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Having shingles. Crawling and burning sensation under skin. What should be done?

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Infectious Diseases Specialist
Practicing since : 2002
Answered : 877 Questions
I have shingles. my blisters have healed over but I continue to have a crawling sensation under my skin and pain pills don't seem to touch it. It is keeping me awake. If I touch the area it burns and the whole area seems to be on fire. I have tried cold compresses, to no avail. Please help me know what to do. Thank you.
Posted Wed, 30 Oct 2013 in Infections
Answered by Dr. Roopa Hiremath 47 minutes later
Brief Answer:
Herpes Zoster

Detailed Answer:
Welcome to Health care magic.
I understand your pain as shingles can cause very severe tingling and nerve tenderness.

I want to explain few details about shingles to make you understand your symptoms better.

Shingles is medically called as Herpes Zoster which is caused by a virus called varicella zoster. The uniqueness about herpes viruses is that these viruses remain latent (hidden) in the body in the nerve roots. This virus gets reactivated in few individuals most commonly in the elderly.

During reactivation, this virus travels along the sensory nerves causing inflamed nerves, and then it causes lesions in the area supplied by that nerve. This is called dermatomal distribution.

Before the lesions appear, there is a phase of tingling, abnormal sensations and pain along the affected nerve region.

Then lesions develop and this episode lasts for 2-3 weeks. Unfortunately pain and tingling remains for months together.

I am glad that your lesions are healing.
But nerve pain still persists. This is suggestive of post herpetic neuralgia.

I suggest you get in touch with your doctor for stronger pain killers and complete the full course of antiviral therapy.

There is also a psychological factor involved here which I want to stress upon.
Stress and worry increases your pain. I suggest you do not isolate yourself, keep connected with family and friends. Do not dwell on your symptoms too much. Keep yourself busy to divert your mind away from your symptoms.

I hope I have helped you and wishing you a speedy recovery. Let me know if I can assist you further.


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Follow-up: Having shingles. Crawling and burning sensation under skin. What should be done? 12 hours later
Thank you for your explanation of Shingles, most of which I already knew. I was just hoping you could give me a suggestion about what to do for the tingling mostly. It interrupts sleep at night in a big way. I do stay busy when not flattened by the pain (the pain meds don't cover a whole 8 hours). I am a person who avoids any kinds of medication, so taking anything has been hard for me, but I am following my doctor's orders.

Taking 2 gabapenten every 8 hours, and they about put me out of commission for a couple hours. Then taking 2 acetominifin midway through the gabapenten term to extend the pain relief a little. But neither of these seems to take care of the "tingle" that feels like it's crawling through your eye or your skin as it reaches out for more areas to affect. If I could control that, I could sleep.

I appreciate anything you might have to share with me.
Answered by Dr. Roopa Hiremath 7 hours later
Brief Answer:
Zoster pain management

Detailed Answer:
Welcome back to Health care magic.
Pain management in Zoster is quite complex and depends on whether the pain is during the attack, or long term pain (post herpetic neuralgia)

Pain during the attacks can be managed by over the counter pain medications like acetaminophen, ibuprofen.
But long term pain or post herpetic neuralgia is treated by stronger medications like amitriptyline, gabapentin etc.

Gabapentin is quite effective for post herpetic neuralgia.

But if it is not helping you, get in touch with your doctor for a prescription of opioid medication preferably codiene.

There are skin patches also available for post herpetic neuralgia which slowly release pain medication and are effective for longer time.

I hope I have answered your query satisfactorily.


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