Shingles Without Rash Symptoms: Treatment For No Rash Shingles

Shingles or herpes zoster as it is commonly known is a viral disease, caused by herpes vericella virus. The virus is from same family which causes chickenpox. Shingles is easily diagnosed due to the characteristic rash with blisters. However, in rare conditions shingles can be present without rash, the condition is known as zoster sine herpete, and in such cases diagnosis becomes difficult.

What Causes Shingles?

Singles virus affects the nerve roots. People of elderly age are the usual victims, most often people above the age of 60 are affected with herpes zoster.

Usually shingles appear with a typical rash in a specific region of the body over the skin, which is one sided. The common sites of its appearance are on the chest, back, neck and face. In some cases shingles can affect the eye which is a serious concern due to chances of vision loss.

Commonly the rash develops as a stripe of blisters on the surface of the skin, either on the right or left side of the body. Before the rash develops, there may be severe pain on particular section of the body. Fever and chill, body ache, headache, tingling and burning, with nausea and vomiting are some associated symptoms. The rash may develop after 3 to 4 days and last for a week; eventually the fluid filled blisters will dry.

Symptoms Of Shingles Without Rash Or Blisters

The above description is classical for shingles with rash, however sometimes shingles may develop without rash. It is important to know the symptoms as one can be easily misdiagnosed in absence of shingle rash. Following are shingles without rash symptoms:

  • Pain: severe pain is a noticeable symptom of zoster sine herpete.
    The pain is excruciating on the skin surface. It is also felt deep down the muscles. The characteristic pain of shingles without rash is ‘burning’. In absence of rash, many times the pain is misdiagnosed if present over the chest as heart attack. If present on the back as kidney pain.
  • Fever is another symptom that is frequently associated with herpes without rash. However, without rash it becomes difficult to for the physician to clinch the diagnosis of herpes zoster, this is because there are many other conditions where fever with pain can be a presenting symptom.
  • Itching and tingling over the particular section of the skin.
  • Headache and body ache are other features that may be associated with zoster sine herpete.
  • One unusual symptom of herpes without rash is Bell’s palsy. The disease is characterized by paralysis of one sided facial muscles. The virus infects the facial nerves that supply the muscles of the face causing inflammation. The person is not able to smile from the affected side of the face. He also finds difficulty in closing his eyelids of the affected side. There may be drooling of saliva from the angle of mouth of the affected side of the face.

Shingles No Rash Treatment

Usually shingles without rash is generally present in elderly individuals. With growing age and absence of classical rash, diagnosing shingles in such circumstances becomes difficult for the attending medical practitioner.

The symptoms sometime mimic as that of heart attack or chest disease when present over chest. So to confirm shingles without rash, blood sample is tested in laboratory for presence herpes virus. Once herpes virus is confirmed, the physician prescribes anti viral medicines to shorten the period of symptoms and for its cure.


  1. Larke

    I have been suffering from itching for weeks with slight rash and blotchy skin. I am having severe headaches and my skin feels like I am being stung by bees on my back, buttock and right leg. I have terrible pain around my torso and have aching muscles. I have slight rash under my breasts and am convinced I have shingles. Please can you help me?

  2. Charlin

    I was wondering if I have the shingles because in the last couple of days my left leg is paining every now and then and you can’t touch it. It feels like it is raw but there is no rash. I had headache and was feeling nausea and also I was cold. I don’t know what is happening but my leg doesn’t feel right. I feel pain on the side of my leg and around my vagina. Please let me know about this.

  3. Sue

    This is the second time that I am having shingles, in the same place, but this time there is no rash. I was given multiple tests, like a spinal MRI etc before being diagnosed with shingles (still a guess since just about everything else has been ruled out). I have had severe headaches and pain for last 16 days so far. I started on an anti-viral medication today. Please advise.

  4. Kathy

    I have zoster sine herpete (shingles without a rash). I am suffering from all the symptoms of shingles, but have no rash and I had the shingles vaccine less then a year ago. The pain is intense and I am having a very hard time getting a doctor to treat it. They keep sending me to the ER and the ER sends me back to my PCP. They want to run lot of other very expensive test like MRI’s, CAT Scans, and invasive exploratory surgeries etc. I know it is shingles without a rash. I have had experience taking care of many people with shingles. What can I do to get someone to treat this properly and work with me to relieve this pain?

  5. Turner

    I have had this burning tingling sensation around my left shoulder blade. Also shooting pain, like someone sticking a pin in me with a pressing feeling in my left rib. I have been to hospital to make sure its nothing to do with my heart. I have had MRI scan to see if there is a calcium build up in my heart and also a CT scan of my lungs and abdomen. This pain is continuous and nothing takes it away.

    After reading other remarks about shingles without rash it seems to me that this is what I have. What can I do as my doctor says you cannot have shingles without rash. I am at my wits end. Kindly help me.

  6. Lolita

    For at least three days there was a growing pain on top of my head with the feeling of thickness and numbness. The pain was forming a little circle growing almost on top of my head. It was associated with fever and chills. They suspect it was MS.
    After 5 to 7 days I was back in hospital, with the pain on my right side of my ribs, very painful that tylenols won’t get rid the pain. Later on the pain is shooting up to my back. This time I have no more fever and chills but very painful that I can’t help but cry. This time they suspect it is a kidney stone. I took a scan and the result was ok.
    They injected something for pain as I was moaning loudly. I went home without a diagnosis. I was sick for more than a month and lost lot of weight, around 8lbs in 2 weeks alone, although I was eating as usual. Earlier in the month, I had a pelvic ultrasound test for my fibroids.
    Was it a viral infection or bacterial infection? If it was, do you think I didn’t acquire some kind of STD’s. I am so worried that up to now, it’s giving me a nightmare that I cannot breathe properly. Please advise me.

