Herpes and shingles both cause blistering rashes. Herpes typically affects the face or mouth, or the genitals or rectum. In contrast, shingles usually affects one side of the body close to the waistline.

Shingles and herpes occur due to viruses from the herpesvirus family. 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 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 typically experiences pain or a burning sensation on the skin area where the rash will develop. This may happen 1–2 days before the rash appears.

Although the rash can appear anywhere on the body, it typically develops on one side of the body around the waistline. It can also develop on one side of the face.

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:

Learn more about shingles.

According to the Centers for Disease Control and Prevention (CDC), herpes sores usually develop as one or more blisters around the mouth, genitals, or rectum.

The blisters then typically break and result in painful sores, which can take about 7 days or more to heal.

Read more about herpes.

Oral herpes

The World Health Organization (WHO) notes that oral herpes is typically asymptomatic, so a person may not experience symptoms. However, before the blisters appear, they may experience an itching or burning sensation around the mouth.

People may also experience:

  • pain when drinking or eating
  • foul-smelling breath
  • swollen gums

Read more about oral herpes (cold sores).

Genital herpes

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Most people experience mild symptoms or no symptoms at all. It is also possible to mistake herpes for other skin conditions, such as an ingrown hair or a pimple.

During the first outbreak, a person may develop flu-like symptoms, including:

  • fever
  • 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.

Learn more about genital herpes.

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.

The CDC notes that it can take 7–10 days for the blisters from shingles to scab over. The agency added that the rash takes 2–4 weeks to resolve completely.

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 CDC, approximately 1 out of 3 people in the United States will develop shingles. Additionally, over 99% of people in the United States born before 1980 have had chickenpox and are at risk of developing shingles.

The AAD states that a weakened immune system and a person’s age increase the risk of developing shingles.

Shingles typically develops in those:

Some people may be eligible to receive the shingles vaccine. This can help prevent shingles from developing.


People typically contract HSV-1 if they come into contact with the virus present on surfaces, in saliva, or in sores around the mouth.

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
  • stress

However, there may not be an apparent reason for the outbreak.

Healthcare professionals 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 healthcare professional 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.

The most commonly prescribed antiviral medications are:

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 herpes viruses. 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 healthcare professional will generally prescribe antiviral medications.