PHN years after shingles outbreak?

Patient: I have a question I cannon find on the Internet. Can a 70 year old develop PHN 9 years after an intense shingles outbreak. I have since had the vaccine and also suffered three major stress factors in my life. I read where PHN usually develops right after an outbreak but can it develop many years later for the first time? Thank you for your time.

Doctor: Post-herpetic neuralgia or PHN is caused by nerve damage resulting from an outbreak of shingles, that lasts for months o r even years after the blisters have scabbed and fallen off. PHN does not develop years after complete recovery from shingles outbreak. However since the Herpes zoster virus responsible for shingles harbour in the nervous system, it could be possible that you may be having a recurrent episode of shingles followed by PHN or even PHN may continue for years after initial outbreak. Hope this helps.