Shingles and psoriasis are two skin conditions. They can both affect large areas of the skin with itchy, painful rashes. Read on to learn the differences between these two conditions.
Shingles itself can’t be transmitted from person to person. But you can contract the virus that causes shingles from a person who has shingles. The virus that causes shingles is called varicella-zoster virus (VZV).
VZV can be in your body in an inactive form for decades. This is the same virus that results in chickenpox. It can become active again at any time. If you previously had chickenpox, you could develop shingles from the reactivated virus. It can cause a rash and blisters when reactivated.
You can transmit the virus to someone who isn’t immune to chickenpox if you have shingles in the blister phase. Someone who isn’t immune to chickenpox never had chickenpox or received the chickenpox vaccine. The virus is transmitted by contact with fluid from the rash’s blisters.
If you transmit the virus to someone who hasn’t had chickenpox, they can develop chickenpox, but not shingles.
The virus lives in the nervous system. When it’s activated, it moves up the nerves to the outer surface of the skin. Once the rash from shingles crusts over, it’s no longer contagious.
According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 people will develop shingles at some point in their lives. The CDC estimates there are 1 million cases of shingles each year in the United States.
The risk of developing shingles increases with age. Approximately half of all cases appear in people who are age 60 and older. You can reduce your risk by 51 percent if you take the shingles vaccine, according to the CDC. You should retake it every five years.
Psoriasis is a chronic autoimmune disorder. Unlike shingles, it’s not contagious. People with psoriasis will experience periods of remission followed by flare-ups. The condition is associated with rapid skin cell turnover.
There are five different types of psoriasis:
People can get more than one type of psoriasis. It can appear on different places on their bodies at different times throughout their lives.
According to the American Academy of Dermatology, 7.5 million people in the United States have psoriasis. Many begin to see symptoms between ages 15 and 30. Another peak time for psoriasis symptoms is between the ages of 50 and 60. People who have psoriasis usually have at least one other family member with the condition.
There’s no cure for psoriasis. However, steroids and drugs that suppress the immune system can help treat flare-ups.
A shingles rash can appear anywhere on your body. It’s often found on the right or left side of your torso. It may also spread to your back, chest, or abdomen.
The rash is usually quite painful, itchy, and sensitive to the touch. It’s common to feel pain at the surface of the skin a few days before the noticeable rash develops.
Other symptoms may include fever, fatigue, and headache.
Psoriasis may also appear on your torso, but the patches of dead, scaly skin typically form on the scalp, knees, and elbows. The red rash may be covered with silvery scales or dry, cracked skin. It may also occur on the fingernails and toenails. Affected areas may itch or burn.
Psoriasis can also affect the joints, making them feel stiff and sore. This condition is known as psoriatic arthritis.
Your doctor will need to diagnose the condition first before they can treat you. Here are the different methods your doctor will use to diagnose you.
Early symptoms of shingles may be confused with hives, scabies, or other skin conditions. Sometimes your doctor can make a diagnosis by looking at your skin and the associated symptoms. They may not need to test further.
If you’re at risk for other complications because of shingles, your doctor can order the following tests to diagnose it:
- Viral culture. A sample of fluid from a blister is taken to check for the virus.
- Antibody test. A blood sample is taken to test for the presence of VZV antibodies.
- Skin biopsy. A piece of the rash is removed and evaluated under a microscope.
Diagnosing psoriasis is similar to diagnosing shingles. Doctors can typically diagnose psoriasis with an examination of your scalp, nails, and skin, along with your medical history. Sometimes your doctor may order a skin biopsy of the rash to diagnose psoriasis and rule out other conditions. This can also help diagnose the exact type of psoriasis.
If you’re experiencing a persistent rash that doesn’t go away and pain or fever, consult your doctor.
While there’s no cure for shingles, treatment is still available to make people more comfortable. Treatment can also decrease the duration of the disease, which generally lasts between two and six weeks. Treatment for shingles includes:
- Antiviral medications. These can speed up healing and reduce the chance of complications.
- Medications for nerve pain. These numbing agents, like lidocaine, can help with any pain.
Shingles start with pain, and blisters follow soon after. At the end of the virus’s course, these blisters will crust over. You’re most contagious when the blisters appear and haven’t yet crusted over. Before and after this stage, you aren’t contagious.
Not treating blisters properly can lead to bacterial skin infections. Scarring may also occur. It will depend on the severity of the rash and how well it was treated.
Psoriasis is a chronic condition. It can be more complicated to treat than shingles. However, it’s possible to manage your symptoms. This revolves around treating the symptoms and keeping flare-ups at bay.
Treatment options include:
- Topical medications. Corticosteroids, for example, can reduce inflammation and redness.
- Tar shampoo. This is used to treat scalp psoriasis and flaking.
- Oral medications. Examples include acitretin or otezela to reduce symptoms. These medications require frequent blood work to monitor their effects.
- Biologic medications target specific parts of the immune system instead of the entire system. These medications can target specific proteins associated with psoriatic flare-ups.
- Phototherapy. UVB light is applied to the skin to help treat flare-ups and symptoms. It can be done in a medical facility or at home with a specialized lamp.
Psoriasis flare-ups are typically the result of a trigger. A flare-up can last from a few days to a few weeks. Here are 10 common triggers to avoid.
Scarring is common among people with psoriasis, particularly in people with plaque psoriasis. Reduce the likelihood and severity of scarring by:
- keeping your skin moisturized
- applying ice packs to the skin
- keeping your medications handy
Shingles can be prevented, while psoriasis cannot. However, there are things that may help alleviate your symptoms.
The risk of developing shingles increases as you age. The CDC recommends that healthy adults 50 and older receive the shingles vaccine, even if you had chickenpox when you were younger. The CDC estimates the vaccine is about 90 percent effective in preventing shingles.
The vaccine is good for about five years. It’s important to keep up your protection. The complications from shingles can be more serious the older you get. If you’ve already had shingles, you should get the vaccine to avoid getting shingles again.
There’s no psoriasis vaccine. While you can’t prevent psoriasis, there are steps you can take to reduce your symptoms. One thing you can do is try to eliminate or reduce your exposure to psoriasis triggers, such as stress and irritation or injury to your skin, including sunburn.
If you smoke cigarettes, quit. If you drink alcohol, drink in moderation. Avoiding infections as much as possible can also help you avoid flare-ups, or make it easier for you to deal with them.
The risk factors for shingles and psoriasis differ. But having another condition that affects the immune system is a risk factor for both.
The risk factors for shingles include older age and having a disease that weakens the immune system. This includes cancer and HIV. Cancer treatments can also lower your resistance, making it more likely that an inactive shingles virus could become active.
Psoriasis risk factors tend to be more related to family history. If you have a close relative with psoriasis, your odds of also having the condition increase. Like shingles, psoriasis is more likely to appear in people with a weakened immune system. Other risk factors include:
See your doctor at the first sign of a rash, blisters, or patch of dead skin. They may refer you to a dermatologist if the condition is serious. If it appears you have psoriasis, you may need to see a rheumatologist who treats autoimmune conditions, such as psoriatic or rheumatoid arthritis (RA).
Don’t ignore the symptoms of either shingles or psoriasis. Early diagnosis and treatment can often control symptoms.