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Rash looks like shingles: Difference Between Shingles & Skin Rashes

Difference Between Shingles & Skin Rashes

Skin rashes are sneaky, uncomfortable, and sure to raise some eyebrows—especially in senior living communities and in similar communal settings where undiagnosed skin rashes can signal the alarms for a serious, potentially contagious viral infection like shingles. The easiest way to interpret skin conditions is to seek diagnosis from a medical professional, like a dermatologist. However, there are ways that you can spot the difference between an atypical skin rash and a severe skin condition like shingles—an important aid that all caregivers and senior community leaders should have in their arsenals.

Stick around as we discuss the differences in these skin conditions and the value of seeking professional medical diagnosis and care when dealing with an unknown skin rash or shingles in a dependent.


Is It a Skin Allergy?

It’s no secret: Self-diagnosing a skin condition or jumping to extreme conclusions is a bad path to travel down when questioning the health of dependents or residents in your senior living community. For skin rashes in seniors, mistaking visual markers and accompanying symptoms for another contagious, viral condition that affects the skin (like shingles) is an easy trap to fall into. If you think the skin rash is just an allergic reaction, pause and consider these common causes and symptoms of skin allergies:

Skin Allergies: Causes & Symptoms of the Reaction

Skin allergies and stress are two common causes of skin rashes, but an allergic skin reaction can look very similar to the shingles rash—making the two skin conditions difficult to differentiate. To spot the difference, it’s important to ask your resident or the elderly loved one in question about any recent changes in his or her routine. An allergic skin reaction can be caused by medication, exposure to an outdoor skin allergen (like poison oak or poison ivy), or exposure to new cosmetics (shampoo, bodywash, perfume, etc.). These allergic reactions can look like sporadic or irregularly shaped red sores on the skin. This flat or raised irritation can be itchy and bumpy, and even lead to blisters. However, unlike shingles, allergic skin rashes like this will often clear up on their own—with most gone around two weeks after exposure.

Or Is It Shingles?

Shingles is a virus that can be spread from person to person during the blister phase, reactivating the nerve tissues of at-risk individuals with the dormant chickenpox virus or causing the chickenpox in someone who has never had it or received the chickenpox vaccine. It’s important to note that shingles is much more common in both immunocompromised individuals and people over the age of 65 who have had chickenpox.

Shingles Symptoms

Caused by a virus, shingles is a common infection of the nerves that can trigger a painful skin rash that manifests into small blisters along the midsection of the body or face. Symptoms to look for in a potentially infected individual include:

  • Fever and chills
  • Headache
  • Upset stomach
  • Skin sensitivity (tingling, itchiness, pain—especially when touching clothing)
  • Skin rash (will likely appear after one to five days after symptoms begin and will look like small, red spots)
  • Fluid-filled blisters (will likely form soon after the skin rash, scabbing over in seven to 10 days and clearing within four weeks)

While an active shingles rash (a blistering rash) is contagious, once the blisters crust over, the shingles virus is no longer infectious. Even with the blisters gone, however, an individual can experience extreme residual pain in and around the rash site.

The Shingles Belt: The Key to Spotting the Difference

The shingles “brand” or “girdle” is the easiest visual sign to spot when dealing with the active virus and a great way to tell the difference between this serious condition and a mild skin rash in seniors. Shingles classically appears around the waist or rib cage, circling the area to look like a belt. This rash formation can be wide or narrow and will typically cover only one side of the midsection.

If you believe you might have shingles, isolate to control the spread of the virus and contact a healthcare professional to complete a physical examination. A healthcare provider will quickly know if it’s shingles because of the virus’s unique, active, blistering rash. They will prescribe the needed antivirals after the visit and suggesting at-home remedies to quicken recovery time and relieve pain.

DispatchHealth Is Here to Help

DispatchHealth brings complex medical care out of an expensive hospital setting and right to your door. This enables you to be safely treated and recover faster at a dramatically lower cost. Our medical teams will come prepared with nearly all the tools and technologies found in a traditional ER setting, treating compromised individuals with shingles and skin infections who are more likely to develop severe complications from the illness.

