weaker and weaker with each passing year. As a result, the pain lasts longer in this case than it would in a normal human being.
  • As you age, your immune system weakens, making it possible for the latent varicella-zoster virus to reactivate and cause shingles in some people. Cancer, chronic infectious diseases (such as HIV/AIDS), organ transplantation, and the use of immunosuppressant medications are all medical conditions that may weaken the immune system (such as chemotherapy, immunosuppressant medicines, steroids, or anti-organ rejection medicines). Weak immunity compromises the protective shield of the body. During these situations, several other diseases attack the body. That doesn’t help the body to recover, and the pain after the treatment persists for a far longer duration than the normal duration.
  • The intensity of your shingles: A severe rash increases your chances of developing PHN. Prior to the onset of shingles, you may have a painful, itchy, or tingling feeling. You are more prone to developing PHN if you experience these symptoms in a skin area a few days before your shingles outbreak. When herpes sores appear around the softest part of the body, they cause significantly more pain than in other areas. For example, the rash around the lips will give you more pain than the rash on your cheeks or on your hand. Similarly, the rash on your genital regions will create more trouble and pain than the rash on the thighs or the groin region.

The chance of getting PHN increases if you wait longer than three days after your rash appears to consult a doctor, which is the window during which antiviral medication is most effective.

Self-help to alleviate the discomfort and irritability of post-herpetic neuralgia:

  • Cotton or silk clothing is less likely to irritate the skin than other fabrics.
  • Use cling film or a plastic wound dressing to protect the injured area.
  • Use cold packs; however, never apply ice directly to the skin. Some people find that wrapping an ice pack in a towel and placing it on the affected area helps to cool the skin. 
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