Postherpetic Neuralgia Complications and Prevention

Introduction to Postherpetic Neuralgia

Postherpetic neuralgia (PHN) is definitively the most common complication of herpes zoster infection, according to the Centers for Disease Control and Prevention (CDC) and the Infectious Diseases Society of Taiwan 1, 2, 3, 4

The Infectious Diseases Society of Taiwan explicitly identifies PHN as the most common complication among the potential sequelae of herpes zoster, which also include HZ ophthalmicus, bacterial superinfections, cranial and peripheral nerve palsies, and visceral involvement 2, 3, 4
The CDC/ACIP guidelines state that the most common complication of HZ, particularly in older persons, is postherpetic neuralgia (PHN), defined as the persistence of sometimes debilitating pain weeks to months after resolution of HZ 1

The lifetime risk of HZ itself is estimated at 20-30% in the general population, according to the Infectious Diseases Society of Taiwan 2, 4

Herpes zoster ophthalmicus is a severe but less common manifestation that can lead to blindness, as reported by the CDC 1
Bacterial superinfections are mentioned as potential complications but occur less frequently than PHN, according to the Infectious Diseases Society of Taiwan 2, 3, 4
Unilateral facial paralysis (cranial nerve palsy) is a recognized but uncommon complication, as noted by the Infectious Diseases Society of Taiwan 2, 3, 4

The most effective strategy to prevent PHN is vaccination against herpes zoster, with two available vaccines: zoster vaccine live (ZVL) and recombinant zoster vaccine (RZV), as recommended by the Infectious Diseases Society of Taiwan and the CDC 2, 4, 5