To request care, simply contact us via phone, mobile app, or our website.


DispatchHealth relies only on authoritative sources, including medical associations, research institutions, and peer-reviewed medical studies.

Sources referenced in this article:

  1. https://www.healthline.com/health/shingles-pictures
  2. https://www.hopkinsmedicine.org/health/conditions-and-diseases/shingles
  3. https://www.mayoclinic.org/skin-rash/sls-20077087?s=11
  4. https://www. everydayhealth.com/pictures/shingles-other-skin-conditions/
  5. https://www.cdc.gov/shingles/about/transmission.html

Is it shingles? Symptoms vs. other conditions and causes

Shingles, also called herpes zoster, is an infection that causes a painful, blistering rash, often on one side of the body or face. There may also be ongoing neurologic pain.

Shingles happens when the chickenpox virus reactivates, often many years later. It affects about 1 million people each year in the United States. There may also be a fever, chills, headache, gastrointestinal disturbances, and headache.

In most cases, shingles is not a life threatening condition, but it can cause severe pain, and the effects can linger for months or years as postherpetic neuralgia.

Vaccinations against the chickenpox virus and the shingles virus can help prevent shingles.

The first symptoms of shingles are usually:

  • pain
  • itching
  • tingling

Next, the following may start to appear:

  • a painful rash of blistering sores, which appears as a single stripe around one side of the trunk
  • a rash around the eye
  • fever and chills
  • headache
  • gastrointestinal symptoms
  • a rash or ulcers in the mouth, known as oral shingles

The rash from shingles tends to develop in a hallmark pattern, usually on the trunk. People sometimes call it a “shingles band” due to the striped pattern. They appear over 3–5 days.

Pain occurs because the virus causes inflammation in the nerves.

Over the next 7–10 days, the blisters often rupture, form sores, and then crust over and heal. The rash usually disappears in 2–4 weeks.

Disseminated shingles involves a widespread rash. It can affect people with a weakened immune system.

In some people, the rash heals, but the pain continues for 4 weeks or longer. In some cases, there may be severe pain lasting 90 days or more, known as postherpetic neuralgia (PHN).

According to the Centers for Disease Control and Prevention (CDC), PHN affects 10–18% of people who have had shingles. It rarely affects those under 40 years, but 13% of individuals aged 50 years or over will develop PHN after shingles. By the age of 70, this figure rises to around 75%.

In some cases, shingles can lead to:

  • vision loss
  • pneumonia
  • hearing loss
  • encephalitis, an inflammation of the brain
  • partial facial paralysis
  • polyneuritis, where multiple peripheral nerves become damaged

In some cases, the virus affects the internal organs, such as the lungs, liver, brain, spinal cord, or blood vessels. In this case, it can become life threatening. Having a weakened immune system may increase the risk of internal involvement.

What is internal shingles?

The symptoms of shingles can sometimes resemble those of other conditions, such as:

  • cellulitis
  • chickenpox
  • herpes simplex
  • impetigo
  • folliculitis
  • irritant contact dermatitis
  • insect bites
  • mucosal candidiasis, or oral thrush

The best way to work out if a rash is shingles is to speak with a doctor. In most cases, a doctor can make a diagnosis according to a person’s medical history, a physical exam, and symptoms. However, they may take a sample of skin, mucus, or blood for testing to confirm the diagnosis.

Anyone who suspects they have shingles needs to seek medical advice. Treatment can help speed recovery and reduce the risk of complications.

What do skin infections look like?

A virus called varicella zoster causes shingles. It also causes chickenpox, which used to be a common childhood illness before health experts developed a vaccine for it.

Once a person has a chickenpox infection, the virus remains in their nervous system, even after they recover. Although the virus stays in the body, doctors consider it latent, meaning it is inactive and does not cause any symptoms.

