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Suggest Treatment For Shingles
Question: I AM 80 YEARS HAVE HAD SHINGLES SINCE XXXXXXX 18 I RECEIVED 2 WKS OF CYCLOGEL I STIL PAIN WHEN WILL BE OVER THIS
Brief Answer:
Oral gabapentine, amitryptiline etc
Detailed Answer:
Hello,
Thank you for posting on HCM.
I can understand your concern regarding the relentless pain due to shingles(Herpes Zoster).
It seems you are having post-herpetic neuralgia.
Postherpetic neuralgia (PHN) is the most common complication of herpes zoster.
It produces chronic pain along cutaneous nerves. The pain can either persist after the acute episode of shingles or it can recur in an area previously affected by shingles.
Several factors like old age, delay in treatment,improper treatment,extent of shingles etc all can predispose to PHN.
Management of PHN is highly challenging.
In my patients, I advise them oral analgesics like tramadol as required to relieve pain along with several other medications like gabapentin, amitryptiline for several months to control PHN.Topically, I advise application of capsaicin and diclofenac gel thrice a day over affected area. Topical lidocaine can also be used in certain cases.
Non-responders to above therapy may need to be complemented with physiotherapy and transcutaneous electrical nerve stimulation (TENS).
Apart from these, general advise includes use of loose cotton garments, application of cold ice-packs etc.
Hope you will get well soon.
Thanks
Dr Hardik Pitroda
Oral gabapentine, amitryptiline etc
Detailed Answer:
Hello,
Thank you for posting on HCM.
I can understand your concern regarding the relentless pain due to shingles(Herpes Zoster).
It seems you are having post-herpetic neuralgia.
Postherpetic neuralgia (PHN) is the most common complication of herpes zoster.
It produces chronic pain along cutaneous nerves. The pain can either persist after the acute episode of shingles or it can recur in an area previously affected by shingles.
Several factors like old age, delay in treatment,improper treatment,extent of shingles etc all can predispose to PHN.
Management of PHN is highly challenging.
In my patients, I advise them oral analgesics like tramadol as required to relieve pain along with several other medications like gabapentin, amitryptiline for several months to control PHN.Topically, I advise application of capsaicin and diclofenac gel thrice a day over affected area. Topical lidocaine can also be used in certain cases.
Non-responders to above therapy may need to be complemented with physiotherapy and transcutaneous electrical nerve stimulation (TENS).
Apart from these, general advise includes use of loose cotton garments, application of cold ice-packs etc.
Hope you will get well soon.
Thanks
Dr Hardik Pitroda
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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