Will Botox Help Nerve Damage in Face from Shingles?

Question

I've had nerve damage and PAIN for three years from shingles in left side of face. Would Botox help the pain ?

Kenneth D. Steinsapir, MD · Answer

Botulinum toxin has been used as a treatment of pain that can follow after an episode of herpes zoster. However, this treatment cannot be considered a proven treatment of this condition. Rather than experimenting with such a treatment, it is much more reasonable to see a neurologist regarding this issue and try the more established treatments first.

Ron Shelton, MD · Answer

There are reports of Botox being used to treat pain from Shingles in the chronic form. I'm not aware of the mechanism of action and it has been theorized that the Botox blocks more than just acetylcholine, the neurotransmitter used to conduct signals from nerves to muscles. This needs to be studied further.

Barry Resnik, MD · Answer

BOTOX can be a miracle treatment for post-herpetic neuralgia, the pain that sometimes comes after shingles. It is injected in a "point and shoot" manner, and often brings relief for this very painful condition. Dilute cortisone injected in the same manner also works well.

Alexander Gross, MD · Answer

I have had excellent success injecting Botox to alleviate several different types of nerve pain including nerve pain from shingles ("post-herpetic neuralgia").

	A study in the December 2010 issue of Pain Medicine showed that the majority of patients receiving this treatment experienced a decrease in overall pain scores, improvement in sleeping, and a decreased need for pain medication.  The effects lasted for at least  3 months.

	If you chose to pursue this treatment, be sure to find a physician with lots of experience.  As I am aware that post herpetic neuralgia is a significantly debilitating problem, I wish you the best in finding a solution to eliminating your pain.

Francis R. Palmer, III, MD (retired) · Answer

IMHO, you should seek out a neorologist or pain specialist that is experienced using the various neorotoxins: (Botox, Dysport and Xeomin) and have a consultation.

Charles Virden, MD (retired) · Answer

Absolutely Botox may have a high likelihood of helping with post herpetic neuralgia due to Shingles. It will probably fall under a Neurologists specialty. good Luck

Richard Galitz, MD, FACS (in memoriam) · Answer

The answer is possibly. But see a Neurologic specialist  ( Neurologist ) who does pain work and get his opinion.

Kevin C. Smith, MD (retired) · Answer

BOTOX&reg; can be useful to treat pain in the face ["post herpetic neuralgia" = PHN] after shingles. Several treatment sessions may be needed.

	If shingles has caused relaxation of muscles on one side of the face, sometimes BOTOX&reg; is used to relax the same muscles on the opposite side of the face, in order to restore facial symmetry for the patient.

F. Victor Rueckl, MD (in memoriam) · Answer

I have injected Botox for excessive pain from Shingles before, though this is an off-label use of the product. There are various studies about the effectiveness of this, but most of my patients say they experienced about 50%-70% improvement overall. You will need to consult a board-certified, very experienced physician for this type of injection, as the sites the Botox needs to be injected differ greatly than the cosmetic use of the product and the dosing needs to be very specific to ensure muscles continue to work properly.

Will Botox Help Nerve Damage in Face from Shingles?

Answers (9)

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