Post-herpetic neuralgia (PHN) is an extremely painful syndrome that sometimes occurs as a result of the herpes zoster virus (commonly called shingles). This PHN pain forms in the areas of the body where the rashes were present. Generally, it follows the path of the nerve on one side of the body. Although the main feature of this infection is itchy, painful blisters and blisters that form on the body, neuralgia can precede the breakouts. Most often, the first symptom of shingles is a burning or tingling sensation on the skin. If the infection is treated early, the symptoms can go away easily. Read on to learn more.
Steps
Part 1 of 5: Reduce Pain and Itching
Step 1. Try to avoid scratching the blisters
As difficult as it may be, you need to let them be and avoid touching them. They form a crust on the surface, which then falls off on its own. If the scratches open, they can become infected more easily.
You can also spread the bacteria with your hands if you scratch them. If this happens inadvertently, always wash your hands afterwards to keep hygiene levels high
Step 2. Use a baking soda paste to reduce irritation
This product has a pH above 7 (which makes it alkaline) and is able to neutralize the chemical that creates the itchy sensation, as the latter is acidic with a pH below 7.
- Make the dough with 3 teaspoons of baking soda mixed with 1 teaspoon of water and apply it to the affected areas. This relieves itching and helps the blisters dry out faster.
- You can freely put it on as many times as you like to soothe the uncomfortable feeling.
Step 3. Apply a cold compress to the blisters
Use a cold, wet compress to relieve discomfort and apply it for 20 minutes at a time, several times a day.
You can make one by wrapping ice in a clean towel and pressing it against your skin. Alternatively, you can use a bag of frozen vegetables. The important thing is that it is not in direct contact with the skin and not to keep it more than 20 minutes at a time, as both of these conditions can create tissue damage
Step 4. Spread benzocaine cream on blisters after removing the cold pack
Apply a topical cream, such as a non-prescription benzocaine-based cream, immediately after applying the cold pack. This substance works as an anesthetic, numbs the nerve endings in the skin.
Part 2 of 5: Treating Infected Blisters
Step 1. Check if the ulcers are infected
In this case the situation is not one of the best, so if you are concerned that they may have become infected, you should contact your doctor immediately. Among the signs that the blisters are infected are:
- Fever
- Increased inflammation which causes additional pain
- The wound is hot to the touch
- It is shiny and smooth
- Symptoms get worse
Step 2. Soak the infected sores in Burow's solution (aluminum acetate)
You can soak infected sores in Burow's solution (trade name, Domeboro solution) or tap water. This helps reduce fluid leakage, prevent scabs and soothe the skin.
- Burow's solution has antibacterial and astringent properties. You can buy it without a prescription at the pharmacy.
- Instead of soaking the blisters, you can also apply aluminum acetate directly to the bubbles with a cold compress. You can keep it on the affected areas for 20 minutes, several times a day.
Step 3. Apply a capsaicin cream when the bubbles have formed a crust on the surface
When the lesions have become hard and are no longer leaking, you can apply this cream (for example Zostrix). You can use it up to 5 times a day to facilitate healing.
Part 3 of 5: Taking Medication When The Blisters Have Gone
Step 1. Put on a lidocaine patch
When the blisters have healed, you can apply a 5% lidocaine patch to the skin to reduce nerve pain. This provides effective pain relief without the risk of negative side effects.
You can find this product at major pharmacies and online. However, patches with a higher content of lidocaine require a doctor's prescription
Step 2. Take non-steroidal anti-inflammatories for pain relief
These drugs (NSAIDs) are often prescribed in addition to other analgesics to increase pain relief. They are cheap and most likely you already have at least one in the bathroom cabinet.
Examples of NSAIDs are paracetamol, ibuprofen or indomethacin. You can take them up to three times a day; make sure you follow the instructions on the leaflet and the appropriate dosage for you
Step 3. Try corticosteroids for nerve pain relief
These drugs are often prescribed for relatively healthy older people who have moderate to severe nerve pain. They are usually added to antiviral drugs.
