Can a person have herpes zoster inside the nerves of body and not rash?

Yes, it is possible for a person to have herpes zoster, also known as shingles, inside the nerves of the body without developing a rash. This condition is called zoster sine herpete or zoster without rash.

In zoster sine herpete, the virus that causes shingles, the varicella-zoster virus, reactivates and travels along the nerve pathways but does not reach the skin. As a result, the characteristic rash of shingles does not appear.

Instead, people with zoster sine herpete may experience pain, burning, tingling, or numbness in the affected area. This pain can be severe and can persist for weeks or even months. Other symptoms may include fever, chills, fatigue, and headache.

Zoster sine herpete is relatively rare, occurring in less than 10% of cases of shingles. It is more common in people with weakened immune systems, such as those with cancer, HIV/AIDS, or diabetes.

Treatment for zoster sine herpete is similar to that for shingles with rash and may include antiviral medications to reduce the severity and duration of the pain. In some cases, pain relievers or corticosteroids may also be prescribed to manage the symptoms.