Post-herpetic neuralgia
Symptoms of post-herpetic neuralgia
Post-herpetic neuralgia is common after you've had shingles. It affects the areas of your body where you had the shingles rash.
The symptoms usually start while you have the shingles rash or soon after it gets better. In rare cases symptoms start a few weeks or months after the shingles rash has gone.
Symptoms of post-herpetic neuralgia may include:
- aching, burning or sharp pain in your skin that may be constant or come and go
- skin that's very sensitive to pain – you may have pain from slight touch or pressure, or from changes in temperature
- itchy skin
- loss of feeling in your skin
The pain is often mild, but some people have severe pain.
Non-urgent advice: See a GP if:
- you've had shingles and you get pain that does not get better where you had the shingles rash
Treatments for post-herpetic neuralgia
Post-herpetic neuralgia can be difficult to treat. It usually gets better eventually, but how long this takes can vary from a few months to over a year.
A GP will usually prescribe medicines to help with pain, such as:
- paracetamol, or paracetamol with codeine, if you have mild or moderate pain – this helps some people but it's unlikely to completely relieve your pain
- medicine to treat nerve pain, such as amitriptyline, duloxetine, gabapentin or pregabalin, if paracetamol and codeine have not worked
- plasters containing lidocaine (a local anaesthetic), if you have mild pain or other medicines are not suitable for you
- tramadol, if you have severe pain – you can usually only take this for a short time
Medicines for nerve pain may not work straight away. You'll usually start on a low dose that will be increased gradually over a few weeks. You'll have check-ups to see how well it's working and if you're getting any side effects.
If you have severe pain, if pain is affecting your daily activities, or if medicines from a GP have not worked, the GP may refer you for:
- cognitive behavioural therapy – a type of talking therapy that can help you cope with pain
- treatment from a specialist in nerve conditions (neurologist) or a specialist pain clinic – this may include treatments such as stronger skin patches, injections, or talking therapies to help you cope
Things you can do to help with post-herpetic neuralgia
If you have post-herpetic neuralgia there are things you can do to help ease the symptoms.
Do
-
wear loose cotton or silk clothes to avoid irritating your skin
-
protect sensitive skin using a layer of bandage, cling film or plastic wound dressing under your clothes
-
try holding an ice pack (or bag of frozen vegetables) wrapped in a tea towel on the painful area for up to 20 minutes every 2 to 3 hours
-
take cool baths or showers
-
try keeping a daily pain diary to help you see how well any treatment is working and whether your symptoms are getting better
Causes of post-herpetic neuralgia
Post-herpetic neuralgia is caused by damage to your nerves from shingles.
It's not known why some people continue to have pain for a long time after shingles has gone. It's more likely to happen if your shingles symptoms were severe and if the shingles rash affected a large area of your body.
Post-herpetic neuralgia is more common in older people and people with other health conditions such as diabetes or a weakened immune system.
How to reduce your risk of post-herpetic neuralgia
Getting treatment for shingles as soon as possible can help your recovery and reduce the risk of post-herpetic neuralgia.
Having the shingles vaccine also reduces your risk of getting shingles and post-herpetic neuralgia.
The shingles vaccine is available on the NHS for:
- people who turned 65 on or after 1 September 2023
- people aged 70 to 79
- people aged 50 and over with a severely weakened immune system
Ask your GP surgery if you can get the vaccine on the NHS.
Page last reviewed: 24 February 2025
Next review due: 24 February 2028