Compared with aciclovir alone Corticosteroids plus aciclovir may be no more effective at reducing the risk of postherpetic neuralgia 6 months after the onset of the acute herpetic rash in immunocompetent adults (moderate-quality evidence). The aim of the study was to describe the temperature distribution in patients suffering from acute herpes zoster or post-herpetic neuralgia. The pain associated with PHN is neuropathic in origin and is notoriously difficult to treat. Moreover, PHN, like HZ itself with a heavy socioeconomic burden, reduces the patient’s quality of life. Famciclovir significantly reduced duration but not incidence of PHN in one placebo-controlled trial of 419 patients. We compared the patient group who developed PHN with those who did not. Steroids had no effect on PHN.
Amitriptyline for 90 days reduced pain incidence at 6 months in one placebo-controlled trial of 80 patients. (1) As pain severity increased, the occurrence of PHN increased significantly. CONCLUSIONS: There is limited evidence that current interventions prevent or shorten PHN. Famciclovir and valacyclovir have been shown to reduce the duration of PHN in single published trials. Risk factors for the occurrence of post herpetic neuralgia are the length and severity of the prodromal phase, the length, severity and the extent of the acute phase and the persistence of pain after healing of the rash has begun.