Professor Bifa Fan from China–Japan Friendship Hospital led a comprehensive review on zoster-associated pain mechanisms. The study, titled "Research Progress on Zoster-Associated Pain and Its Pain Mechanisms," was published in the journal Skin on April 21, 2026.

The review indicates that following varicella-zoster virus infection, injured nerve fibers become hyper-excitable due to abnormal ion channels. Additionally, the study states that the spinal cord and brain develop central sensitization, amplifying pain signals.

The authors of the study state that acute pain and postherpetic neuralgia represent a single, continuous disease process. This principle is incorporated into the 2025 guidelines.

Fan commented on the implications of these developments. "This guideline update is a game-changer that will spare countless patients from years of unnecessary suffering," Fan said.

Why It Matters

This research provides an understanding of zoster-associated pain, from its acute phase to postherpetic neuralgia. The findings regarding nerve fiber hyper-excitability and central sensitization describe mechanisms underlying the pain experienced by patients. The inclusion of the continuous disease process principle in the 2025 guidelines indicates a shift in the conceptualization and potential management of this condition.