How does nerve damage cause rash on the skin? And what exactly hurts, the nerve damage or the blistery skin?
Also how do antidepressants relive the pain?
In: Biology
During chickenpox infection, it’s thought that the virus moves down the nerve pathway into the main body (neuron) of the nerve cells. It never gets completely cleared from your system and lays there in a latent state. Once you get old or immunocompromised, the virus reactivates and is able to cause the rash you see in shingles. Because it follows the nerve, it causes a rash in the area of the skin that the nerve controls/innervates.
The pain is both because of the blistery skin and because of the nerve involved. The neuropathic or nerve component isn’t treated well with opioids and anti-inflammatories. Specific antidepressants called tricyclics (or other neuropathic pain drugs like pregablin) are used for the pain.
Tricyclics work by reducing reuptake of particular neurotransmitters, allowing them to persist longer in the synapse where neurons communicate between each other. It’s different to how they act in your brain for antidepressant effects. The gist is that it activates existing pathways that your body uses reduce pain.
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