Shingles is a disease that is most common in people above age 50. It is caused by the varicella-zoster virus, the same virus that causes chicken pox. A majority of people over age 40 have had chicken pox, mostly during childhood and young adult years.
People with weakened immune systems are most likely to develop shingles. About 75% of all cases occur in people above age 40. Complications of shingles are more likely after age 60. While there is no cure for this viral disease, patients are advised to seek treatment within 72 hours of first symptoms.
Normally, shingles causes a painful rash and blisters alongside other symptoms. When no rash is present, internal shingles is said to have occurred. This form of shingles is not very common and can be hard to diagnose, let alone treat.
What is internal shingles without rash?
Can shingles be internal? What do we mean by internal shingles without rash? When a person recovers from chicken pox, the causative virus doesn’t entirely leave the body. Some of it hides in nerve fibers that innervate particular dermatomes. The virus stays dormant but may later become active and cause shingles.
Reactivated herpes zoster virus replicates and heads for the skin through nerve fibers. Once in the skin, the virus causes a rash and lesions which soon turn into blisters. The blisters take a couple of days to crust over and completely heal without scarring. The defining characteristic of shingles rash is a band-like appearance and affecting only one part of the body. This can be seen in pictures of shingles on chest. Can you get shingles under your breast? Commonly affected areas are the chest, face and lower back. Since every part of the skin is supplied by a particular sensory nerve, shingles can show up on anywhere including under the breast, armpits and buttocks. See also shingles on buttocks pictures and information on shingles symptoms armpit.
Internal shingles without a rash don’t follow the normal process described above. In this case, signs and symptoms may only be present inside the mouth, inside the ear, in the eyes, muscles, nerves, brain or other organs.
What are the symptoms of internal shingles?
We have seen that the only special thing about internal shingles is the absence of rash. Now, what are the symptoms of internal shingles? Typical symptoms may include:
- Body or muscle aches
- Back or spinal pain
When the eye is involved, it is referred as Hutchison’s sign. The following symptoms may be present:
- Blurry vision
- Swelling inside eye
- Vision problems
This type of shingles is caused by the herpes zoster virus inside the ophthalmic nerve. This is the nerve that serves the forehead, scalp, upper eyelid, cornea and tip of the nose. Therefore, there may be symptoms such as pain, tingling and burning sensation in the mentioned areas. Medical attention is necessary to avoid permanent blindness.
When the ear is involved, it is referred to as Ramsay Hunt Syndrome. In this case, the nerve that serves facial areas near ear and around mouth is affected. Symptoms may include:
- Paralysis or weakness in facial muscles on one side
- Pain inside ear
- Hearing problems
- Balance issues
Balance issues and hearing problems are caused by inflammation inside ear. Although the condition often resolves on its own, medical assistance is important.
When internal organs such as the brain or lungs are involved, the following symptoms may occur:
- Difficulty breathing
These complications occur in people with serious immune issues. Healthy immune systems are able to control a herpes zoster invasion and keep the virus in latency.
In summary, symptoms of internal shingles may include:
- Abdominal pain, nausea and diarrhea
- Being sensitive to light
- Enlarged lymph nodes
- Flu-like symptoms
- Difficulty concentrating due to inflammation in the brain or spinal cord
- Presence of ulcers or blisters inside mouth or on throat
- Pain which may be localized or more intense along certain areas such as spinal cord
What causes internal shingles nerve pain?
Anyone who has ever been diagnosed with chicken pox can get internal shingles. Regardless, there are some people who are more likely to develop the disease.
Anything that may compromise the immune system is a risk factor of internal shingles. Good examples are diseases like HIV, leukemia, diabetes and autoimmune diseases.
People who have recently undergone organ transplant surgeries also suffer from lower immunity. This is necessary to ensure that the body doesn’t reject the transplanted organ.
Chemotherapy and radiotherapy are popular cancer treatments. Along with cancer itself, they often weaken a patient’s immunity.
As we get older, our bodies are no longer able to perform tasks as efficiently as they used to. Ultimately, the immune system will be somewhat affected. This is why shingles is most common after age 60.
There are two theories that may explain what causes internal shingles pain. So far, we have seen that shingles is caused by a reactivated chicken pox or herpes zoster virus.
