Postherpetic neuralgia is pain in the affected area of the skin that persists for more than 3 months even after the herpes lesions have subsided in patients with acute herpes zoster, and is mainly characterized by persistent, paroxysmal burning or deep throbbing pain in the skin, spontaneous knife-like pain, abnormal pain and nociceptive hypersensitivity. Its prevalence is 30 to 100/100,000 and increases with age. With the aging of the population, the incidence of herpes zoster and postherpetic neuralgia has been increasing year by year. It has received more and more attention from scholars because of its heavy clinical symptoms and long duration, leading to anxiety, depression and sleep disorders, which seriously affect the life of patients. Pharmacological treatment is still the first choice at present Pharmacological treatment is still the primary treatment for herpes zoster neuralgia at present. In recent years, some new drugs have emerged for the treatment of herpes zoster neuralgia, including gabapentin, pregabalin, and capsaicin patches. Gabapentin and pregabalin are new antiepileptic drugs, both of which are calcium channel α2-delta ligands that act mainly by blocking the inward flow of calcium ions and inhibiting the generation and afferentation of ectopic impulses from damaged primary sensory neurons and their axons. Both domestic and international studies have found that pregabalin and gabapentin for postherpetic neuralgia can reduce pain, relieve anxiety, improve sleep, and have better efficacy than other antiepileptic and antidepressant drugs. Pregabalin has just been launched in China, and studies abroad have found that it can also significantly reduce pain and improve sleep in patients with herpes zoster neuralgia. It has a faster onset of action compared to gabapentin, with an oral bioavailability of >90%, a peak time of 1.3 hours, and no binding to plasma proteins. There are no interactions with other drugs because it is excreted in prototype form through the kidneys. The side effects of both drugs are drowsiness, dizziness, and peripheral edema, and care should be taken when using them that the dosage should be reduced as appropriate in patients with renal insufficiency. Capsaicin is a natural plant alkaloid, and its mechanism of action is to activate TRPV1 receptors, depleting the storage of substance P and other neurotransmitters in nerve endings, desensitizing the axon endings that feel injury, and reducing or eliminating the transmission of pain stimuli from peripheral to central nerves. A randomized controlled trial published in The Lancet in 2008 showed that a single treatment with an 8% capsaicin patch resulted in pain relief in patients with herpes zoster neuralgia for up to 12 weeks. A clinical study published just this year overseas showed that a single treatment with an 8% capsaicin patch could last up to 48 weeks if the patient could receive three more treatments. The side effects are mainly localized burning sensation of the skin, so capsaicin patches are considered a promising treatment method. However, the efficacy and safety of long-term use of capsaicin preparations, especially their effects on the structure of intradermal nerve fibers, remain to be clarified by more clinical studies. Nerve block Not yet widely used Nerve block therapy as one of the treatments for postherpetic neuralgia has become more and more accepted, and subarachnoid administration is a new treatment for herpes zoster neuralgia that has emerged in recent years. Foreign studies have found that intrathecal injection of glucocorticoids and lidocaine is effective in relieving postherpetic neuralgia. The mechanism is to reduce the level of interleukin 28 in cerebrospinal fluid through the anti-inflammatory effect of glucocorticoids, thus reducing cell edema and toxic reaction, promoting the repair of affected nerves, and stabilizing nerve cell membranes and reducing the abnormal discharge of C nerve fibers, thus relieving pain. Although this method can effectively relieve patients’ pain, its effectiveness has not been fully confirmed in clinical practice due to concerns about its safety, and intrathecal injection has not been widely used. The future of iontophoresis is promising. iontophoresis is a new treatment for postherpetic neuralgia and is one of the promising methods for the future treatment of postherpetic neuralgia, including refractory postherpetic neuralgia. The pain was significantly reduced after treatment. Another study showed good results in refractory herpes zoster neuralgia treated with iontophoresis of 0.01% vincristine. New drugs and techniques are emerging to provide new treatments for herpes zoster neuralgia, especially in refractory patients, but even new drugs inevitably have side effects and new techniques may have complications. Therefore, each patient should choose the appropriate treatment plan according to his or her specific situation, and should not blindly seek “new” treatment.