Discovering a rash on your skin can be alarming, especially when that rash is itchy or painful.
Shingles and herpes are two of the many common conditions that can cause rashes. These conditions create very similar rashes and blisters, making it hard to tell the difference between them when looking at your skin.
No. Although they may look alike, the two conditions are very different. Beyond the causes of each condition, there are multiple other ways you can tell shingles and herpes apart.
Shingles and herpes differ in some of their:
- risk factors
Here’s how you can learn to tell the difference between the two conditions and how each is treated.
Both shingles and herpes can cause itchy, red bumps and blisters on your skin.
Symptoms of shingles include:
- pain, itching, or tingling, sometimes before the rash appears
- burning sensation on your skin
- numbness or tingling on your skin
- sensitivity to touch
- red rash that appears after you’ve already been in pain for a few days
- blisters that break open and then scab
Pain is usually the first symptom of shingles to appear. The pain of shingles can be intense and will likely let you know that something’s wrong. Rashes generally first appear a few days after the pain begins.
Most shingles rashes appear around your midsection, but they can also appear on your neck, on your face, or around your eyes. Some people with shingles never develop a rash at all.
Symptoms of herpes include:
- tingling, itching, or burning before blisters form
- red bumps and tiny white blisters on your skin
- itchy or painful skin
- genital ulcers that can make it painful to urinate
- scabs that appear when ulcers and blisters heal
Some people have herpes without ever having any symptoms. When you do have symptoms, they usually appear between 2 and 12 days after you’re exposed.
Bumps and blisters caused by herpes may appear on your:
- mouth, where they’re known as cold sores
- upper thighs
- cervix, in people with vulvas
Pictures of shingles and herpes
Scroll through the photos below for a better idea of what each condition looks like.
Both shingles and herpes are chronic viral conditions that may flare up intermittently throughout your life.
Shingles results from infection with the varicella-zoster virus, which also causes chickenpox. This virus can reactivate multiple times during your life and cause episodes of shingles for weeks at a time. After flare-ups, shingles symptoms usually take about 3 to 5 weeks to resolve.
Herpes results from the herpes simplex virus, also known as HSV, which has two types: HSV-1 and HSV-2.
Herpes can also reactivate regularly throughout your life — as often as several times a year for some people. It’s also possible to be infected with the herpes simplex virus and never experience symptoms. Ulcers caused by herpes usually take about 10 to 14 days to heal.
Shingles itself is not contagious, but the virus that causes it is. People exposed to the virus for the first time, including those who are unvaccinated for chickenpox, can develop chickenpox. Along with chickenpox comes the risk of the virus reactivating to cause shingles in the future.
While you have shingles, avoid contact with:
- pregnant people
- anyone who has never been exposed to the virus
The virus is contagious from the time that shingles blisters first form until when they finally crust over.
The herpes simplex virus is much more contagious. It’s passed on primarily through:
- sexual intercourse, when you come in contact with thin tissue linings of the genitals, such as the lining of the vagina or the cervix
- kissing and other contact with saliva
- skin-to-skin contact
- sharing items that come into contact with a cold sore, such as lipstick or eating utensils
The herpes simplex virus lives inside your body even when you don’t have active blisters and sores. This means that the virus can still be passed on to others. And when you have an active cold sore, having oral sex can spread the virus to the genitals, resulting in genital herpes.
Shingles is caused by the varicella-zoster virus, which first enters your system when you catch chickenpox. The virus stays in your system after chickenpox clears up and can remain dormant for years. In some people, the virus eventually reactivates, causing shingles. Not everyone who has had chickenpox gets shingles.
Herpes can be caused by two different types of the herpes simplex virus. HSV-1 is a virus that usually causes oral herpes but can be passed to other parts of your body. HSV-2 is a virus that causes genital herpes. HSV-2 also flares up more frequently than HSV-1.
Both HSV-1 and HSV-2 are lifelong infections and lay dormant in your system even when you don’t have any symptoms.
Shingles can develop in anyone who’s had chickenpox. Because the chickenpox vaccine was not available to children before 1995, most adults in the United States today are at risk of developing shingles.
Not everyone who had chickenpox as a child will get shingles. Other
- being older than 50
- having a condition that weakens your immune system
- undergoing radiation therapy or chemotherapy
- taking medications that suppress your immune system
- using steroids for an extended period of time
For those at risk of shingles, a vaccine is available.