Talk to your doctor about this option. Stronger corticosteroids are available by prescription only
Step 4. Discuss the possibility of taking narcotic pain relievers with your doctor
These are sometimes prescribed to treat severe neuropathic pain caused by shingles. However, they only provide symptomatic relief, they do not treat the cause of the pain.
In addition, these are addictive substances that the patient can quickly become addicted to. Therefore, their use must be carefully monitored by a doctor
Step 5. Get a prescription for tricyclic antidepressants
These are drugs that are sometimes prescribed to treat specific types of neuropathic pain caused by this infection. Although their exact mechanism is not known, they work by blocking pain receptors in the body.
Step 6. Take antiepileptic drugs to treat nerve pain
These are widely used in pain therapy centers to treat neuropathic pain. There are many types of antiepileptic drugs, such as phenytoin, carbamazepine, lamotrigine and gabapentin; any of these can be prescribed for the treatment of neuropathic pain in patients with herpes zoster.
Your doctor will be able to determine which type of medication is best for your specific situation, whether it is antiepileptics or tricyclic antidepressants. Usually, these types of drugs are reserved for the most severe cases of neuropathic pain
Part 4 of 5: Treating Neuropathic Pain with Surgical Procedures
Step 1. Get an alcohol or phenol injection
One of the simplest surgical techniques to relieve nerve pain is an injection of alcohol or phenol into the peripheral branch of the nerve. This causes permanent nerve damage, thus helping to prevent pain.
This is a procedure that must be done by a professional doctor. Your medical history and health condition will determine if this is a suitable treatment for you
Step 2. Try transcutaneous electrical nerve stimulation (TENS)
This treatment involves placing electrodes on the nerves that are causing the pain. The electrodes cause tiny, painless electrical impulses in nearby nerve pathways.
- Exactly how these impulses are able to relieve pain is still an uncertain fact. One theory is that the pulses stimulate the production of endorphins, the body's natural pain relievers.
- Unfortunately, this treatment doesn't work for everyone, but it appears to be most effective when given in combination with an antiepileptic drug called pregabalin.
Step 3. Evaluate stimulation of the spinal cord or peripheral nerves
These treatments use devices similar to TENS, but are implanted under the skin. As with TENS, these units can be turned on and off as needed to control pain.
- Before surgically implanting the device, doctors do a test with a fine-wire electrode. The test is done to make sure the stimulator will provide effective pain relief.
- In the case of a spinal stimulator, the electrode is inserted through the skin into the epidural space along the spinal cord; in the case of a peripheral nerve stimulator, the electrode is implanted under the skin over the affected nerve.
Step 4. Talk to your doctor about pulsed radiofrequency (PRF)
This is a very safe and effective form of pain relief that uses radiofrequency to modulate pain on a molecular level. After a single treatment, relief can last up to 12 weeks.
Part 5 of 5: Treating Herpes Before It Occurs
Step 1. Know the symptoms of shingles
This infection first presents itself as pain, itching and tingling of the skin. Sometimes these initial symptoms are followed by feelings of confusion, fatigue, fever, headache, memory loss, upset stomach, and / or upset stomach.
Up to five days after these initial symptoms appear, a painful rash may appear on one side of the face or body
Step 2. See your doctor within 24 to 72 hours if you think you have the infection
They may prescribe antiviral medicines such as famciclovir, valaciclovir and aciclovir to effectively treat your symptoms, but only if they are treated within 72 hours of onset.
Step 3. Apply topical medication to clear the blisters before they get worse
In addition to antiviral medications, your doctor may prescribe a topical medication, such as Caladryl, for example. This can help reduce the pain and itching of already open ulcers.
- The drug works by interfering with the pain signals that the nerves send to the brain and is available as a gel, lotion, spray or stick.
- It can be applied every 6 hours, up to 4 times a day. It is necessary to wash and dry the affected area before application.
