shingles symptoms

Shingles Symptoms With and Without a Rash

Many of us had chickenpox when we were children. The same virus, varicella-zoster virus, can reactivate and cause shingles during adult years, usually after the age of 40.

Shingles will occur sporadically in healthy adults. It mostly affects those with weakened immune systems, especially the elderly. About half of those 85 years or older will experience an episode of singles.

While shingles is not a serious or life-threatening condition, it can cause discomfort. Those with shingles may experience pain even after the rash has cleared.

In this article, we’ll explore the symptoms of shingles, including cases where the characteristic rash is not present.

shingles symptoms - shingles rash with blisters

Signs and Symptoms of Shingles

After getting chickenpox, the virus will stay dormant in the body and in the nerves. Individuals will experience a set of characteristics symptoms during a shingles infection.

The main symptom of shingles is pain. This can be mild or severe and can mimic other conditions such as heart or kidney problems.

Other early symptoms include numbness or burning sensation and sensitive skin. Some people experience fever, sensitivity to light, fatigue, and headaches, as well.

A few days later, a shingles rash will occur. It’s red, itchy, and tingly. This eventually develops into blisters. These blisters are full of clear fluid and will break in three to five days. They are then replaced with crusts.

It takes about two to four weeks for the rash to heal. However, the skin may remain permanently darker at the site of the rash.

A shingles rash has a few unique characteristics. It has a band-like appearance that wraps around one side of the torso without crossing the body’s midline. Doctors can diagnose shingles upon a physical examination. The rash is highly suggestive of shingles.

If a shingles rash is the telltale sign of the condition, what happens if shingles develop without a rash?

shingles symptoms - woman fatigued in bed holding her head

No Rash Shingles Symptoms

Some people experience shingles without a rash. This form of shingles is uncommon, though.
A diagnosis can be difficult and cause many missed cases due to the missing rash. Other shingles symptoms include:

  • Pain on one side of the body
  • Burning sensation
  • Tingling sensation
  • Itchy skin

The skin will be sensitive to the touch. Some people also experience fatigue and headaches.
Doctors can use blood tests and testing of the cerebrospinal fluid to diagnose shingles. These tests will detect the presence of antibodies. However, they are not routinely done.

shingles symptoms - old man in pain holding his knee

Shingles Complications

People with compromised immune systems are at risk to develop shingles complications. Postherpetic neuralgia, a persistent pain that can last weeks, is a common complication. The pain may be present for months after the shingles rash clears.

Pain can be severe in older adults. It’s rarely experienced by those younger than 40 years of age. The larger the rash, the more severe the pain will likely be.

Another possible complication of the varicella-zoster virus reactivation involves the eyes. Herpes zoster ophthalmicus is a condition that starts with tingling in the forehead. It’s then followed by a painful rash on the forehead, eye pain, eyelid swelling, and light sensitivity. This infection can leave scarring that impairs vision.

Secondary bacterial infections, like nerve palsies, may develop after shingles. Complications may also affect the heart, lungs, and liver.

shingles symptoms - bottle of blue and white pills

How to Treat Shingles

Antiviral drugs, like oral acyclovir, can treat shingles. Antiviral drugs help decrease viral shedding. Therefore, it speeds up skin healing and reduces pain. Doctors recommend starting antiviral treatment within three days of the rash developing.

Do not use topical antivirals as they don’t seem to work for treating shingles.

You can use acetaminophen and nonsteroidal anti-inflammatory drugs to relieve pain and inflammation. Older generation antidepressants like amitriptyline can treat postherpetic neuralgia.

Transcutaneous electrical nerve stimulation (TENS) is a newer non-drug therapy for shingles. It blocks the pain and can help in cases of postherpetic neuralgia.

shingles symptoms - woman meditating in nature

Managing Shingles with Home Remedies

When a shingles rash is present, keep the affected area of the skin clean. Use sterile dressings to avoid contact with clothes and skin irritation.

Some home remedies to relieve symptoms include oatmeal baths, cold compresses, and calamine lotion. Cream with a capsaicin base, the key ingredient from cayenne pepper, can help manage pain. It’s available over-the-counter.

Stress is a major trigger for shingles, and the acute episode can make a person feel more stressed. Try yoga, meditation, and deep breathing to stay as calm as possible.

If you suspect you have shingles, call your doctor as soon as possible. Antiviral medications work best when used early.

Zoster vaccines are also available for adults over 50 years of age. This is best for those who are healthy and are not immunocompromised.

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