Postherpetic neuralgia (PHN) is nerve pain that continues after a shingles rash has healed. While shingles symptoms may go away, affected nerves can remain irritated or damaged, causing ongoing pain in the same area where the rash appeared.
At Banner Health, our neurology and pain management specialists evaluate nerve pain after shingles and create personalized treatment plans to help manage symptoms, improve comfort and support your quality of life.
Postherpetic neuralgia (or post-herpetic neuralgia) is a type of neuropathic (nerve) pain. It is one of the most common complications of the shingles infection. Many people describe it as nerve pain after shingles or pain after a shingles rash is gone.
PHN happens when shingles damages or irritates the nerves in the same area where the shingles rash appeared. Even after the skin heals, the damaged nerves may continue sending pain signals to the brain.
Symptoms can last for weeks, months or longer. For some people, nerve pain is mild and improves over time. For others, it can affect sleep, mood, clothing tolerance and daily activities.
PHN symptoms usually affect the same area where you had shingles. The pain may continue after the rash and blisters have completely healed.
Symptoms could include:
Some people describe the affected skin as feeling overly sensitive or painful even when there is no visible skin problem. A simple touch, temperature change or friction from clothing may trigger discomfort.
The severity of symptoms can vary. Some people have occasional discomfort. Others have ongoing pain that affects work, relationships or activities they enjoy.
PHN happens when shingles affects the nerves. Shingles is caused by the same virus that causes chickenpox (varicella-zoster virus). After someone has chickenpox, the virus can remain inactive (asleep) in the body and later reactivate as shingles.
You may have a higher risk of developing PHN if you:
The length of time PHN lasts varies. Most people notice their pain gradually improves over weeks or months. Occasionally, symptoms continue for years and require ongoing care to manage nerve pain.
If pain continues after your shingles rash has healed, talk to your health care provider. A neurology or pain management specialist can help evaluate your symptoms and discuss options to reduce pain and improve your quality of life.
Usually, testing is not needed. Providers usually diagnose PHN based on your symptoms and history of shingles. They may also check the affected area for changes in sensation, such as increased sensitivity or numbness.
Additional testing may be recommended if you had shingles without a rash or a rare type that affects your throat.
Treatment focuses on reducing nerve pain, improving comfort and helping you return to activities you enjoy.
Your treatment depends on your symptoms, overall health, medical history and how much pain affects your daily life. Your provider may recommend one treatment or a combination of treatments.
Some medicines can help calm overactive nerve signals that cause PHN pain. Others can affect how your nervous system processes pain. Medications may include:
Your provider will work with you to find an approach that helps manage pain while supporting your overall health.
Topical treatments are applied directly to the painful area and may help reduce nerve pain signals near the skin.
Options may include:
Some people with ongoing PHN may benefit from treatments that target specific pain pathways. Options may include:
Learn more about pain management.
Your care team may also help manage related concerns, such as poor sleep, anxiety, depression or reduced activity caused by chronic pain.
No single treatment relieves pain for everyone. It may take a mix of treatments to ease the pain. Your care team will work with you to find the best plan.
PHN is different from active shingles. Shingles usually causes a painful rash or blisters. PHN is pain that continues after the rash heals.
If you currently have a new shingles rash, see your health care provider as soon as possible. Antiviral treatment works best when it is started early.
See your health care provider if pain continues after your shingles rash heals, especially if it affects your daily life. You may benefit from seeing a neurology or pain management specialist if you have:
A specialist can help determine whether your symptoms are related to PHN and recommend treatment options to help manage long-term nerve pain.
Call 911 or go to the nearest emergency room if you have shingles along with:
Living with ongoing nerve pain can be tough. PHN may disrupt your sleep, mood, movement and daily activities. Working with your care team helps you manage symptoms and stay active.
Some helpful strategies are:
Managing PHN needs a mix of medical care, lifestyle changes and support. Your care team can help you find the right plan.
Living with ongoing nerve pain after shingles can be frustrating and disruptive. At Banner Health, our neurology and pain management teams provide care for people with postherpetic neuralgia and other nerve pain conditions.
Our specialists can help evaluate your symptoms, identify the cause of your pain and create a treatment plan based on your needs and goals.
When you choose Banner Health, you have access to:
If pain continues after your shingles rash has healed, you do not have to manage it alone. Our team can help you explore options to reduce symptoms and improve your quality of life.
Postherpetic neuralgia is long-lasting nerve pain that can happen after shingles. The pain usually affects the same area where the shingles rash was.
PHN may feel like burning, stabbing, shooting, aching, tingling or very sensitive skin. Some people feel pain from light touches, like clothing or bed sheets.
It varies. Some people get better in weeks or months, while others have pain that lasts longer. Talk to your doctor if the pain does not get better or affects daily life.
No. Shingles is the viral infection that causes a painful rash. Postherpetic neuralgia is nerve pain that continues after the shingles rash has healed.
Yes. Treatment may help reduce pain and improve quality of life. Options include medicines for nerve pain, topical treatments, pain management procedures and supportive care.
Talk to your provider if pain is still there after the rash heals, especially if it is severe, affects sleep, causes skin sensitivity or interferes with daily activities.
Yes. Shingles near the eye or face can be serious and may lead to ongoing pain or vision problems. Seek urgent care if shingles are near the eye or if you have eye pain or vision changes.
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