Internal Shingles

Internal shingles is preceded by shingles. Shingles is a common infection that causes painful blisters or rashes on your skin. While it is common, it can develop into something greater than a skin ailment when it affects other areas of your body. When these complications happen, internal shingles, also known as systemic shingles, can develop.

An overview of Internal Shingles

Shingles that do not have a rash are called zoster sine herpete (ZSH). These type of shingles are tough for your doctor to diagnose because the typical rash brought on by shingles is not on the skin. Having chickenpox is the precursor for shingles. The medical name for chickenpox is varicella zoster virus (VZV). Having chickenpox in the past does not mean that the virus is out of your body forever. In fact, it lies dormant in nerve cells.

Why does chickenpox activate later in some people’s lives and not others?

It is not known what causes this virus to flare up again later in life for some people and not for others. Experts have studied this extensively and still have not uncovered a definitive answer.

Internal Shingles Causes

After a person has had chickenpox, two outcomes are possible. First, the virus never activates again and they will not have any further complications or second, the virus reactivates and causes internal shingles.

When a person’s immune system has been weakened, this increases the likelihood of internal shingles occurring. Some reasons for a compromised immune system are:

  • AIDS
  • HIV
  • Age
  • High levels of stress
    • Emotionally traumatic event
    • Severe illness
    • Physical trauma
  • Large doses of corticoid steroids
  • Organ transplant
  • Chemotherapy / radiation because of cancer treatment
  • Certain types of medications

The shingles virus is not contagious, but if a person has shingles and they come into contact with a person that has not had chickenpox or did not get vaccinated against it, that person can contract chickenpox. This is only caused by direct contact with the shingles rash on a person. Shingles without a rash is internal, and should not be able to be passed on to others.

Internal Shingles Symptoms

Evidence of internal shingles is revealed by an itchy, painful, blistery rash. But internal shingles has different symptoms to differentiate it:

  • Chills
  • Aching muscles
  • Fever
  • Pain
  • Burning sensation under the skin
  • Sensitivity to light
  • Your lymph nodes become swollen
  • Numbness and tingling
  • Headache
  • Sensitivity of touch

The pain felt from internal shingles will either be mild or severe. It can cause the following symptoms based on which internal organs are affected:

  • Encephalitis – the virus spreads to the membranes in your brain
  • Hepatitis – the virus spreads to your liver
  • Pneumonia – the virus spreads to your lungs
  • Blood vessel problems
  • Transverse myelitis – inflammation of both sides of one section of your spinal cord. This interrupts the signals that the spinal cord sends throughout your body.

Other symptoms of internal shingles include:

  • Eye problems – Roughly 10 to 25 percent of shingles cases afflict facial nerves. This causes inflammation on or around the eye.
  • Postherpetic neuralgia (PNH) - According to research, 5 to 20 percent of people who get shingles end up developing this. Nerve fibers that are affected by the formerly dormant virus become inflamed and alter your nerve impulses causing pain. Even after the infection is gone, the pain can persist, causing PHN. This results in constant pain coupled with numbness and tingling that can last for months or even years.

How is Internal Shingles Diagnosed?

Internal shingles is not a common ailment. Because of this, it is difficult to diagnose by only your symptoms. The types of tests needed to lead to an internal shingles diagnosis are:

  • Blood test
  • Cerebrospinal fluid test
  • Testing your saliva for any VZV antibodies

Keep in mind that while these tests are used, many times they are inconclusive.

How to Treat Internal Shingles

There are numerous treatment options to reduce the signs and symptoms. There is also a vaccination on the market that lessens the overall rates of outbreak and the symptoms that come with it. The list below mentions the most effective treatment options:

  • Antidepressants
  • Antiviral Medications (Acyclovir, Valacyclovir, Famciclovir, Valtrex or Zovirax)
  • Eating a healthy diet
  • Pain Medications
  • Skin Creams (with antiviral and anesthetics)
  • Steroid Medications
  • Using natural products

Some common side effects of antiviral medications include:

  • Sickness
  • Flu-like symptoms
  • Migraines
  • Nausea
  • Diarrhea
  • Dizziness, vertigo or visual impairment

Internal shingles takes roughly 3 to 5 weeks to fully go away. In the majority of cases, it is cured without major issues. People of all age groups (children, teens, adults, the elderly and those with compromised immune systems) can show internal shingles symptoms that are severe. At the first sign of any of these potentially life-threatening symptoms, you should contact your doctor to evaluate your treatment options and move toward recovery.

Who is most likely to have Internal Shingles?

The only way to get shingles is if you have had chickenpox previously. Your risk for internal shingles increases when:

  • You’re over the age of 50
  • Your immune system is weakened
  • Your body is under stress resulting from surgery or other physical trauma

Prevention of Internal Shingles

Internal shingles is a preventable disease. The greatest method of prevention is either getting the shingles vaccine or the herpes zoster vaccine, known as Zostavax. This vaccine is recommended once you turn 60. In addition to vaccination, there are other ways to abate the onset of internal shingles:

  • Sleeping enough at night
  • Not smoking
  • Working on eliminating current health problems
  • Regular visits to the doctor for ailments that currently target your immune system
  • Following your doctor’s treatment guidelines stringently

The Center for Disease Control states that 1 in 3 people in the United States will have shingles in their life. Internal shingles is a rare disease, but if it affects certain organ systems, it can threaten your life.

Last Reviewed:
June 22, 2018
Last Updated:
June 21, 2018