Shingles with or even without the rash

gaymen2
Nov 22, 2025
3 min read

I recently had another Shingles jab to protect me from getting Shingles. A friend had Shingles when she was just 23 and while common in older people, is a painful and re-occuring ailment especially if you have a weakened immune system or you are older.

5 years ago while watching telly one evening, it felt like I had been burned with a fat red hot end on a cigar on the side of my stomach, all of a sudden - out of the blue, and it was REALLY PAINFUL and the skin really hurt for the next few months as the pain slowly crawled across my lower stomach to the other side, and then after a couple of months of pain and discomfort, which was ignored by my doctor, it went.

The doctor was somehat dismissive when I asked if it could be varicella-zoster virus (VZV) ( I do my homework ) and I was left to feel I had wasted her time. You see, there was nothing to see, no rash at all.

Now it is back again but this time just under my left nipple and in the centre of my chest is VERY sensitive and sore - not just to touch, but all the time, aches always these days. Even my shirt rubbing against it is sore. So do I waste me time agan trying to get some attention from my doctor ? Or do I ignore and hope it goes away again as it did some years ago.

Shingles are a symptom of a viral infection caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After you have chickenpox, the virus remains dormant in your nervous system and can reactivate later in life, often due to a weakened immune system, to cause shingles.

Cause and reactivation

Initial infection: When you first get chickenpox, the VZV enters your nerve cells and stays inactive for years.
Reactivation: Shingles occurs when this dormant virus reactivates.
Immune system: A weakened immune system makes shingles more likely to occur. This can be due to age (most common over 50), stress, or certain medical conditions or treatments like chemotherapy.

Symptoms

Pain: A common early symptom is pain, tingling, or itching in a specific area.
Rash: A rash typically follows the pain, appearing as a band of red spots that turn into fluid-filled blisters.
Location: The rash usually appears on one side of the body or face.

Can I get Shingles with no rash, no outward visible signs of an infection, no eruptions on the skin etc ?

Yes, you can have shingles without a rash, a condition called zoster sine herpete (ZSH) or "internal shingles".

This occurs when the varicella-zoster virus reactivates but does not cause the characteristic rash, leading to symptoms like pain, burning, itching, numbness, and flu-like symptoms on one side of the body. It can be difficult to diagnose because there are no visible skin symptoms, so it's important to see a doctor if you have these symptoms.

Symptoms of zoster sine herpete (ZSH)

Pain, burning, tingling, or itching
Numbness
Headache and fatigue
Generalized aches
Hypersensitivity to touch
Deep sensation that affects muscles and joints

Diagnosis and treatment

Diagnosis:
Because there is no rash, a doctor may diagnose ZSH by reviewing your medical history and performing lab tests to detect the virus.
Treatment:
Early treatment with antiviral medications is crucial to reduce the risk of complications. Some common antiviral drugs include acyclovir, famciclovir, and valacyclovir.
Importance:
It is important to see a doctor if you suspect you have shingles, even without a rash, because timely treatment can prevent long-term complications like chronic nerve pain (postherpetic neuralgia.)