About After-Shingles Pain

Each year, about 1 million people in the United States get shingles1. The medical name for shingles is herpes zoster2. Shingles is an infection caused by the same virus that causes chicken pox. Anyone who has had chicken pox is at risk for shingles and after-shingles pain. The virus can stay quiet in your body for years or even decades and comes back later to cause shingles3,4. Not everyone who has had chicken pox will get shingles5.

When the virus comes back, it is thought that it travels along nerves to the skin and causes blisters to form5. Sometimes just a few blisters form; sometimes so many form that they appear as a rash5. Shingles can occur anywhere on the body, but it usually appears on the torso (chest or back), waistline, upper arms, or side of the face4, 5. The rash usually clears up within 2 to 4 weeks6. In rare cases, no rash develops at all.

The early signs of shingles can easily be mistaken for another illness. Some people begin by feeling a burning or shooting pain, numbness, tingling or itching in one area of the body or face. Others may feel mild, flu-like symptoms, such as fever, headache, chills and nausea. One day to two weeks after the shingles pain begins, a rash or cluster of blisters appears on the skin7. If you or your loved ones notice any of these early signs, you should see your healthcare professional immediately, because early treatment of shingles can decrease the amount of time you suffer from the painful condition8.

Though a rash and blisters are symptomatic of shingles, an outbreak may begin without them, so it is important to recognize the other signs and symptoms that accompany the rash. Sometimes, though uncommon, shingles will occur without a rash, which is called zoster sine herpete7. In rare cases, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation or death9.

After-shingles pain

Some people still have pain after shingles heals. After-shingles pain results from nerve damage caused by the shingles virus and usually occurs in the same place where you had shingles10,11. For some people, pain from shingles can last for months or even years3. The medical name for after-shingles pain is postherpetic neuralgia, or PHN. Out of every 5 people who develop shingles, about 1 will go on to develop after-shingles pain. That’s about 120,000 to 200,000 people in the United States every year1.

Who is at risk for after-shingles pain?

Age is the main risk factor for after-shingles pain. People 50 years or older who have had shingles have a 50% risk of getting after-shingles pain. And people 80 years or older have an 80% chance for after-shingles pain1. Other risk factors include severe shingles pain and severe shingles rash within 3 days of infection12.

After-shingles pain — you are not alone

Like you, other people suffer from after-shingles pain. Anyone who has had chicken pox is at risk for shingles and after-shingles pain. Because people like you may develop after-shingles pain, you should never feel that you’re alone. Although there is no cure for after-shingles pain, there are several medications available to treat it. Ask your healthcare professional to discuss them with you.

After-Shingles Pain Symptoms
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Areas most commonly affected by after-shingles pain
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How to Apply the Patch
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Indication

LIDODERM® (lidocaine patch 5%) is used to relieve the pain of post-herpetic neuralgia, also referred to as after-shingles pain. Apply only to intact skin with no blisters.

Important Safety Information

You should not use this product if you are sensitive to local anesthetics such as lidocaine, or to any of the other ingredients in LIDODERM.

Even a used LIDODERM patch contains a large amount of lidocaine. A small child or a pet could suffer serious adverse effects from chewing or swallowing a new or used LIDODERM patch. Store and dispose of patches out of the reach of children, pets and others. Never reuse a patch.

LIDODERM patches should be worn for no more than 12 hours a day. Applying the patches for a longer time or using more than 3 patches could cause serious reactions.

Fold used patches so that the adhesive side sticks to itself, and safely discard used patches or pieces of cut patches where children and pets cannot get to them.

Avoid the use of external heat sources, such as heating pads or electric blankets, as this has not been studied.

Avoid contact of LIDODERM with the eye. If contact occurs, immediately wash the eye with water or saline and protect it until sensation returns.

Be sure to tell your healthcare professional if you have liver disease, are pregnant or nursing, or are taking medication for irregular heartbeat. For such people, LIDODERM should be used with caution.

Allergic reactions, though rare, can occur.

During or immediately after using LIDODERM, the skin around the patch may develop a change in color, colored spots, irritation, itching, flaking of the skin, rash, bruising, swelling, pimple-like raised skin, a cyst containing fluid, pain, burning, or abnormal sensation. These reactions are generally mild and go away on their own within a few minutes to hours. Other reactions may include dizziness, headache, and nausea. Tell your healthcare professional if you experience any of these symptoms while using LIDODERM.

Only your healthcare professional can determine if LIDODERM is right for you. Always follow your healthcare professional’s instructions when using LIDODERM.

Please see the LIDODERM important product information and discuss it with your healthcare provider.

References

  1. Cluff RS, Rowbotham MC. Pain caused by herpes zoster infection. Neurol Clinics. 1998; 16(4):813-832
  2. Weaver BA. The Burden of Herpes Zoster and Postherpetic Neuralgia in the United States. JAOA. 2007; 107(3): S2-S7
  3. Watson. C. Peter N. Pain: Mechanisms and Syndromes.1989;7:231-248
  4. LaGuardia JJ, Gilden DH. Varicella-Zoster Virus: A Re-Emerging Infection. Journal of Investigative Dermatology Symposium Proceedings. 2001; 6:183-187
  5. Shingles: Hope Through Research. National Institute of Neurological Disorders and Stroke web site. Available at: http://www.ninds.nih.gov/disorders/shingles/detail_shingles.htm. Accessed February 9 2006
  6. Gnann JW, Whitley RJ. Herpes Zoster. New England Journal of Medicine. 2002: 347(5):340-346
  7. Shingles & PHN: Your Questions Answered, VZV Research Foundation, Inc 2000: 1-12. Available at: http://vzvfoundation.org/publicdownloads/Shingles_PHN_Q&A_2000.pdf. Accessed April 6, 2009
  8. Cure PHN: Your Questions Answered, VZV Research Foundation, Inc. 2004: 1-6. Available at: http://www.vzvfoundation.org/publicdownloads/PHN_Brochure_Feb2004.pdf. Accessed April 6, 2009
  9. Shingles Vaccine: What You Need to Know. Department of Health and Human Services: Centers for Disease Control. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-shingles.pdf. Accessed February 20, 2009
  10. Dworkin RH, et al. Advances in Neuropathic Pain: Diagnosis, mechanisms, and treatment recommendations. Arch Neurol. 2003;60:1524-1534
  11. Galer BS. Advances in the Treatment of Postherpetic Neuralgia: The Topical Lidocaine Patch. Today’s Therapeutic Trends. 2000; 1-20
  12. Jung BF, et al. Risk factors for Postherpetic neuralgia in patients with herpes zoster. Neurology. 2004; 62: 1545-1551