  7. Frank

    I started feeling pain without rashes in my upper spine and around under my right back and even palpitations in my chest. Chest X-ray and ECG were taken but chest was ok. Pain increased and I went to physio but pain persisted. Now after quite some time pain has nearly gone but rashes are showing down my spine and also started on my right side. I am suspecting that I had shingles. What is your opinion? Please advise.

  8. Chery

    My mum has had shingles before with blisters and I think she has it again but without the rash. She gets the sensations on her shoulders at the back area and also on her arms and elbows. The pain is so bad that she screams out when she rests her elbows on the table as if she has lent on drawing pins or stung by bees. Can you please help me?

  9. Shane

    A few weeks ago, I started having pain in my right leg, similar to a leg cramp or Charly horse. I went 3 times to the doctor; they thought it might be gout, arthritis or plebitisis. No rash, only a few red pin pricks on my right ankle. Pain is from my hip to my shin and varies usually, not hip and shin pain at the same time.
    First I started using heat to take away the pain, but after a day I could not stand the heating pad, too much pain and now doctors want me to ice the area. I have had difficulty sleeping at night for weeks. It is as if my leg cannot stand the weight of the blankets. Using a ben gay patch and compression stocking during the day I am usually somewhat pain free.
    The pain at night wakes me up and makes it difficult to get back to sleep. I had pain in the right foot for few weeks, similar to a pulled nerve that went away. I am still having pain from hip to leg, which sometimes comes from waist. Pain usually decreases once I am up and about, even before I take the morning pain medicines. Could I have shingles without the rash?

  10. Paula

    Over the last 11 years I have had shingles multiple times. The first time I had them it started with a sharp pain in my ear and then got blisters on my face, one being pretty large. My doctor diagnosed shingles. I have had them several times since.
    But the last couple of years I started getting sharp pain in my ear and then flu like symptoms fatigue, weakness, body aches, chills, and extreme weakness in my legs. I have to lie down frequently and I feel like my legs can’t hold me up. But in these last couple of years I don’t get the rash.
    What I find that helps me is bed rest, taking L-Lysine (as much as you safely can) and Vitamin C, drinking plenty of water and staying away from any nuts, chocolate, and broccoli (foods high in arginine, which counteracts l-lysine). Try to learn to pace yourself and live a healthy lifestyle to thwart future attacks.

  11. John

    I have had the pain in my lower left leg, mostly on the inside calf/tibula area. It is burning sensation, pin pricks, tingling and sore under pressure of pants/blanket/even its own weight. My therapist is willing to go with this diagnosis for now and use antiviral essential oils. There are areas that are intensely more sensitive than others and she thinks these are the nerve endings that are more affected. Hope it just goes away, it has been two weeks now.

  12. Joyce

    My husband has had severe face irritation and severe headaches. He had ct scan on head, on sinus, behind the eyes, mouth scan, and a pet scan but nothing showed up. He he been in intensive care with it but nothing has cured the pain. He was a very fit man but can’t do any thing now. He sits rubbing his face and holding his head. This has been going on for 3 years and he is in agony. They are now sending him back to neurologist, wondering if it is zoster sin herpete? Any suggestion from anyone?

  13. Fuehr

    I have been diagnosed with Zoster Sine Herpete and currently on Valacyclovir. I am on my 6th day but symptoms have not changed. I have tried the Capzasin ointment, Lidocaine patches, Gabapentin and currently prescribed Nortriptylin. None of these have helped or stopped the chronic and sometimes severe pain. The severe pain begins early in the evening and continues all night. I have yet to get 3 or 4 yours of sleep at night because of the pain. Is there another pain medicine that I would be able to take at night to ease this severe pain, which is truly unbearable?

  14. Barbara

    I had chicken pox when I was a child. Since that time I have had shingles many times since I was twelve. I was once diagnosed with poison oak which I knew was incorrect. Blisters always appeared on my upper arm in the same location except for one time when they appeared on my buttock. The first time I went to the doctor he said it was herpes zoster. I feel similar pain in my arm without the rash and wonder about having shingles again.

  15. Janet

    I am on my 7th episode of shingles without rash. I suffered with symptoms for approx 6 weeks before being diagnosed and treated the first time (almost 20 years ago). That doctor was skeptical, but put me on the antiviral and within 72 hours, all symptoms were gone. I didn’t wait long to be seen by the doctor when the second episode started, and with antiviral treatment, the burning pain was gone within 48 hours.

    My 6th episode started up after a 12 year break in Jan 17. My doctor chastised me for not having received the shingles vaccine. I didn’t know I could have it since I had shingles and besides that, I am only 55, and I thought the vaccine was intended for 60+ people. The doctor told me I needed to wait for at least 6 weeks from that shingles episode before getting the vaccine. I waited 4 and a half months because I kept forgetting to do it. Within 48 hours of taking the injection, I had a sizable reaction, which I was told was because I have a high level of the antibody in my system.

    The reaction was probably much lower than it might have been, as I take daily antihistamines due to having a very elevated amount of histamine in my body. They asked me why I got the vaccine? I answered them that two of my doctors urged me to do it, in view of my numerous episodes of shingles in the past. It has been exactly five weeks today since I received the vaccine and symptoms have started again.

  16. Snoddy

    I have been dealing with the symptoms of the shingles with no rash. I have been told that there is no test to confirm Zoster Sine Herpete. I have even been on antiviral medicines for almost two weeks, however there is no relief at all. I am currently taking extremely high doses of opiates with very little relief. I feel like I am about to go crazy and I don’t think anyone really can comprehend the amount of pain I am in. This started at the end of February and has gotten more painful as time has gone by. Please help soon.

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