The shingles rash usually occurs on one side of the body or face, most commonly on the trunk.
It’s easy to mistake a shingles rash for another health condition that affects the skin. The shingles virus typically causes a painful rash and blisters, which can resemble many other skin conditions — psoriasis, eczema, and hives among them. However, there are a few signs that your rash is more likely to be shingles than something else.
To get shingles, you must have had chickenpox. Shingles, or herpes zoster, occurs when the chickenpox virus (varicella zoster) reactivates after lying dormant in the body. The Centers for Disease Control and Prevention (CDC) estimates that 1 out of 3 people in the United States will get shingles in their lifetime. While your risk of getting shingles increases as you age, anyone can get it if they had chickenpox, notes the CDC.
About half of all shingles cases occur in adults age 60 or older, and the risk of getting shingles becomes much greater by age 70, according to the National Institute on Aging.
Signs and Symptoms of Shingles
Shingles may cause mild to severe pain, and the viral rash most commonly appears on the trunk, notes the CDC. Unlike chickenpox, the shingles rash usually occurs on one side of the body or face.
The first symptom of shingles is usually pain, itching, or tingling in the area where the shingles rash will later appear. This may happen several days before the rash erupts, leading to fluid-filled blisters like those of chicken pox. The blisters typically scab over in 7 to 10 days and clear up within two to four weeks, according to the CDC.
Other signs and symptoms of shingles may include:
- Chills
- Fever
- Headache
- Upset stomach
- Vision loss
How to Prevent Shingles: Get Vaccinated
Two vaccines may help prevent the shingles virus: the chickenpox (varicella) vaccine and the shingles (recombinant zoster) vaccine. The shingles vaccine is approved for adults ages 50 and older and for those 18 and older with weakened immune systems or at increased risk of herpes zoster because of a disease or treatment, according to the CDC.
Per the CDC, talk to your doctor about getting a shingles vaccination if you are 50 or older or if you have the following risk factors:
- You have cancer, especially leukemia or lymphoma.
- You have human immunodeficiency virus.
- You are a bone marrow or solid organ (renal, cardiac, liver, or lung) transplant recipient.
- You take immunosuppressive medications, including steroids, chemotherapy, or transplant-related medications.
Seek Prompt Treatment for Shingles
If you suspect that you might have shingles, seek medical attention right away, as prompt treatment can reduce your risk of painful complications like postherpetic neuralgia, according to the Mayo Clinic.
Here’s a look at some other skin conditions that may resemble shingles.
Chickenpox Is Caused by the Same Virus
The same virus, varicella zoster virus, causes both chickenpox and shingles.
Chickenpox typically causes an itchy rash that spreads over the entire body, as opposed to just one side of the body or face like shingles. More than 99 percent of Americans born on or before 1980 have had chickenpox, per the CDC. If you don’t know if you had chickenpox, check with your family doctor, who can review your records.
Psoriasis Forms Red Patches on the Skin
Psoriasis is an autoimmune disease that is easy to confuse with the shingles rash. As with the shingles virus, psoriasis forms red patches on the skin, according to Johns Hopkins Medicine. One type of psoriasis — pustular — can lead to the development of blisters. Areas of skin affected by psoriasis often develop into silvery scales on the scalp, elbows, knees, and lower back. Treatment can help control the condition.
Eczema Can Cause Red, Itchy Skin With Bumps
Like shingles, a skin allergy can also cause red, bumpy, itchy skin, according to the American College of Allergy, Asthma & Immunology (ACCAI). These reactions include eczema, hives, and contact dermatitis. Eczema can cause dry, red, itchy, irritated skin, per the ACAAI. Small, oozing, fluid-filled bumps may also appear, especially when the skin is infected. Eczema is most common on the face, inside the elbows and behind the knees, and on the hands and feet, per MedlinePlus. There is no cure for eczema, but treatments can help manage the condition.
Hives Can Cause Itchy Red Bumps
Hives are red or skin-colored bumps that can cause mild to severe itching, according to the ACAAI. They typically appear suddenly and disappear quickly. Pressing the middle of a red bump will make it turn white, which is known as blanching. Hives can be caused by a number of triggers, including allergies, cold or hot weather, and infections.
Contact Dermatitis Can Cause a Rash and Blisters
Contact dermatitis can also cause a rash, blisters, itching, and burning, per the ACAAI. It occurs when the skin comes into contact with an irritant or an allergen, such as soaps, laundry detergents, shampoos, metals, medications, and more. Allergens like poison ivy, poison oak, or poison sumac can cause red, itchy rashes that may include blisters. Treatment can offer relief and aid healing.
Ringworm Causes an Itchy, Red, Circular Rash
Ringworm is a skin infection that, despite its name, is caused by a fungus, whereas the shingles rash is caused by a virus, according to the CDC. Ringworm can cause a red, itchy, circular rash on your skin. It may also cause scaly, cracked skin and hair loss. The rash can appear on any part of your body, and it spreads easily through skin-to-skin contact or contact with an item contaminated with the fungus, like dirty clothes or a shower floor. Some forms of ringworm can be treated with over-the-counter medication, while others must be treated with prescription antifungal medication.
Herpes Simplex Can Be Mistaken for the Shingles Rash
Herpes simplex virus type 1 (HSV-1) is a common viral infection that causes fever blisters or cold sores, usually on the lips or around the mouth but sometimes on the face or the tongue or elsewhere on the body, according to the American Academy of Dermatology. One or more painful, fluid-filled blisters may appear, then break open, ooze fluid, and form a crust before healing. The sores can last from 7 to 10 days. HSV-1 can be spread by skin-to-skin contact such as kissing or touching. Most people get the virus as an infant or child from an adult who carries the virus. Herpes simplex virus type 2 is sexually transmitted and usually causes sores on the penis, vagina, buttocks, or anus, but sores can appear anywhere on the skin. There is no cure for herpes, but treatment can relieve symptoms and shorten an outbreak.
Fungal Infections Can Cause Rashes
Fungal infections other than ringworm can also cause rashes and blisters like those of the shingles rash. Athlete's foot causes an itchy, scaly rash that usually begins between the toes, according to the Mayo Clinic. Jock itch causes a red, itchy rash, often in the groin and inner thighs, per the Mayo Clinic. Yeast infections cause irritation and itchiness of the vagina and the vulva, and may cause symptoms including rash, pain, and burning, notes the Mayo Clinic.
Measles Rash Looks Like Flat Red Spots
Like the shingles rash and herpes simplex, measles is caused by a virus. Measles is highly contagious. Symptoms of measles typically begin with a high fever, cough, runny nose, and red, watery eyes, according to the CDC. Three to five days later, a rash that looks like flat red spots appears, normally starting on the face at the hairline and spreading down the body to the neck, trunk, arms, legs, and feet. Measles is a very serious disease that can lead to complications and death; fortunately, it can be prevented with a measles vaccine.