Shingles is a viral infection that can cause painful blistering rashes on any part of the body. In some cases, people may experience shingles on the penis or genitals.

Around 1 in 3 people in the United States will develop shingles, also known as herpes zoster, in their lifetime, with roughly 1 million people getting the virus yearly. Any person could develop shingles if they have had chickenpox in the past. But shingles is more common in people older than 50 years old and individuals with suppressed or weakened immune systems.

After a person recovers from chickenpox, the varicella-zoster virus (VZV) remains dormant in the dorsal root ganglion, which is a collection of nerve bodies that deliver sensory information from the skin to the spinal cord. People can divide the surface of the skin into dermatomes, which are areas where the sensory nerves come from a single nerve root. Once reactivated, the VZV can cause painful rashes to appear on dermatomes supplied by the affected nerve root.

In this article, we will discuss whether a person can get shingles on their penis and what other conditions may have a similar appearance.

An image of a clothed person that has shingles on their penis.Share on Pinterest
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People can develop shingles on any part of the body, including the genitals. Those with shingles commonly have a rash in one or two adjacent dermatomes, typically appearing on either the face or trunk of the body. But the rash can be more widespread across the body and can affect more than two dermatomes.

Sacral lesions are lesions in the area of skin where the sensory nerves come from the base of the spine, or sacrum. They are rare, occurring only in 5% of shingles cases, but there are a few reported cases of penile herpes zoster.

Reported cases of penile herpes zoster typically involve S2–S4 dermatomes. These include the skin on the scrotum, buttocks, back of the legs, and genital area.

Characteristic symptoms of shingles include the presence of red rashes with fluid-filled blisters that typically develop on one side of the face or body. But a person will likely experience initial symptoms several days before the rash appears. These include numbness, burning or sharp pain, tingling, and itchiness in the affected area.

A person may also develop other symptoms, such as:

A 2020 case report notes that initial symptoms may include burning and itching of the head of the penis (glans), followed by red blisters on the glans and severe sharp pain in the shaft of the penis. In another case report, shingles affecting the S2–S3 dermatome presented with a lack of pain, numbness of the penis, difficult or painful urination (dysuria), inflamed bladder (cystitis), constipation, and frequent urination.

A person can also develop bladder and bowel dysfunction and urinary retention from shingles. One person reported sudden urinary retention caused by shingles. In another case, the person lost the sensation of urinating. But these symptoms typically subside with the correct treatment.

Doctors usually prescribe antiviral medications such as acyclovir within 72 hours after the rashes appear to help prevent the virus from multiplying. Taking antivirals can help to both reduce the length of time a person has shingles and prevent complications such as postherpetic neuralgia (PHN).

A person can also take over-the-counter or prescription medications to address pain and discomfort. Doctors may prescribe anticonvulsants and antidepressants to manage severe pain in people with neuralgia.

The Centers for Disease Control and Prevention (CDC) also recommends the following to help soothe itching:

  • colloidal oatmeal baths
  • calamine lotion
  • wet compresses

A person cannot be infected with shingles. But people with shingles can spread the VZV virus and cause chickenpox in people who have not received the chickenpox vaccine. The only way to prevent having shingles is through receiving Shingrix, the vaccine for shingles. All healthy adults who are ages 50 years and over can get the vaccine.

The CDC does not recommend Shingrix for individuals who:

  • currently have shingles
  • have had an allergic reaction after a previous dose of Shingrix
  • have not had the chickenpox virus (meaning they have no immunity to VZV)
  • are pregnant
  • are breastfeeding

Genital herpes zoster may be challenging to differentiate from other genital lesions due to its varied presentation and possible co-infections. A person with genital lesions may instead have one of the following conditions:

  • Syphilis: Syphilis is a kind of sexually transmitted infection (STI) that causes genital sores. These sores are usually round, firm, and painless.
  • Herpes simplex 2: Genital herpes is another STI that people may mistake for shingles, because it can also cause open sores and blisters on the anus and genitals.
  • Chancroid: Chancroid is an STI that can cause chancroids in the genital area that become painful, ulcerated sores.
  • Behçet’s syndrome: Behçet’s syndrome is a rare type of vasculitis that leads to a multisystem inflammatory disorder. It causes oval sores that occur on the mouth and genitals. The condition comes with other skin lesions and eye abnormalities such as uveitis.
  • Fixed drug eruption (FDE): FDE is an allergic skin reaction that results in round, localized patches after taking certain drugs.
  • Genital psoriasis: Genital psoriasis causes thick, scaly patches to appear in the genital area.

Doctors recommend early treatment for shingles to help prevent complications. Those who suspect they may have shingles should contact a doctor as soon as rashes appear, since antivirals work best within 72 hours after the rashes appear.

While complications can happen to anyone, older adults and immunocompromised individuals are at greater risk for developing complications such as PHN. People who experience the following should immediately contact their doctor:

  • spreading of blisters to other areas of the body
  • fever and chills
  • extreme discomfort or pain

Shingles is a viral infection that is relatively common in older or immunocompromised individuals. It results in a painful, blistering rash. A person can get shingles on the genital area, but this is uncommon. Aside from blisters, genital shingles may also cause bladder and bowel problems.

While shingles can cause genital lesions, other conditions, such as syphilis and genital herpes, can also have a similar presentation. It is advisable for people to contact their doctor to determine the cause of the lesions and get prompt treatment.