Which of the following is an effective treatment for post-herpetic neuralgia?

Which of the following is an effective treatment for post-herpetic neuralgia?

• A. Short-acting antibiotics
• B. Topical lidocaine patches and capsaicin cream or patches
• C. Oral NSAIDs
• D. Antifungal agents

Answer: (B)

Post-herpetic neuralgia is a neuropathic pain problem arising after herpes zoster, so treatments that soothe nerve pain locally can be especially effective. Topical lidocaine patches work by blocking sodium channels on peripheral nerves, reducing ectopic nerve firing and giving targeted pain relief with limited systemic effects. Capsaicin, used as a cream or an 8% patch, acts on TRPV1 receptors on nociceptive fibers; with repeated use it desensitizes these fibers and decreases substance P, diminishing pain transmission. Together, they address the abnormal nerve signaling at the site of pain and can be used alongside other systemic neuropathic agents if needed. The other options don’t target neuropathic pain: antibiotics treat infections, not nerve pain; oral NSAIDs address inflammation rather than nerve signaling; antifungals are for fungal infections and have no role in PHN.

Post-herpetic neuralgia is a neuropathic pain problem arising after herpes zoster, so treatments that soothe nerve pain locally can be especially effective. Topical lidocaine patches work by blocking sodium channels on peripheral nerves, reducing ectopic nerve firing and giving targeted pain relief with limited systemic effects. Capsaicin, used as a cream or an 8% patch, acts on TRPV1 receptors on nociceptive fibers; with repeated use it desensitizes these fibers and decreases substance P, diminishing pain transmission. Together, they address the abnormal nerve signaling at the site of pain and can be used alongside other systemic neuropathic agents if needed. The other options don’t target neuropathic pain: antibiotics treat infections, not nerve pain; oral NSAIDs address inflammation rather than nerve signaling; antifungals are for fungal infections and have no role in PHN.