The herpes simplex virus is transmitted through sexual activity and other skin-to-skin contact.
The herpes simplex virus can be passed on even when a person is showing no symptoms at all. Unless you know your partner has tested negative for sexually transmitted infections (STIs), it’s important to consistently use protection.
Having any type of sex without a condom or other barrier method puts you at risk of developing a herpes infection. Practicing correct condom use, which includes checking expiration dates and scanning for defects, is an important way to decrease your chances of exposure.
Shingles is generally diagnosed based on your symptoms. A medical professional will examine your rash and blisters and talk with you about your pain.
They might also send a small swab from one of your blisters for a lab test to determine if the varicella-zoster virus is present.
It’s especially important to seek medical care for shingles if:
- your shingles rash is near your eye, where it could lead to permanent eye damage
- you’re over age 60
- you have a weakened immune system
- someone in your family has a weakened immune system
- your rash is painful and covers large areas of your body
Herpes is diagnosed through a physical exam and lab tests. Just like with shingles, your doctor will examine your rash and take a swab from one of the blisters to send for a lab test.
Though testing a culture from an infected site is the preferred and most accurate diagnostic method, your doctor may also have blood drawn to look for herpes simplex virus antibodies in your system. A blood test can determine whether you have HSV-1 or HSV-2.
Get tested as soon as possible if you think you’ve been exposed to the herpes simplex virus or are having symptoms of herpes. Multiple options for testing are available even if you don’t have a primary doctor. Testing may be free or offered at a low cost at a community clinic or your local health department.
Neither condition can be cured, but treatments are available.
Shingles is treated with both antiviral prescription medications that can speed up your healing and with medications that can help with your pain. Your exact treatment plan will depend on:
- how severe your case is
- your overall health
- the medications you already take
Antiviral options include:
Herpes is also treated with antiviral medication.
Antivirals can help you heal first and reduce your symptoms. Depending on your case and your overall health, you might take these medications during an outbreak or daily.
Options for herpes treatment include both acyclovir and valacyclovir.
Some other pain management options may include:
- numbing patches, gels, or creams you can apply to your skin
- capsaicin pain patches
- codeine or other narcotic medications
- steroid injections
- anticonvulsants or antidepressants that can control pain
Talk with a doctor before using any of the treatments above. These treatments should not be used without guidance from a medical professional. A medical professional can help you avoid any unintended side effects, such as allergic reactions.
Is shingles considered an STD?
Shingles is not a sexually transmitted disease (STD) and cannot be passed from person to person. However, direct contact with fluid from the blisters caused by shingles can spread the varicella-zoster virus — which can lead to the possibility of developing shingles in the future.
Is chickenpox and shingles a form of herpes?
Though shingles and herpes are two distinct conditions caused by two distinct viruses, the viruses are both members of a family formally known as herpesviridae. The herpes simplex virus takes its formal name from this umbrella term, while the varicella-zoster virus does not.
Although it is a condition unrelated to herpes, shingles is sometimes referred to as “herpes zoster,“ a nickname that references the shared family of the viruses that cause them. Within this viral family, only the herpes simplex virus causes the condition we know today as “herpes.“
If you are ever unsure whether your doctor is referring to herpes simplex or shingles when you hear the word “herpes,“ ask for clarification.
What triggers a shingles flare-up?
Shingles can be triggered by a number of factors, and sensitivities to each factor can vary from person to person.
Things that weaken the immune system, such as stress, certain medications, or other health conditions, can cause shingles flare-ups, as can certain foods that contain an amino acid that helps the virus to replicate.
Is there a cure?
There is no cure for either shingles or herpes, though treatments that can help ease symptoms are available for both.
Some herpes treatments can also reduce your risk of passing it on to others, but that risk won’t be completely eliminated.
Can you get shingles without having herpes?
Yes. The development of shingles is unrelated to the herpes simplex virus.
Is it possible to have both shingles and herpes?
Shingles and herpes are caused by two different viruses and are acquired in different ways. It’s possible for you to have symptoms of shingles and a herpes flare-up at the same time.
Shingles and herpes both cause red bumps and blisters to form on your body, but they aren‘t the same condition. Each condition has its own telltale signs.
If you’re not sure and think you might have shingles or herpes, contact a medical professional. They’ll be able to examine your rash and run tests if needed.
Once you have a diagnosis, you can get treatment so you can start to feel better.