At some point, the virus can reactivate and cause shingles. The reason the virus reactivates is not entirely clear — it may become active again if a person’s immune system becomes weakened or stressed.

What treatment options are there for shingles?

A person cannot get shingles from another individual, but they can get chickenpox from someone who has shingles if they do not have immunity to chickenpox.

Transmission can occur through contact with the fluid that comes from the blisters.

When is shingles contagious?


According to the CDC, the shingles vaccine (Shingrix) is safe and can provide up to 97% protection against shingles, depending on the person’s age and the status of their immune system.

The Department of Health and Human Services advises everyone to have the shingles vaccine if they are:

  • are aged 50 years or older
  • are aged 19 or older and have a weakened immune system due to a health condition or treatment, such as chemotherapy
  • are aged 19 or older and are at risk of a weakened immune system because of upcoming treatments

People should have the vaccine even if they:

  • have already had shingles
  • have previously been vaccinated with Zostavax, a vaccine that is no longer in use
  • are not sure if they have had chickenpox

The vaccine comes in two doses, the second being 2–6 months after the first.

Here are some questions people often ask about shingles symptoms.

What are the first signs of shingles?

Early symptoms include a feeling of pain, burning, and itching in one area of the skin. After this, a rash appears, and fluid-filled blisters form. The rash is painful because the virus causes infection in the nerve cells.

What are the triggers for shingles?

Possible triggers for shingles include:

  • emotional stress
  • the use of immunosuppressant medications
  • having a health condition that affects immunity

Will shingles go away without treatment?

There is currently no cure for shingles, but the rash usually clears up in 2–4 weeks. However, treatment can help manage it. If a person takes antiviral medication soon after the rash appears, it may shorten the duration of the infection and reduce the severity of symptoms.

Over-the-counter pain relief, wet compresses, calamine lotion, and lukewarm baths with colloidal oatmeal may help manage discomfort.

What are some natural treatments for shingles?

How long does shingles last?

The first symptoms of shingles are often pain, tingling, itching, and then a rash. The rash often forms a band around one side of the trunk. In time, blisters can form. These usually heal within 2–4 weeks, but some people have ongoing pain known as postherpetic neuralgia.

The rash can also affect the eyes and mouth, with a risk of vision loss.

Vaccination can help prevent shingles. Health experts recommend it for people aged 50 years and above and those aged 19 and over who have or are at risk of having a weakened immune system.

Herpes Virus -3 (continued) – Shingles – Propid

Designed by pct.vector/ Freepik

Shingles is an infection caused by the same virus that causes chickenpox and presents as a painful skin rash. But it turns out that he can be without a rash! And it can also manifest itself as severe dizziness, or as stomatitis on only one half of the oral cavity. Here are some surprises! What else this virus can threaten a person with and how to deal with it will be discussed below.

VZV (varicellazostervirus) is the same virus that causes chickenpox, which we have already written about. After a person has had chickenpox, VZV remains dormant in their body for the rest of their lives. If the virus reactivates, which can happen decades later, most often due to a weakened immune system, then the resulting condition will be herpes zoster . Although anyone with a history of chickenpox can develop shingles, the condition most commonly affects people over 60 years of age.

Good to know: shingles is also known as herpes zoster , but it is important to note that this condition is not caused by the same virus called herpes simplex that causes genital or oral herpes.

Herpes zoster symptoms

The main symptom of herpes zoster is a painful skin rash. At first it looks like a red rash, similar to hives, and then weeping blisters appear.

Prior to the onset of the rash, previous signs of herpes zoster include:

  • Itching, burning pain, numbness, tingling where the rash will develop.
  • Flu-like symptoms, such as chills, fever, headache, feeling tired.

After the initial skin complaints have developed into herpes zoster, this condition usually lasts two to four weeks. The pain usually increases as the rash develops and decreases as the rash heals. Many people experience only one shingles flare in their lifetime, although the disease can recur.

