Symptoms

Depending on the localization of the nerve damage caused by the Varicella zoster virus, post-zosteric neuralgia can have complex symptoms. Therefore, patients usually describe three different types of pain: a constant pressing or burning pain, short stabbing (lancinating) pain – like electric shocks – and pain that is touch-sensitive (allodynia, hyperpathy). These touch-dependent pains are sometimes so strong that it is already unpleasant for the patient to have material on his body.

They are mainly triggered by light touch, whereas firm pressure at the respective point is not perceived as unpleasant. Furthermore, stress and temperature changes can also cause or increase post-zosteric pain. Another common symptom of shingles is itching, which is often the first symptom of shingles.

It also typically occurs in the area of skin where the rash has formed and where the patient feels increased pain. As the disease progresses, the itching may increase. The itching is also due to damage to the nerve by the virus.

Due to the nerve damage, the sensitivity of the nerve is disturbed and the patient feels a strong itching. In rare cases, the itching can also occur instead of the pain. The itching usually heals with drying and encrustation of the zoster blisters. In order to support the rapid drying out, the regular application of a zinc ointment is recommended. This also leads to a relief of itching.

Can shingles also occur without pain?

As a rule, the damage to the nerve fibers in the context of shingles causes severe pain. This usually occurs in combination with a rash on the skin and itching and is often the first symptom of shingles. The intensity of the symptoms varies from patient to patient.

While in some patients the pain symptomatology is at the forefront of the disease, the skin rash in combination with itching causes other patients more problems. In individual cases, however, shingles can occur without the occurrence of pain. Especially within the first few days, the pain is often absent. Sometimes the damage to the nerve is also perceived by those affected as a burning or itching sensation. In this case, however, an early start to pain therapy is also indicated in order to prevent the development of severe pain and possible complications (post-zosteric neuralgia).