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Dr. Andrew Rynne

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What causes pain in the left side of the head after recovering from shingles?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 2849 Questions

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Posted on Thu, 26 Jul 2018 in Skin Hair and Nails
Question: I was told I had shingles about one month or so ago. The shingles has cleared up but I am still having pain, most on my left side of my head. The sores have healed in my head but it is painful to touch. How long will the pain continue? Do I need to go back to the doctor's. Should I be concerned?
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Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
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Detailed Answer:
Hello xxxxxx,

What you are describing is called subacute herpetic neuralgia. Shingles is caused by herpes varicella zoster, the same virus that causes chicken pox. It lives dormant in part of the nervous system and comes out as shingles. But then sometimes the pain in the associated nerve continues for awhile longer.

If the pain interferes significantly, you can talk with your doctor about using a medication for this such as gabapentin (Neurontin) or a tricyclic antidepressant that has the function of decreasing nerve pain such as Elavil (amitriptyline). With either, if you tend to be sensitive to medications, start with the lowest dose and gradually increase.

After the shingles lesions have cleared, if there is pain in the 1st 4 months after this, subacute herpetic neuralgia and it usually goes away in most people, especially if you started on an antiviral medicine within 3 days of the initial shingles outbreak.

If there is still pain after the 4 months from the time of the initial rash, then unfortunately it can persist (post herpetic neuralgia).

So there is still a good chance that this will resolve in time, but if you need help with the pain now, do go talk with your doctor about considering either of the 2 medications I mentioned above.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 45 hours later
I sent in a more detailed description of my issues.
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Answered by Dr. Bonnie Berger-Durnbaugh 6 hours later
Brief Answer:
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Detailed Answer:
Hello xxxxxxx,

I just read the additional information you sent. I agree with the dermatologist about taking an antihistamine.

You have a few options for that:
For sleep you can take a sedating antihistamine such as diphenhydramine (Benadryl) 50 mg every 6 hours.

If that is too sedating, you can take cetirizine (Zyrtec) 10 mg. It lasts for 24 hours, but for itching, you may need a higher dose than what is recommended for respiratory allergies. It can be taken in dosages of up to 40 mg/day. I would start with 10 mg/day to see what affect it has and gradually increase as needed.

But I still think you may need gabapentin also. I wrote about this medication above. It helps with nerve pain, and some itching is related to nerve irritation and causes both itching and pain. While the antihistamines I described above are sold without prescription, gabapentin requires a prescription.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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