The varicella-zoster virus that causes shingles is dormant in the nervous system after a person has recovered from chickenpox, so the rash appears exclusively on dermatomes (dermatome – a strip or area of ​​skin on the body corresponding to the innervation of a certain nerve).

*Renee Gordon, Public domain, via Wikimedia Commons

Shingles usually appears on the face, neck, torso, but only on one side.

, via Wikimedia Commons

Good to know: If the related nerves are affected, shingles may also appear on the leg. Less commonly, but it is also possible to develop shingles in more than one area of ​​the body, that is, in relation to more than one branch of the nerve. Even more rarely, especially in people with a weakened immune system or diagnosed with PID, three or more dermatomes may be affected. This form of the disease is known as disseminated herpes zoster .

As condition 9 progresses0011 blisters appear at the site of the rash, which are filled with a clear liquid.

The original uploader was Fixi at German Wikipedia.(Original text: Prof. Cremer), CC BY-SA 3.0 , via Wikimedia Commons

It is the connection of the virus with the human nervous system that entails a symptom of severe stabbing pain, which intensifies as the rash develops. The area affected by the rash may be hypersensitive to touch, which can make it difficult to dress or sleep in certain positions.

The blistering phase of the rash usually lasts seven to ten days, after which the lesions should decrease in size as they heal and eventually disappear.

Although a painful rash on one side of the face, neck, or trunk is present in most cases of typical herpes zoster, it can sometimes take on other forms.

Less common ones include:

  • herpes zoster, with severe pain but no rash
  • herpes zoster affecting internal organs
  • Herpes zoster ophthalmic or Herpes zoster affecting the optic nerve
  • Herpes zoster affecting the facial nerve

Herpes zoster ai without rash :

A person can develop shingles without a rash, although this is rare. Then the first symptoms of the disease may include:

  • Feeling of numbness in a certain area
  • Itching, burning
  • Painful sensation
  • Headache
  • Fatigue
  • Generalized pain
  • Hypersensitivity to touch

The sensations will be concentrated in a specific area of ​​the body – usually the face, neck, one side of the torso or the eyes. However, even in the absence of a rash, this condition can rarely lead to neurological conditions such as inflammation of the brain (encephalitis). The early signs of encephalitis—headaches, fever, muscle aches, and nausea—are similar to the flu. More severe symptoms include drowsiness, seizures, and difficulty speaking.

In cases where there is no rash, laboratory analysis is usually required to determine the presence of varicella-zoster virus in the body.

Internal herpes zoster

In rare cases, herpes zoster can affect the lungs, nervous system and brain in association with external rashes. This is more likely if the person has a weakened immune system, such as the human immunodeficiency virus (HIV) or is undergoing chemotherapy, or if the person has a congenital immunodeficiency.

People who have a weakened immune system and who suspect they may have shingles but do not have the typical rash should tell their doctor immediately about their medical history to prevent organ damage and shingles.

The symptoms of these complications are related to the specific internal organ affected. If a person has herpes zoster that affects the lungs, for example, pneumonia may develop.

Herpes zoster ophthalmicus

This form of disease includes herpes zoster affecting the optic nerve. The first sign that shingles may have spread to the eyes is the development of shingles and/or associated sensations at the tip of the nose (Hunt’s sign) so it is recommended to consult with an ophthalmologist immediately in this localization as this form Shingles can cause visual disturbances and even blindness.

By Burntfingers – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=38576180

Another type of shingles occurs when shingles affects the facial nerve. In this case, rashes are localized on the face, neck, ear and even in the mouth. On the oral mucosa, rashes resemble stomatitis, but are located only on one half.

Well, the least common forms of herpes zoster are:

  • peripheral paralysis of the facial nerve, characterized by acute pain in one ear and half of the face. Vesicles may be present in the external auditory canal and in some cases, hearing, taste, photophobia
  • A disorder of the vestibulocochlear nerve in which, in addition to a rash, there are symptoms of imbalance in the balance system, such as dizziness .

Causes of shingles

All people who have had chickenpox, and in very rare cases, people who have been vaccinated against chickenpox and therefore carry VZV in their bodies, are at risk of developing shingles.

