Shingles and psoriasis are two skin conditions. They can both affect large skin areas with itchy, painful rashes. Yet they differ significantly in terms of transmission, diagnosis, and treatment.

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Shingles is caused by a virus — the same virus that causes chickenpox. Psoriasis, on the other hand, is an autoimmune disorder. This means that shingles is contagious, but psoriasis is not.

Read on to learn the differences between these two conditions.

Shingles itself cannot 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 the varicella-zoster virus (VZV).

VZV is the same virus that results in chickenpox. It can be in your body in an inactive form for decades and 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.

If you have shingles in the blister phase, you can transmit the virus to someone who isn’t immune to chickenpox. This is someone who has 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.

The virus lives in the nervous system. When it’s activated, it moves up the nerves to the skin’s outer surface. 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 also 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 over. According to the CDC, the current shingles vaccine is generally about 90% effective. Immunity stays strong for at least 7 years following vaccination.

Psoriasis is a chronic autoimmune disorder. Unlike shingles, it is 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 in different places on their bodies at different times throughout their lives.

According to the National Psoriasis Foundation, more than 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. Steroids and drugs that suppress the immune system can help treat flare-ups.


A shingles rash can appear anywhere on your body. It often appears 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.

Early shingles lesions are typically discolored compared with your surrounding skin. Depending on your skin tone, they may appear purplish, dark pink, or dark brown in color. On highly pigmented skin, a shingles rash may be red, the same color as the skin, or slightly darker. The scabs may be gray.

Other symptoms may include fever, fatigue, and headache.

Learn how to identify shingles on black and brown skin.


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 also comes in other forms. Symptoms on light and fair skin include raised, red, or pink skin patches occasionally paired with a silvery scale.

On medium skin tones, psoriasis tends to be salmon-colored, with silvery-white scales. On darker skin tones, the patches are more likely to appear as violet or dark brown patches.

Psoriasis can also affect the joints, making them feel stiff and sore. This condition is known as psoriatic arthritis.

Learn more about the look of psoriasis on black versus white skin.

Your doctor must diagnose each condition before they can treat it. Here are the different methods your doctor will use to diagnose shingles and psoriasis.


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.

Many images of the shingles rash show how it appears on different skin tones. These images typically display a very red and inflamed skin patch. This is called erythema and is due to the dilation of blood vessels in the skin.

While erythema can happen in all people, its effects can be harder to see on darker skin tones.

If you’re at risk for other complications because of shingles, your doctor can order the following tests to diagnose it, according to the American Academy of Dermatology Association (AAD):

  • Viral culture: A healthcare professional takes a sample of fluid from a blister to check for the virus.
  • Antibody test: A healthcare professional takes a blood sample to test for the presence of VZV antibodies.
  • Skin biopsy: A healthcare professional removes a section of skin containing the rash. It will then be 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, per the AAD.

If you’re experiencing a persistent rash that doesn’t go away and pain or fever, consult a doctor.

Since shingles and psoriasis are caused by fundamentally different things, they require different treatments. It’s important for a healthcare professional to correctly diagnose your condition so you can receive the appropriate treatment.


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 2 and 6 weeks.

According to the AAD, 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. These blisters will crust over at the end of the virus’s course. Singles is most contagious when the blisters appear and haven’t yet crusted over. Before and after this stage, shingles is not 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.

According to the AAD, 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 (Soriatane) or apremilast (Otezla) to reduce symptoms. These medications require frequent blood tests to monitor their effects.
  • Biologic medications: 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. Yet it is possible to manage your symptoms.


The risk of developing shingles increases as you age. The CDC recommends that healthy adults age 50 and older receive the shingles vaccine, even if you had chickenpox when you were younger. The CDC estimates the vaccine is about 90% effective in preventing shingles.

Immunity from the vaccine lasts for at least 7 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.


While you can’t prevent psoriasis, you can take steps to reduce your symptoms. One thing you can do is try to eliminate or reduce your exposure to psoriasis triggers, the AAD suggests. Triggers may include stress, irritation, and injury to your skin, including sunburn.

If you smoke cigarettes, it’s recommended that you try to quit. Your doctor can help you come up with a smoking cessation plan. If you drink alcohol, it’s recommended that you consume it in moderation. Avoiding infections as much as possible can help you avoid flare-ups or manage them easier.

The risk factors for shingles and psoriasis differ. Another condition that affects the immune system is a risk factor for both.


Per the CDC, 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 an inactive shingles virus more likely to become active.


Psoriasis risk factors tend to be more related to family history, 2019 research suggests. 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:

  • smoking
  • stress
  • obesity

Shingles and psoriasis both affect the skin, causing an itchy and painful rash. Since the symptoms are not always easy to tell apart, you should contact a 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 severe.

If it appears you have psoriasis, you may need to see a rheumatologist who treats autoimmune conditions, such as psoriatic arthritis or rheumatoid arthritis (RA).

Do not ignore the symptoms of either shingles or psoriasis. Early diagnosis and treatment can often manage symptoms.