Can You Have Internal Shingles Without the Rash on the Outside of the Skin?

Shingles pain unaccompanied by the shingles rash is uncommon but still possible, according to Mayo Clinic. Known as zoster sine herpete, this type of shingles occurs more often in elderly patients and can be more difficult to diagnose initially, reports The New York Times.

Pain is usually the earliest symptom of shingles, according to The New York Times. The sensation varies among patients, described as sharp, aching, piercing, tearing or electric. The area of infection can also become sensitive, itchy or tingly, worsening the symptoms of pain. All patients with shingles experience severe pain. Other symptoms include blisters, muscle aches, fever and fatigue, reports Mayo Clinic.

Shingles is divided into three stages, states The New York Times. The first stage, prodrome, serves as a warning sign and is characterized by the pain. It generally lasts only one to five days before the second stage, the active infection, occurs, usually signaled by the start of the rash. The pain may persist past the prodrome stage. While the rash is most often found on the trunk or side of the head, if it encroaches on the eye or follows the noise, the cornea is in danger.

The third stage, known as postherpetic neuralgia, occurs in 10 to 20 percent of patients, says The New York Times. It is marked by persistent and lingering pain.