Which topical agents are used in the treatment of postherpetic neuralgia (PHN)?

Updated: Jan 25, 2019
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Topical capsaicin can be helpful; its active ingredient depletes neurotransmitters at involved nerve endings. However, the cream must be applied at least 5 times daily, and pain may increase upon application for the first few days as accumulated neurotransmitters are released. Once neurotransmitter reserves have been depleted, any resultant pain relief is temporary.

Topical lidocaine is occasionally used to treat patients with PHN, though the data are insufficient to allow it to be recommended as a first-line agent for PHN with allodynia. [115] In one small study, administration of lidocaine 4% ophthalmic eyedrops produced a significant reduction in eye and forehead pain. [83]


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