As the virus replicates and moves along nerve fibers to reach the skin, affected nerves can become damaged in the process. The damaged nerves may heal abnormally and end up sending unnecessary pain signals to the brain. As a result, nerve pain occurs and may persist even after the outbreak is over. It could also be that affected nerves get inflamed and keep sending pain signals to the brain. Either way, internal shingles pain is usually very distressing and a great source of discomfort.
How long does internal shingles last?
How long does it take for shingles to heal? What is the recovery period for internal shingles? How long does internal shingles last? Normally, shingles lasts for 2-4 weeks. Severe cases or not using medications can see outbreaks last for 5 weeks.
As for internal shingles, it is not easy to predict the recovery period. The problem with internal shingles is that one or more complications are usually involved. For example, we have seen that the disease is most common in people with serious immune issues. In that case, an outbreak can persist much longer than expected.
When post-herpetic neuralgia is involved, things become even more complicated. Post-herpetic neuralgia is a condition characterized by prolonged shingles pain that outlasts all other symptoms. The pain can last for months or even years.
Is it contagious?
Shingles is not contagious. It cannot be passed from person to person. So how does shingles spread? Herpes zoster virus can be passed to others during direct contact. Patients remain contagious until blisters have fully crusted over. Since the causative virus is contained in fluid from shingles blisters, coming into direct contact with the fluid can also transmit shingles.
Internal shingles treatment
Before treatment, diagnosis will be necessary. Doctors are sometimes able to recognize internal shingles from its symptoms. Patients will be required to provide their medical history details and timeline or nature of symptoms. Writing down some of these details may help during appointment. To confirm diagnosis, additional tests such as virus culture and antibody stain may be performed.
Antiviral medications like acyclovir and valacyclovir are primarily used for internal shingles treatment. These drugs are most effective when started during shingles rash early stages. Otherwise, they are of little or no help. Other options include:
- Tricyclic antidepressants
It is very important that any of these medications be taken with a doctor’s consent.
Treatment can also be done at home with capsaicin ointments. These work by reducing internal shingles pain. Capsaicin is a substance found in chili peppers. In absence of ointments, a paste can be made at home for almost similar benefits.
You can also try anesthetics and topical analgesics. A good example is lidocaine cream. These work by reduce skin sensitivity so that even minor stimulations do not translate into pain. For better results, you can try mixing aspirin into the cream. Don’t give aspirin to children under the age of 6 months. If you have kidney issues, problems with your blood pressure or stomach ulcers, don’t take aspirin.
Some home remedies may succeed in reducing internal shingles pain to some extent. Apple cider vinegar for example is an anti-inflammatory. It can help reduce swelling inside affected nerve fibers. Tea tree oil can also be used for the same purpose. As for essential oils, the likes of lavender oil and frankincense oil are known to reduce pain and promote relaxation. Olive leaf extract is said to relieve shingles pain in days. The ingredient can be found in a number of products available over the counter.
If internal shingles is causing both pain and itchiness, a cool compress may help. To use a cool compress, soak a piece of cloth in cool water, wring it out and compress on the affected areas for 15 minutes. You can repeat the process as many times as you would like. The cool compress numbs the affected areas which in turn prevents excess pain and itchiness.
Vaccines and supplements for internal shingles
Shingles vaccine can help prevent internal shingles. Currently, you can choose from the two FDA approved vaccines. These are zostavax and shingrix. Zostavax is a live vaccine and is effective for about 5 years. Shingrix is a nonliving vaccine and may be effective for longer. Both are recommended for people above age 60.
People who have never contracted chicken pox are urged to get chicken pox vaccine. Among other things, the vaccine can help prevent shingles and pregnancy birth defects.
Healthy diets and supplements are aimed at keeping the immune system healthy. This may help prevent nerve pain from shingles years later. Examples include:
- Water – water is very crucial for most body functions. Even when not dealing with a shingles outbreak, try keeping up with the recommended volume per day.
- Green leafy vegetables – these contain many important minerals and vitamins. They also reduce risk of obesity and diseases that may compromise immunity.
- Vitamin B12 – promotes quick recovery and may reduce nerve pain.
- Vitamin C – it promotes healthy immunity and aids in skin health.
- Zinc – zinc is an important mineral in regards to a healthy immune system.
- Lysine – lysine taken in supplements has been shown to reduce shingles nerve pain.
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