The itch that sometimes occurs during or after shingles can be quite severe and painful. Clinical experience suggests that postherpetic itch is harder to treat than postherpetic neuralgia. Topical local anesthetics (which numb the skin) provide substantial relief to some patients. Since postherpetic itch typically develops in skin that has severe sensory loss, it is particularly important to avoid scratching. Scratching numb skin too long or too hard can cause injury.