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Dr. Andrew Rynne

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Best treatment for prurigo?

Answered by
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Dr. Sudarshan

Dermatologist

Practicing since :2005

Answered : 1391 Questions

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Posted on Mon, 28 Jan 2013 in Skin Hair and Nails
Question: Best treatmant for prurigo for my wife? Diagnosed by dermatoligist. Mainly on the face and seems to have followed shingles - ongoing for months. Seems to be more painful than itchy.
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Answered by Dr. Sudarshan 1 hour later
HI XXXXXXX
Thanks for writing in.
The persistent pain which follows shingles is called Post herpetic neuralgia or PHN. It begins after healing of cutaneous lesions and it can last for months together.
It is more likely in your wife's case.
Whereas prurigo occurs more commonly on upper and lower extremities.More commonly over the lower extremity.It is more itchy and pain is rarely present.
So prurigo is unlikely in your case.

The treatment for post herpetic neuralgia or PHN is neuroprotective agents like methylcobalamine or vitamin B12.Also a few neuroprotective agents like gabapentin or pregabalin should be given.Tramadol like analgesics will help in controlling pain.
Amitryptaline will prevent the associated emotional disturbunces.

The drugs are prescription drugs and should be taken after consulting your doctor.
Hope this helps.
I will be available for follow up.
REgards.
DrSudarshan
MD
Dermatology.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudarshan 6 hours later
Thank you for your advice - she will follow up with her family dcotor and dernmatologist. I should have mentioned that she is also waitimng for 3 pending root canals that are casuing a lot of pain and dental surgeon will not touch until face cleared up. This all started about 8 months ago when teeth were already acting up, some botched rooit canal work that was never completeddue to sugery for baldder that left a burn on the face supposedly due to anestehesia or shingles was present pre surgery. So I missed the info that nerve pain in teeth and face are proabbly related.

One quick question. The face is still not cleared up with a continuing rash and pain - is this possible with PHN? Her plan is to dry iup remaining gfacial lesions and then immediatedly get dental work done for which she has been on antiobiotics for nearly a year now.
XXXXXXX XXXXXXX
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Answered by Dr. Sudarshan 13 hours later
Hi XXXXXXX ,
PHN usually causes only pain and rash is not seen.if the rash is recurring it may be other cause.
Bacterial infection can cause such rash and pain.
Tooth infection can cause pain on the face.If you can upload photographs of the face then it would help in predicting the nature of the rash.
Upload the photographs and we can continue the discussion here.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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