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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.
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