Shingles, also known as herpes zoster or chickenpox, is a viral infection that causes skin lesions to appear. Creams are typically used to soothe these painful rashes. The symptoms of the infection can vary from person to person, and it may be difficult to tell if you have shingles internally by looking at your skin. This article will discuss how you might know that you have internal shingles.
While shingles usually affects the skin and results in distinctive patterns of rashes, internal shingles is a condition in which shingles affects the organs in your body, such as the eyes, stomach, or even the brain. The symptoms of internal shingles may be similar to other conditions and can sometimes go unnoticed for years.
The first step is to determine what symptoms you might have. Typically, there is an onset of pain accompanied by other systemic symptoms, including chills, pain, muscle aches, numbness/tingling sensations, headache, and fever. These symptoms are not unique to internal shingles. There are also more specific symptoms that you can keep a lookout for to determine if you have internal shingles:
- Pain in an area other than where the shingles rashes are
While internal shingles is known to only affect the organs of the body, you can have both typical shingles and internal shingles, which would mean that both the skin and organs are affected. It may be easy to diagnose shingles in this case, but to determine if you are affected by internal shingles, you have to also experience severe pain in another area where rashes do not appear.
- A deep, twisting pain in muscles, joints, or ligaments and burning superficial pain in or near the skin.
- Having muscular weakness and pain, or even partial paralysis caused by an unknown origin.
- A burning pain associated with disturbances in the internal organs such as the abdomen. One is only affected for a short period by this, and it usually fully resolves on its own.
- Having severe shooting pain in the eye or the eye muscles, accompanied by muscle weakness.
- Pain in the ear that is not caused by middle ear disease and associated with facial palsy, sensitivity to sound (finding sounds excessively loud even when the sound is not actually loud), or loss in taste in the front ends of the tongue
- Inflammation on the inner part of the ear with evidence of the involvement of other nerves
- Unexplained paralysis of the soft palate, pharyngeal muscles, or vocal cord, especially when pain in the ear or inflammation in and around the larynx is also observed (Lewis, 1958)
If you think you might have this condition, consult a doctor immediately for the proper diagnosis and treatment options. Even for doctors, it can be challenging to diagnose internal shingles, especially since there are no skin rashes to indicate the presence of shingles. Doctors will need to review a patient’s medical history to identify possible indicators, especially in patients with a history of radicular pain, peripheral facial palsy, or muscle paralysis without a rash (Zhou et al., 2020). Laboratory testing such as polymerase chain reaction (PCR) and viral antibody tests can also determine if there is a case of internal shingles to be treated.
While there are maybe cream to put on shingles rashes, such treatments are not helpful for internal shingles. Instead, a doctor may choose to prescribe antiviral drugs such as acyclovir and valacyclovir, prescription painkillers such as non-steroidal anti-inflammatory drugs, tramadol, and opioids, tricyclic antidepressants, and/or corticosteroids to manage the severity of symptoms. The aims of treatment are to minimize viral activity and lower the risk of neuropathological damage. If internal shingles is not detected and treated, there may be damage to the nerve cells. This may cause postherpetic neuralgia (PHN), in which a person suffers from continuous pain lasting for months or even years after the bout of shingles has been resolved. Unfortunately, the chances of developing postherpetic neuralgia are higher for people with internal shingles than for people suffering from typical shingles.
In conclusion, internal shingles is a relatively rare condition, even among shingles patients. Most people who have had a bout of typical shingles will not go on to develop internal shingles later in their lives. Knowing the signs and symptoms that may indicate having this type of shingles will help you determine if there is a cause for concern or just another bout of shingles. Examples of such signs and symptoms include having a severe, shooting pain in the eye or ear, which is accompanied by facial palsy or muscle paralysis without an accompanying rash. In the case where rashes are present, pain in other areas with no rashes can be an indicator of internal shingles. So, if you suspect that you might be afflicted with this condition, do seek a doctor’s opinion immediately for proper diagnosis and treatment options. While it can be very difficult to diagnose for internal shingles, (especially since there are no skin rashes to indicate the presence of shingles), doctors can review a patient’s medical history and arrange for laboratory testing such as polymerase chain reaction (PCR) and viral antibody tests to determine if there is a case of internal shingles.
LEWIS G. W. (1958). Zoster sine herpete. British medical journal, 2(5093), 418–421
Zhou, J., Li, J., Ma, L., & Cao, S. (2020). Zoster Sine Herpete: A Review. The Korean Journal of Pain, 33(3), 208–215