Manage post-herpetic neuralgia by offering self-management advice, including information on the condition, with patient information leaflets available from the Shingles Support Society NICE CKS.
Advise patients to wear cotton or silk fabrics to minimize irritation and protect sensitive areas with a protective layer such as a bandage or compression clothing NICE CKS.
Consider frequent application of cold packs, unless this causes pain (allodynia) NICE CKS.
When planning treatment, consider the degree and nature of pain (constant or intermittent), the impact on daily activities, and the patient's mood, including signs of depression or anxiety NICE CKS.
Offer analgesia, such as paracetamol with or without codeine, for mild to moderate pain, being aware this may be insufficient alone NICE CKS.
If pain remains uncontrolled, consider prescribing drugs for neuropathic pain, such as amitriptyline, duloxetine, gabapentin, or pregabalin, titrated according to response and tolerability NICE CKS.
Prescribe topical treatments like lidocaine plasters, especially if allodynia is prominent, in older patients, or as adjuncts to oral therapy NICE CKS.
Arrange early follow-up to assess treatment progress, including dose titration, tolerability, and effectiveness NICE CKS.
Educate patients on the importance of dosage titration, explaining that treatment may take weeks to be effective, and suggest keeping a pain diary to aid management NICE CKS.