Good to know: If a person who has been vaccinated against varicella develops shingles, the infection is usually much less severe than it might be when it affects people who carry some form of natural VZV into your body. Therefore, it is generally advisable for a person who has not had chickenpox to be vaccinated against , even if it is a weakened vaccine (containing a weakened version of the virus that does not cause disease), and therefore does not provide complete protection against comorbidities, such as herpes zoster.

Herpes zoster vaccine is not recommended for certain populations, including

  • Pregnant women.
  • Those suffering from a condition that weakens the immune system , such as those with HIV.
  • Cancer patients with damage to the bone marrow or lymphatic system.
  • Receiving immunosuppressants, such as steroids.
  • Undergoing radiation therapy or chemotherapy
  • Those who received an organ or bone marrow transplant less than 4 weeks before vaccination

Herpes zoster vaccine in Russia is not recommended for use as standard vaccination. postherpetic neuralgia. If vaccination is necessary, they try to resort to drugs of foreign origin – Shingrix ( Shingriks) and Zostavax (Zostavax).

Shingrix contains a small amount of surface antigens of the virus and an “adjuvant” which consists of substances that enhance the immune response. Zostavax live attenuated vaccine

Is shingles (shingles) contagious?

Shingles is contagious only when the rash is blistering. At this time, VZV can be transmitted from one person to another through direct physical contact, through traces of infected fluids on blisters when sharing towels, bed linen and utensils.

You can only get the shingles virus, not the shingles itself : If a person who has never had chickenpox before gets infected with VZV from someone with shingles, they will develop chickenpox, the first infection that VZV causes when ingested, and never immediately get sick with herpes zoster.

If a person gets shingles during pregnancy, it is usually mild and does not pose any additional risk to the person or their unborn child. But still, you need to remember – Pregnant women who have never had chickenpox should avoid contact with people with chickenpox and shingles as a precaution. they can infect other people with VZV, and developing chickenpox during pregnancy can lead to potentially serious health complications for both the pregnant person and the developing fetus.

Herpes zoster rarely affects children under three years of age and may only affect children who have already had chickenpox. However, a weakened immune system as a result of an autoimmune disease, another chronic or serious illness, or due to excessive stress can make a child more likely to develop shingles.


Since the herpes zoster rash is instantly identifiable due to its dermatomal pattern and the presence of accompanying pain, usually on one side of the body, this may be sufficient for a correct diagnosis. The doctor usually performs a physical examination and may take a swab from the blister, sending a sample of cells from the area of ​​skin to a lab to confirm the diagnosis.

After diagnosing shingles, your doctor will give you recommendations to ease the discomfort associated with shingles.

  • Rest and relaxation
  • Wear loose clothing
  • Keep rash clean and dry to dry blisters.
  • Do not cover the rash so that the blisters can progress to the scab stage as quickly as possible.
  • Use cool compresses to relieve burning sensations on the skin.
  • Avoid sharing bed linen, clothing, or towels as this may spread the infection to others.

Medications to promote recovery

Medications that may be prescribed to relieve shingles and flare-ups may include:

  • Pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol. In some cases, antidepressants or anticonvulsants may be prescribed due to their pain-relieving properties, which can work effectively when combined with other pain relievers.
  • Antiviral drugs (acyclovir, valaciclovir, famciclovir)

But, despite all the modern means of control, you need to be prepared for the fact that the virus remains alive with a recovered person and the purpose of these drugs is only to prevent complications and reduce discomfort.

In our next issue, we will talk about the 4th type of human herpes virus – Epstein-Barr virus, which is accused of “weakened immunity” in children and adults, and even in the occurrence of oncology. We will look for the truth about this difficult type of virus and remove unnecessary slander.

Neurologist Demyanovskaya explained why shingles occurs and how to treat it

  • Health

If you had chickenpox as a child, in adulthood there is a chance to meet with its unpleasant consequences – shingles.

