Shingles Rash Gone, But Pain Lingers On

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DEAR DR. DONOHUE: I’ve been trying to deal with shingles pain for six months. At times it’s so bad that I can’t sleep. I have tried Tylenol, Aleve and Advil, and some herbals that my wife bought. Nothing works. Can you tell me what will? How did I get it? Will the shingles vaccine take away the pain? — R.M.

ANSWER: Shingles comes from the awakened chickenpox virus that has been hibernating in nerve cells ever since the childhood infection. Even if you can’t remember having had chickenpox, odds are you did. More than 90 percent of adults — in fact, close to 99 percent — have evidence of a prior chickenpox infection in their blood.

Once the shingles rash goes, pain continues to remain in a significant number of people. That’s not shingles. It’s called postherpetic neuralgia. When the chickenpox virus crept down nerves to your skin, it injured the nerves. That’s what causes lingering pain long after the shingles rash has disappeared.

Plenty of medicines can quiet that pain. You have to experiment to find which works for you. Lyrica is a somewhat newer addition to these medicines. You need a prescription for it. Capsaicin cream, gel or lotion is found on the shelves of all drugstores. You apply it directly to the painful skin. Qutenza is a new preparation of capsaicin. It’s applied by your doctor or a health professional in a one-hour treatment, and is touted to provide three months of pain relief.

The lidocaine patch is another skin-applied treatment that quiets pain. Amitriptyline and Cymbalta, both antidepressants, are oral medicines that can dull postherpetic pain. Opioids like tramadol and oxycodone can be turned to when others fail. And this is just an abbreviated inventory of treatments.

The shingles vaccine doesn’t do a thing for postherpetic neuralgia; it cuts the chances of developing shingles in half. And if a vaccinated person does develop shingles, it lessens the chances of postherpetic neuralgia. It’s recommended for everyone 60 and older.

The shingles pamphlet explores this common illness in detail. Readers can obtain a copy by writing: Dr. Donohue — No. 1201W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.


DEAR DR. DONOHUE: Will you discuss the eating of canned tuna? I enjoy a tuna-salad sandwich once in a while. But I read that the mercury in tuna is harmful, especially to expectant mothers and small children, and to adults in general. I also read that light tuna is less toxic than white albacore tuna.

Will you clarify this? — D.R.

ANSWER: Shark, swordfish, king mackerel and tilefish are the fish with the highest mercury concentrations.

Seafood that is low in mercury and quite safe includes shrimp, canned light tuna, salmon and catfish.

Albacore (white) tuna has more mercury than canned light tuna, but it’s OK to eat 6 ounces of it once a week. Eating a tuna-salad sandwich, whichever the source of tuna, once in a while (once a week) isn’t going to cause any health problems.


Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

© 2011 North America Synd., Inc. All Rights Reserved

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