A Look at Postherpetic Neuralgia
When one thinks of the chickenpox, the words “childhood illness” likely come to mind. While definitely annoying and uncomfortable, the chickenpox is usually not considered very serious, as it is an infection that will run its course. However, the shingles—essentially the more threatening relative of the chickenpox—is no small matter. And even less so is postherpetic neuralgia, the chronic nerve pain that can sometimes develop afterwards as a result of the shingles.
Both the chicken pox and the shingles are caused by the same virus, called the varicella zoster. Upon first contracting this virus, usually as a child, the bug causes the itchy rash that we know as the chickenpox. But after the chickenpox ends, the virus does not die out; rather, it becomes dormant in the body’s nerve cells near the brain, but exists nonetheless. It is because of this that the virus is capable of re-emerging years later, the second time around causing the shingles. The shingles affect about 1 million Americans a year, so it is by no means uncommon. It is more likely to affect those that are over 50, especially if they have already weakened immune systems (such as cancer or HIV patients), or are under stress. However, the shingles can afflict anyone who has had the chickenpox, even those who are younger and very healthy. In rare cases, it can even affect children.
But what exactly are the shingles, and how do they differ from chickenpox? Shingles is characterized by the development of a rash that causes a stabbing or burning pain. This pain can be constant for some people, while for others it can fluctuate or be specifically triggered by certain things, such as temperature change or wind. Eventually, blisters will begin to form over the rash that slowly crust over. After crusting over and falling off the rash will have usually run its course, although for some people the virus can rear its head multiple times. For most people the shingles usually lasts about 2-5 weeks from start to finish, but this can vary depending on the person. For a handful of people, though, the pain does not end after the rash has disappeared. Post-herpetic neuralgia, also known as shingle pain, is a real concern for some sufferers of shingles, especially if over 50. When a person has PHN their symptoms of pain will persist even after the physical signs of rash are gone, sometimes for months or even years. For some, PHN can even last for the rest of their lives.
The best insurance against developing postherpetic neuralgia is ultimately prevention. If a person is able to prevent themselves from developing shingles, then they also effectively protect themselves against PHN. The vaccine Zostavax is recommended by the CDC to be given to all adults over the age of 60, as it has been about 70% effective in preventing shingles. For those who have PHN, there are options to help soothe the pain but ultimately no cure. Because there is no virus present that is actually causing the pain, antiviral drugs are not a viable option. However, a great deal of topical drugs exist that can help ease the nerve pain. For instance, lidocaine patches or capsaicin cream are common options that can provide some relief, and are for a good deal of patients a sufficient treatment. Depending on the person, though, different treatment options should be investigated to find what works best in lessening PHN pain.
For those who have ever had chickenpox and are concerned about shingles, a doctor should be consulted about options regarding Zostavax or other preventative measures against shingle development. Not only could this prevention save one the pain of shingles, but it could prevent the development of postherpetic neuralgia, an even longer and more painful ordeal. For those who already have PHN, though, there are still a great many viable options to lessen nerve pain. A doctor should be consulted immediately to find the most effective treatment options, so that PHN can be controlled and not interfere with ones’ daily life.
References:
https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054
https://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/symptoms-causes/syc-20376588
https://www.cdc.gov/shingles/index.html
