Post-herpetic neuralgia (PHN) is the most common chronic complication of herpes zoster and also one of the most troublesome. It is a prime example of typical neuropathic pain which in many cases contributes to a significant reduction in the patient’s quality of life. Despite the emergence of a prophylactic method in the form of a vaccine, PHN continues to be a significant problem, particularly affecting the elderly and immunocompromised individuals.

The aim of this review is to summarize the knowledge contained in the current literature on the available oral and topical medications for the treatment of neuropathic pain in PHN. An area of particular focus was the effectiveness and safety of their use

Review methods:
The review is based on 49 scientific publications found in PubMed, PubMedCentral, NCBI and Via Medica Journals databases published between 2008–2024.

Brief description of the state of knowledge:
Current treatment of PHN is mainly based on pharmacological therapy. Both oral and topical drugs belonging to a variety of groups are used. Gabapentinoids, tricyclic anti-depressants and, in some circumstances, lidocaine 5% patches, are considered first-line medications. In contrast, capsaicin 8% and opioids are considered second-line medications. The use of multimodal therapy is becoming widespread due to the relatively frequent ineffectiveness of pain management during monotherapy.

Despite the wide range of methods available for use in the treatment of neuropathic pain, management of PHN continues to be a challenging task. Multimodal therapy using medications with different mechanisms of action and an individualized approach to drug selection based on the specific clinical case are crucial for treatment success.

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