Discovering a rash on your skin can be alarming, especially when that rash is itchy or painful.
While many conditions can cause a rash to appear on your skin, shingles and herpes are two common causes. These conditions create very similar rashes and blisters, making it hard to tell the difference between them when looking at your skin.
But the two conditions are very different. Beyond the causes, there are multiple other ways you can tell shingles and herpes apart and figure out which is causing the rash on your skin.
How do I tell the difference between shingles and herpes?
Here are some of the different symptoms, duration, risk factors, and causes of shingles and herpes so that you can learn to tell the difference. You can also learn who can develop each and whether they can be cured.
Symptoms
Both shingles and herpes can cause itchy red bumps and blisters to appear on your skin.
One unique symptomTrusted Source of a shingles rash is that it typically shows up in a stripe-like pattern on one side of your body. A shingles rash won’t usually cross the middle of your body or affect multiple areas of your body at once.
Both conditions have other symptoms that can also help you tell which one you have.
Symptoms of shingles include:
pain, sometimes before blisters appear
burning sensation on your skin
numbness or tingling on your skin
skin that’s sensitive to touch
itching
red rash that appears after you’ve already been in pain for a few days
blisters that break open and then scab
fever
headache
fatigue
Usually, people have pain before they have other symptoms of shingles. The pain of shingles can be intense and will likely let you know that something’s wrong. You won’t develop a rash until a few days after the pain begins.
Most shingles rashes appear around your midsection, but they can also occur:
on your neck
on your face
around your eyes
Some people never develop a shingles 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
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. Herpes bumps and blisters will show up on different parts of your body than shingles bumps will.
Herpes may appear on your:
mouth, also known as cold sores
fingers
upper thighs
buttocks
urethra
genitals
cervix, in people with vulvas
rectum
Duration
Both shingles and herpes are chronic conditions. Both conditions also involve a virus that stays dormant in your body throughout your life and may flare up in short episodes.
Shingles results from the varicella-zoster virus, which also causes chickenpox. This virus can reactivate multiple times during your life and cause episodes of shingles symptoms for weeks at a time. Shingles takes longer to heal from, usually about 3 to 5 weeks.
Herpes results from the herpes simplex virus, also known as HSV, which has two types: HSV-1 and HSV-2.
These viruses can also reactivate multiple times throughout your life, often causing cold sores or genital sores. It’s also possible that you’ll never have symptoms after your infection. Symptoms of herpes usually take about 10 to 14 days to heal.
Herpes is more likely to recur multiple times in your life than shingles is. Herpes can flare up several times a year for some people.
Is it contagious?
Shingles is not contagious, but the virus that causes it can be passed to someone who has never had chickenpox or the chickenpox vaccine. This is because both chickenpox and shingles are caused by the varicella-zoster virus.
People exposed to the virus for the first time will develop chickenpox and not shingles. Avoid contact with infants, pregnant women, and anyone else who has never been exposed to the virus while you have shingles.
The herpes simplex virus, on the other hand, is very 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
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.
Causes
Shingles is caused by the varicella-zoster virus. It’s sometimes called herpes zoster because it’s part of the herpes virus family, but it’s not the same virus that causes herpes.
The varicella-zoster virus 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 virus types lay dormant in your system even when you don’t have any symptoms.
Who gets it
Shingles can develop in anyone who’s had chickenpox. Chickenpox was a very common childhood disease until the chickenpox vaccine became available in the United States in 1995. This means that most current American adults are at risk of developing shingles.
If you think you might be at risk of developing shingles, a vaccine is available that might help protect you against shingles.
Not everyone who had chickenpox as a child will get shingles. Other risk factors include:
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
Herpes simplex virus is transmitted through sexual activity and other skin-to-skin contact. Having any type of sex without a condom or other barrier method puts you at risk of developing a herpes infection.
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), always use protection.
Protective barriers like condoms need to be used correctly to help prevent herpes simplex virus and other STIs from being passed on. The virus can also be passed on no matter the gender of your sexual partner.
Is there a cure?
There is no cure for either shingles or herpes.
You can receive treatment to manage your symptoms. For shingles, treatments help you during the 3 to 5 weeks your symptoms may last.
For herpes, treatments help you address outbreaks as they happen. Some treatments can also reduce your risk of passing it on to others, but that risk won’t be completely eliminated.
What are the next steps I can take?
Treatment can speed up the healing process and help you manage itching and pain, especially if you begin early after your symptoms appear.
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 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
Get tested as soon as possible if you think you’ve been exposed to 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.
How are shingles and herpes diagnosed?
A doctor can diagnose either condition during a single office visit.
Shingles
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.
Herpes
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.
You might also have blood drawn to look for herpes simplex virus antibodies in your system.
A blood test can also determine whether you have HSV-1 or HSV-2.
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 outbreak at the same time.
How are shingles and herpes treated?
Neither condition can be cured, but treatments are available.
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