Question

My mother is 81 and is diabetic. She got shingles 6 months ago that affected the right side of her forehead, head, and around her eye - but not in her eye. She still has the itch on her scalp and cannot relieve the pain. How long will this continue? And is there anything she can use to ease the itch?

Answer

The condition affecting your mother is known as postherpetic neuralgia (PHN). This is pain that persists for greater than 6 weeks in someone with shingles. It occurs rarely in people under the age of 50, but 40% of people over the age of 60 that develop shingles will develop postherpetic neuralgia.

Shingles is a reactivation of the chicken pox virus that lives dormant for many years in the nervous system. It usually develops when one's immune system is weakened, such as with diabetes, older age, or stress. The pain of PHN usually lasts several months. It's unusual for it to last more than a year. Once it goes away, the pain doesn't come back.

There are several oral medications that are effective in reducing the pain of PHN. Among these are amitriptyline, carbamazepine, phenytoin, and gabapentin. The choice of which to use depends on the patient's medical condition. There is also a topical cream known as capsaicin that is somewhat effective in reducing pain as well. These drugs should assist in reducing intense itching. Occasionally, the pain is so severe that it may require strong pain-killers (narcotic analgesics).

Links

• Shingles - When You're Older