54, male & shingles outbreak a month ago - will Botox help?

Question

Hi I am a 54 year old male and had a shingles outbreak a month ago. My rash has gotten crunched over and I took Valtrex for 7 days. It is day 30 since I had shingles. But pain in my right rib will not go away. I have been taking 300mg x 6 gabapentin ever since. My pain is so severe gabapentin gaba will not do much. I heard from someone Botox may help. Do doctors poke injections directly on the affected area? In my case it is my ribs. Is it safe?

Anna Chacon, MD, FAAD · Answer

Botox (botulinum toxin) injections can be used as a treatment option for postherpetic neuralgia, which is the persistent nerve pain that can occur after a shingles outbreak. While traditional treatments like gabapentin are commonly used, some patients may benefit from Botox injections, especially if other treatments have not provided sufficient relief.

Botox works by blocking nerve signals and can potentially reduce pain in the affected area. In terms of administration, injections are typically done directly into or around the painful area, such as the ribs in your case. This is generally considered safe when performed by an experienced healthcare professional.

However, it is essential to conduct a thorough evaluation to determine if Botox is appropriate for your specific situation. A pain management specialist or dermatologist familiar with postherpetic neuralgia treatments can provide guidance on whether this approach is suitable and safe for you.

Camille Cash, MD · Answer

I encourage you to return to your physician treating you for shingles to see about additional treatments for your pain.  Botox is not traditionally used to help with shingles pain, so it's better to explore more well studied treatments.

Mahmood Siddique, DO · Answer

I’m sorry to hear about the ongoing pain you're experiencing. Postherpetic neuralgia (PHN), which is the pain that can persist after a shingles outbreak, can be difficult to manage and may not always respond fully to medications like gabapentin.
In certain cases, Botox injections have been explored as an option for managing chronic nerve pain, including postherpetic neuralgia. Botox may help by blocking pain signals in the nerves and reducing muscle tension in the affected area. Typically, injections are done around, not directly into, the affected area, so targeting the region around your ribs would be possible if a healthcare provider deemed it appropriate.
Here are a few things to consider:
Safety and Suitability: Botox for nerve pain relief is generally considered safe when performed by a qualified professional, though it’s not a standard first-line treatment for PHN. It’s essential to consult with a pain management specialist or neurologist experienced in this type of treatment to see if it might be suitable for your specific case.
Alternative Pain Management: Besides Botox, other options, such as nerve blocks, lidocaine patches, or different medication combinations, may also help with persistent pain after shingles.
Temporary Relief: Keep in mind that Botox effects are temporary and would need to be repeated periodically if you find relief from it.
It’s worth discussing this option with your doctor or a pain specialist to determine the best course for you. Wishing you comfort and relief soon!

Eric M. Joseph, MD · Answer

I am not aware of Botox as being helpful for pain after shingles. If you are taking 1800 mg of Gabapentin daily, that is a sizable dose. Since shingles pain is a type of nerve pain, please consider meeting with a reputable neurologist or pain management specialist for help moving forward. The good news is that this pain will eventually dissipate, but some people, it can take up to a year. If readers of this post are eligible, please get the Shingrix vaccine. Thank you.

Stefan Weiss, MD · Answer

Post-herpetic neuralgia is more related to nerves than muscles - the target of Botox. However, you could speak with your neurologist as to his/her success in the use of Botox for this indication.

54, male & shingles outbreak a month ago - will Botox help?

Answers (6)

Answer: Botox may not be helpful for post herpetic neuralgia.

Answer: Botox may not be helpful for post herpetic neuralgia.

Answer: Will Botox help?

Answer: Will Botox help?

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.

54, male & shingles outbreak a month ago - will Botox help?

Answers (6)

Answer: Botox may not be helpful for post herpetic neuralgia.

Answer: Botox may not be helpful for post herpetic neuralgia.

Answer: Will Botox help?

Answer: Will Botox help?

Browse related questions

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.