Can PHN be prevented?
As mentioned earlier, the longer and more
painful the patient’s acute herpes zoster infection, the greater the chance
that they will develop PHN. Thus, it makes sense that aggressive control of the
pain and symptoms of acute herpes zoster will decrease the intensity of the
PHN. However, as is the case with most topics related to PHN, this has not been
proven in large-scale studies. Based on small studies, it makes sense to treat
the patient early in the acute herpes zoster period with oral analgesics, as
well as oral antiviral agents such as valacyclovir. The use of oral steroids
during the acute herpes zoster infection has never been shown to decrease the
intensity and frequency of PHN pain.
Another controversial topic is the use of
sympathetic blocks during the acute herpes zoster episode. It has been debated
that this technique can decrease the severity and intensity of PHN pain;
however, this too has not been gen-erally accepted as the truth. One may argue
that because of the low risk factor in properly performing such a proce-dure
and the potential debilitating consequences of PHN pain, these techniques
should be employed early on during an acute herpes zoster infection.