Postherpetic neuralgia: Causes, treatment, and prevention

idocaine skin patches

These patches contain lidocaine, a common local anesthetic and antiarrhythmic drug. Lidocaine is also used topically, onto the skin, to relieve itching, burning, and pain from inflammation.

Lidocaine patches are not the first line of treatment for neuralgia, but they can be effective in relieving pain. The patches can be cut to fit the affected area.


Antidepressants help patients with PHN because they affect key brain chemicals, such as serotonin and norepinephrine, which influence how the body interprets pain.

Examples of drugs that inhibit the reuptake of serotonin or norepinephrine are tricyclic antidepressants, such as amitriptyline, desipramine (Norpramin), nortriptyline (Pamelor), and duloxetine (Cymbalta).


Early treatment is key for preventing PHN. Seeking medical help as soon as signs or symptoms of shingles appear can greatly reduce the chances of developing neuralgia.

Aggressive treatment of shingles within 2 days of the rash appearing helps reduce both the risk of developing subsequent neuralgia and the length and severity if it does.

The only effective way of preventing PHN from developing is to be protected from shingles and chicken pox through vaccination. The varicella vaccine protects against chickenpox, and varicella-zoster vaccine against shingles.

Chickenpox vaccine

The Varivax vaccine is routinely given to children aged 12 to 18 months to prevent chickenpox. Experts recommend it also for adults and older children who have never had chickenpox. The vaccine does not provide total immunity, but it considerably reduces the risk of complications and severity if disease occurs.

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