PHN is a condition in which nerve fibers, inflamed or damaged by shingles, continue to send pain signals to your brain months or even years after the blisters have gone away.
- Capsaicin topical patch (Qutenza)
- Antiepileptic drugs, such as gabapentin (Neurontin)
- Tricyclic antidepressants, such as amitriptyline
- Numbing agents, such as lidocaine
- Narcotics, such as codeine
- An injection including corticosteroids and local anesthetics
If postherpetic neuralgia develops, similar medications are used to treat PHN pain.
While it may seem strange for your doctor to prescribe drugs for shingles that are commonly used to treat depression and prevent seizures, shingles is at root a nerve disorder, and these drugs work in different ways to calm overactive nerves.
“Antiepileptics in general are thought to reduce the ability of the neurons to fire at high frequency,” says Sangeetha Kodoth, MD, an allergist and immunologist with Allergy Specialists of Knoxville in Tennessee.
It’s believed that tricyclic antidepressants — an older class of antidepressants — work by increasing the levels of the neurotransmitters serotonin and norepinephrine, which then modify pain response.
Antibacterial agents may also be prescribed if a bacterial infection occurs with the shingles rash.
What if You Have Shingles Around — or in — Your Eye?
On the surface, says Dr. Taylor, they mainly show up on the cornea, which is the clear dome of tissue that covers your iris (where you put your contact lenses), and the conjunctiva — the clear tissue that covers the whites of your eye and the inside of your eyelid.
“If shingles is in these places,” she says, “you’ll be prescribed eye drops with steroids to calm the lesions, and lubricating tears for comfort.”
If you have had shingles in your eye, says Taylor, your eye doctor will monitor you for 3 to 12 months to make sure that your eye is returning to health and that no new developments have occurred. You may also be encouraged to have a yearly eye exam (if you don’t already) until otherwise instructed by your eye doctor.
Who Should Get the Shingles Vaccine?
Getting a shingles vaccine is the only way to reduce the risk of developing shingles and to lessen the risk of postherpetic neuralgia.
Shingrix is given as two shots that are two to six months apart.