Shingles vs. Herpes: What’s the Difference?

Genital herpes and shingles have some similarities in the appearance of a rash. However, when comparing herpes vs. shingles, they are different conditions caused by different viruses.

Genital herpes is caused by herpes simplex virus-1 (HSV-1) or herpes simplex virus-2 (HSV-2). Shingles (herpes zoster) is caused by the varicella zoster virus (VZV). While they both cause rashes, they usually affect different parts of the body and have different healing times.

This article will compare genital herpes vs. shingles, go over how long each condition lasts, the symptoms and treatments for each condition, and how to tell which condition you have.

Shingles

Shingles (Herpes Zoster) vs. Herpes (Simplex): Differences

The biggest difference between genital herpes and shingles is that the conditions are caused by different viruses. 

Genital herpes is most often caused by the HSV-2 virus, but can also be caused by HSV-1. Shingles is caused by the VZV virus. 

Some other key differences between shingles and herpes are the symptoms, how they spread, and how long it takes to heal.

Herpes

Body Parts Affected

Herpes usually affects certain parts of the body, including the genitals, buttocks, rectal area, and thighs. When the infection affects the mouth or lips (“cold sores), it is usually caused by HSV-1. Once the virus has entered your body, you can have outbreaks of rashes and lesions for the rest of your life.

Shingles can affect the skin anywhere on the body but the sores usually show up as a band on just one side of the body. It's common on the torso or face and only rarely in the genital area. Though the virus stays in the body, most people do not get multiple shingles outbreaks.

Contagiousness

Shingles isn't something you can catch from someone else. It's caused by the varicella zoster virus, which also causes chickenpox. After you recover from chickenpox, the virus stays inactive in your body, where it can reactivate years later to cause shingles.

However, fluid from shingles blisters can cause chickenpox in someone else who hasn't had chickenpox or been vaccinated against varicella.

Herpes is contagious. The virus is passed through contact with a herpes sore, saliva, genital fluids, or skin contact with a partner who has oral or genital herpes (even when they do not have a visible sore).

How Long It Lasts

A shingles rash typically goes away within two to four weeks. Blisters associated with the rash tend to clear in seven to 10 days. However, there can be pain and itching in the location where the rash develops in the days leading up to an outbreak. The pain and tingling can last for months after the rash has healed.

With herpes, the first outbreak a person has usually is the worst and takes the longest to heal. The outbreaks they get from then on are usually milder and don't last as long, healing in a few weeks.

Herpes vs. Shingles: Symptoms

Herpes

Someone with genital herpes does not always have symptoms. If they do have symptoms, they’re often so mild that they go unnoticed.

Common symptoms of genital herpes include:

• Blisters around the genitals or rectum
• Pain around the blisters
• Flu-like symptoms (with the first outbreak)

Usually, the first outbreak of herpes causes the most symptoms and lasts the longest. Later outbreaks are usually less severe and get better faster.

Shingles

Shingles lesions usually show up in a line along the affected nerve, and only on one side of the body. 

In the days leading up to a shingles outbreak, the area where the lesions will show up can feel painful or itchy. 

A few days later, small blisters form. They can be very painful and may cause a burning sensation on the skin.

Over the next few days, the small blisters begin to dry up and develop a crust over them before finally going away.

The pain after the blisters heal can last for months or even years. This condition is called postherpetic neuralgia.

Occasionally, herpes may extend beyond the area of skin supplied by one spinal nerve (dermatome). In some cases, it can spread to the entire body, but this is uncommon and mostly happens to people with a weakened immune system.

Other symptoms of shingles include:

• Fever and/or chills
• Headache
• Nausea
  

Herpes vs. Shingles: Treatment

Both herpes and shingles are treated with antiviral medications. These medications can't get rid of the virus, but they can shorten the length of the illnesses and help keep them from getting severe.

Herpes

Herpes can be treated with daily antiviral medications such as Valtrex (valacyclovir), Sitavig, or Zovirax (acyclovir). 

These medications suppress the virus activity in the body, making it less likely to cause an outbreak or spread to a partner. However, taking the medication this way won’t prevent an outbreak—it just helps shorten an outbreak that has already shown up.

At the direction of their healthcare provider, a person with genital herpes can also take an alternate regimen of these medications for a short time during an outbreak, instead of every day.

Shingles

Shingles is treated with antiviral medications such as acyclovir or valacyclovir. The sooner the medication is started after the shingles rash appears, the more effective it will be.

Causes Other Than Shingles or Herpes

The location, symptoms, and appearance of the painful rash are often enough for a healthcare provider to make a diagnosis of genital herpes or shingles. Although rare, a shingles outbreak can appear on the genitals, making it look like genital herpes. 

There are other health conditions that cause similar rashes and symptoms, but providers usually do not confuse them with shingles or herpes.

These conditions include:

• Impetigo (bacterial infection of the skin)
• Dermatitis (inflammation of the skin)
• Allergic reaction
• Insect bites or stings
• Folliculitis (inflammation of hair follicles)
• Erysipelas (bacterial skin infection)

Shingles vs. Herpes: Diagnosis

The diagnosis of genital herpes or shingles is made after a provider looks at the affected area and talks to you about your symptoms. They may want to do some tests to make sure they have the right diagnosis. 

Herpes

Genital herpes can be hard to diagnose if the lesions have gone away before you see a provider. 

If you do have lesions, a sample can be taken and looked at in lab to figure out if HSV-1 and HSV-2 is the cause. 

There are also blood tests that can check for antibodies to the herpes virus. You might be tested for human immunodeficiency virus (HIV) as well.

Shingles

Shingles is usually diagnosed just by looking at the rash, but your provider can do other tests, too. For example, they can take fluid from the blisters to look at in the lab.

Blood tests may not detect an active shingles infection but can help rule out other possible causes.

When to Talk to Your Healthcare Provider

If you have symptoms of genital herpes or shingles, call your provider right away. Both conditions can be treated but you want to start as soon as possible to manage your symptoms and prevent complications.

It's also important to know for sure which condition you have so you can take steps to protect others—for example, if you have herpes, your partner(s) may need to get tested and treated.

Summary

Herpes and shingles are both caused by viruses and can give you a rash, but they are different conditions that have different treatments. 

Herpes cannot be cured but outbreaks can be treated with antiviral medications. The medications can also be taken daily to help prevent outbreaks.

Shingles is caused by the same virus that gives you chickenpox. Once you get the shingles rash, it can be treated with antivirals like herpes. Shingles can also be prevented with a vaccine. 

If you have a painful, itchy, blistering rash on any part of your body, see a healthcare provider right away. Whether it’s from herpes, shingles, or another cause, the sooner you get diagnosed and treated, the better.