Shingles is caused by reactivation of the varicella-zoster virus. It affects a band of skin supplied by a nerve.
Post-herpetic neuralgia occurs when pain persists after the shingles rash has healed. It is more common with increasing age and after severe shingles.
The pain is usually limited to the area where the rash occurred.
A GP usually diagnoses PHN from the history of shingles and the pain distribution.
When the face or eye is involved, eye services, neurology or a pain clinic may be needed.
Other causes should be considered if the pain does not match the previous rash area.
Treatment may include medicines used for nerve pain, topical lidocaine for suitable localised pain, and pain-management support.
Medicines are usually started at a low dose and reviewed for benefit and side effects.
Prompt assessment and treatment of shingles may reduce complications. Shingles vaccination reduces the risk of shingles and post-herpetic neuralgia in eligible groups.
Protect very sensitive or numb skin from irritation and extreme temperatures. Loose fabrics or a soft protective layer may help.
Keep a diary of pain, touch sensitivity, sleep and treatment response.
Persistent pain after shingles can affect sleep, clothing, washing and confidence about touch.
Support for sleep, anxiety, low mood and coping can sit alongside medical treatment. It does not mean the pain is imagined.
If you feel unable to keep yourself safe, call 999 or go to A&E. For urgent mental-health help that is not an immediate emergency, use NHS 111 and select the mental-health option where available.
Answers to common questions
Yes. It commonly starts during shingles or soon after, but can occasionally become apparent later.
PHN is not contagious. Active shingles can transmit chickenpox to someone who is not immune through contact with blister fluid.
It often improves over months, but duration varies and some people have longer-lasting pain.
Shingles vaccination reduces the risk of shingles and PHN in eligible groups.
Other facial pain conditions and useful information
This information is for general guidance and does not replace professional medical advice. Always consult your healthcare professional.
