Localized pain in the area of involvement of shingles that persists beyond one month. The most common complication of shingles is postherpetic neuralgia. This occurs when the pain associated with shingles persists beyond one month, even after the rash is gone. The pain can be severe and debilitating and occurs primarily in persons over the age of 50. There is some evidence that treating shingles with steroids and antiviral agents can reduce the duration and occurrence of postherpetic neuralgia. However, the decrease is minimal.

The pain of postherpetic neuralgia can be reduced by a number of medications. Tricyclic antidepressant medications (amitriptyline /Elavil and others), as well as anti-seizure medications (gabapentin /Neurontin, carbamazepine /Tegretol), have been used to relieve the pain associated with herpetic neuralgia. Finally, capsaicin cream, a derivative of hot chili peppers, can be used topically on the area after all the blisters have healed, to reduce the pain. Acupuncture and electric nerve stimulation through the skin can be helpful for some patients. These options are best discussed with your healthcare practitioner.