Shingles and herpes are skin conditions that occur due to viruses from the herpesvirus family. They both cause rashes on the body and can be challenging to tell apart.
People may confuse the two conditions because they have similar sounding names.
The varicella-zoster virus (VZV) causes shingles, which is also known as herpes zoster.
Conversely, the herpes simplex viruses (HSV) causes herpes. There are two types: type 1 HSV, which primarily appears as a rash on the face or mouth, and type 2 HSV, which mainly appears as a genital or rectal rash.
The appearance of each type of rash is different. There are also additional symptoms that can help a person tell them apart.
The symptoms, causes, and treatment for shingles and herpes are different. This article will examine the differences between herpes and shingles, including their causes and treatment options.
Although shingles and herpes share many traits, they are two different conditions.
Shingles is a reactivation of the VZV, the same virus that causes chickenpox.
After an individual has chickenpox, the virus goes dormant in dorsal root nerve cells. At some point, it may reactivate and travel along nerves to the skin, causing the rash known as shingles.
The shingles rash usually appears in a strip on one side of the torso, although it can also develop on the face, genitals, ears, or other parts of the body.
Herpes simplex develops following infection with one of two types of HSV. Type 1 typically causes a rash on the face or an outbreak of sores in the mouth, while type 2 typically causes a genital or rectal rash outbreak.
Following the first infection, HSV remains dormant in dorsal root nerve cells. When it flares again, it travels along the nerves to the skin or mucous membranes, creating a rash or lesions.
Those with shingles develop a painful, blistering rash. The fluid-filled blisters are small and develop in clusters.
According to the American Academy of Dermatology Association (AAD), a person will experience pain or a burning sensation on the skin area where the rash will develop. This will happen 1–2 days before the rash appears.
In some cases, it can also occur in the mouth, which people call oral shingles. When this happens, a rash can develop inside the mouth or alongside a rash on the face.
The blisters will crack open and crust over, and the rash will then clear within 2–4 weeks.
Other symptoms of shingles include:
According to the
The blisters will then break and result in painful sores, which can take about 7 days or more to heal.
People may also experience:
- pain when drinking or eating
- foul-smelling breath
- swollen gums
During the first outbreak, a person will develop flu-like symptoms, including:
- swollen glands
- body aches
Symptoms are typically less severe in recurrent flares.
Genital herpes typically develops:
- on the foreskin, shaft, and glans of the penis
- around the anus
- on the vulva and vagina
In females, it can be painful or difficult to urinate during an outbreak.
While rare, a person can develop HSV and shingles at the same time.
There is an occurrence called superinfection exclusion, which means that a single cell is insusceptible to two similar types of virus simultaneously.
A 2022 article outlines a case where a male with a compromised immune system presented with symptoms of both a shingles infection and an HSV infection.
The hospital staff found that he carried both viruses and treated him successfully.
The article authors suggested that HSV and VZV were present in the same ganglia, a cluster of nerve cells.
Antiviral medications can help shorten the duration and severity of the infection.
According to DermNet, initial herpes outbreaks can last between 2 and 3 weeks. After the initial outbreak, the virus remains dormant in the body, meaning the rash will likely recur. However, these reoccurrences heal within 7–10 days.
There are several causes and risk factors for shingles and herpes.
Shingles develops due to the reactivation of the VZV. If an individual has had chickenpox or the chickenpox vaccine, they may develop shingles later in life.
According to the
The AAD states that a weakened immune system and a person’s age increase the risk of developing shingles.
Shingles typically develops in those:
- over 50 years of age
- with cancers such as lymphoma or leukemia
- who take immunosuppressive medications, such as chemotherapy or medications to treat severe psoriasis and psoriatic arthritis
People contract HSV-2 if they have sexual intercourse with someone with herpes. This can include vaginal, anal, or oral sex.
Transmission can occur due to contact with:
- a herpes sore
- genital fluids
- the skin in the oral or genital area of someone with herpes
Herpes infections can also result when a partner does not have an active infection or is unaware of the infection. It can result from oral sex from a partner with HSV 1.
However, herpes is not communicable by touching objects, so it cannot transfer from toilet seats, swimming pools, or bedding.
It is not clear why a shingles outbreak develops. However, it may result from a lowered immunity due to treatments, illness, or typical aging.
Once a person contracts HSV, it remains in the body for life. It may not flare again, although reoccurrences are common.
Herpes outbreaks can develop due to:
- minor trauma to the skin
- upper respiratory tract infection
- sun exposure
- hormone fluctuations
However, there may not be an apparent reason for the outbreak.
Doctors diagnose the conditions using the following methods.
Diagnosing shingles generally depends on the appearance of the rash and the symptoms a person experiences.
For further clarification, a healthcare professional may take a swab of fluid from one of the blisters to examine in the lab.
If the doctor cannot diagnose according to the appearance of the rash, a culture from the fluid seeping from the rash can confirm a diagnosis of herpes simplex.
First-line treatment for shingles and herpes involves antiviral medication.
Antiviral medications can reduce the time the rash lasts and the severity of symptoms. For shingles, they can also reduce the risk of developing long-term nerve pain or other problems.
Medications for shingles are most effective if a person takes them within 3 days of the rash appearing. To prevent transmitting the virus to others, a person should cover the rash.
Shingles and herpes both develop due to herpesviruses. However, shingles occurs as a result of VZV, while herpes develops due to HSV-1 and HSV-2.
Both viruses are able to lie dormant within the body and flare up. Shingles typically only flares up once in a lifetime, while herpes can reoccur often.
Although both cause a rash, a shingles rash usually develops on one side of the body. Conversely, the herpes rash develops in or around the mouth and genitals.
To treat herpes and shingles, a doctor will prescribe antiviral medications.