When shingles heals, the pain shouldn’t. Postherpetic neuralgia, a persistent nerve pain that follows a shingles outbreak. Also known as PHN, it’s not just a leftover symptom—it’s damage to the nerves caused by the varicella-zoster virus, and it can last months or even years if not caught early. About 10 to 18% of people who get shingles develop this condition, and the risk jumps after age 60. The good news? You can significantly lower your chances if you act fast.
Preventing postherpetic neuralgia starts with treating shingles right away. Antiviral medications, like acyclovir, valacyclovir, or famciclovir. Also known as VZV inhibitors, they work best when started within 72 hours of the rash appearing. Delaying treatment by even a day can increase your risk of long-term pain. These drugs don’t just speed up healing—they reduce the chance that nerves get permanently irritated. Pair that with pain control: Gabapentin, a nerve pain medication often used for PHN prevention. Also known as gabapentinoids, it’s one of the first-line tools doctors use to calm overactive nerves before they turn chronic. Some studies show starting gabapentin early—even during the shingles phase—cuts the odds of PHN by nearly half.
It’s not just about pills. Shingles vaccines like Shingrix cut your risk of getting shingles by over 90%, and if you do get it, the pain is usually milder and shorter. That’s the biggest win for prevention. But if you’ve already had shingles, don’t wait. See a doctor immediately if you feel burning, tingling, or sharp pain where the rash was—even if the blisters are gone. Early intervention is the only reliable way to stop PHN from taking hold. The longer you wait, the harder it becomes to reverse nerve damage.
You’ll find real-world advice in the posts below: how gabapentin compares to pregabalin for nerve pain, why some people still get PHN even after antivirals, and what steps actually work for managing lingering discomfort. These aren’t theory pieces—they’re based on patient experiences, clinical data, and what doctors are doing in practice right now. No fluff. Just what helps, what doesn’t, and how to protect yourself before the pain becomes your new normal.
26 November 2025
Shingrix is the only shingles vaccine recommended in the U.S. as of 2025. Learn who should get it, when to get the two doses, how effective it is, and what to expect after vaccination.
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