There is a disease called “herpes zoster” that many of you must have heard of. This disease is mainly manifested by herpes on the surface of the skin, accompanied by severe pain in the herpes and the surrounding area, and the pain often attacks at night, so that the patient can not bear the pain and sleep. When patients go to the hospital, they usually choose dermatology because they perceive pain around the skin herpes. After dermatological treatment, the herpes does go away, but some patients feel more painful than before, which is called “postherpetic neuraliga PHN”. Postherpetic neuralgia is neuropathic pain, and current research suggests that the herpes zoster virus is a neurotropic virus that feeds on the nerve sheath, causing damage to the patient’s nerve sheath and nerve self lesions (inflammation —– herpes, pain, conduction disorders —– sensory abnormalities, etc.), however Human nerve cell repair ability is inherently weak, especially in middle-aged and elderly patients, who have basically lost their nerve self-repair ability. According to the statistics, about 10% of herpes zoster patients can be complicated by postherpetic neuralgia (PHN), and its incidence is proportional to age, 49% for 50~59 years old, 65% for 60~69 years old, and 74% for 70~79 years old. That is, the older the age, the more likely it is that postherpetic neuralgia will occur. Many patients need to rely on drugs (and some of them, such as Premarin, are expensive) to relieve pain, and in addition, the effect of drugs weakens and side effects increase after taking them for a long time. They may be suicidal. Therefore, middle-aged and elderly patients must be alert to the herpes demon. Herpes zoster looks like a skin disease, but its essence is neuropathy, and skin herpes is only its appearance. As the old folks used to say, you need to look at things through the surface and see the essence. The best time to treat shingles is within one month of the appearance of the herpes, the earlier the better (the picture above shows the skin changes in the early stages of the disease), so that the virus can be “killed en masse” and prevented from multiplying and growing. In addition to antiviral, anti-inflammatory and pain-relieving, and nerve-nourishing medications, a more important and effective method of early treatment is nerve root nerve block therapy (stopping the treatment criteria, the patient’s pain disappears). According to the statistics, 86% of the patients are cured after nerve block treatment within 1 month, and 93% of the patients are cured after nerve block treatment within 1 week. Therefore, if you find that you have skin herpes with severe pain around, go to the hospital as soon as possible, preferably to the pain department, or if there is no pain department in the hospital, it is better to go to the department that can perform nerve block treatment (anesthesiology, dermatology).