June 20, 20231


Shingles is properly called herpes zoster. This viral infection affects adults and presents as a painful rash on a limited area of ​​the body or face. The disease is caused by the same virus that provokes chickenpox in children, Ekaterina Demyanovskaya, a candidate of medical sciences, a neurologist at the Hemotest laboratory, told Doctor Peter.

One in children, another in adults

Chicken pox in children, as well as herpes zoster in adults, is caused by the varicella-zoster virus, or the human herpes virus type 3. The fact is that after the transferred chickenpox, varicella-zoster, like other herpes viruses, remains forever in the body. The immune system restrains him, and he “falls asleep” in large nerve nodes. But if further immunity decreases, the virus can reactivate and provoke herpes zoster .

“It spreads along the nerve trunks until it reaches the terminals of the nerve fiber and finds an exit on the skin in the form of blisters,” explains Ekaterina Demyanovskaya.

Herpes zoster is not so rare disease, its frequency is on average 1.5-6 cases per 1000 people per year. It develops in adults who had chickenpox as children or were vaccinated against chickenpox with a live attenuated vaccine. The risk of the disease increases significantly with older age. At the same time, those infected are dangerous to others, in particular to those who have not had chickenpox before.

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Always chicken pox first

provoke chickenpox. The virus is easily transmitted through the air, shared bedding or towels , which got liquid from the opened elements of the rash.

The probability of getting sick is higher than in people over 50 years of age, pregnant women, patients with immunodeficiency states , such as HIV-infected or cancer patients, and also in those who take drugs that suppress the immune system, says the doctor.

The leading symptoms of the disease are pain along the affected nerve trunk and a rash, which in terms of localization corresponds to the zone of innervation of the same nerve. The pain is so severe that even the touch of a thin tissue to the body brings discomfort. At the same time, the intensity of pain does not always correlate with the severity of the rash.

It is stored in the nerves for life

The varicella-zoster virus is stored in the spinal ganglions and ganglia of the cranial nerves. In the course of the nerve trunks extending from them, rashes may appear. Localization depends on which nerve is affected. In most cases, these are spinal roots, less often – branches of the trigeminal nerve.

Moving along the nerves, the virus causes severe pain that may precede rashes – this is an unfavorable prognostic factor for the development of persistent pain syndrome – postherpetic neuralgia, can occur simultaneously with rashes or at the height of their appearance.

“The rash is similar to herpes simplex: groups of small vesicles against the background of reddening of the skin, filled with a cloudy liquid, which eventually open up and become covered with crusts,” the expert clarifies.

Read also

There may be complications

Usually the immune system copes with the virus, the skin is completely cleared in 2-4 weeks. However, sometimes herpes zoster can lead to complications and consequences. Severe complications of herpes zoster – herpetic (varicella-zoster virus) meningitis and meningoencephalitis . The likelihood of their development increases if the rash is localized on the head or in the face . Herpes zoster ophthalmicus (affecting one branch of the trigeminal nerve) can lead to herpetic keratitis, up to and including corneal ulceration.

But even with a relatively mild course of the acute period of herpes zoster, approximately 20% of patients develop postherpetic neuralgia – pain that is felt in the innervation zone of the affected nerve trunk at the former site of the rash, it can disturb a person months and years after the disease. The older the person, the higher the risk of developing such a complication.

“Also, risk factors for postherpetic neuralgia are female sex, a long pain prodromal period, high pain intensity in the acute period,” warns Ekaterina Demyanovskaya.

You always need a doctor

Herpes zoster is diagnosed and treated by an infectious disease specialist, a neurologist and a dermatologist. If necessary, you may need to consult an ophthalmologist and a physiotherapist.

A doctor can tell if a person has herpes zoster, for characteristic symptoms – severe pain along the nerve and rashes on the skin . But without rashes, the diagnosis is not obvious, because pain can be a symptom of many diseases. It happens that patients with herpes zoster end up in surgical departments, some even undergo surgery, believing that the pain is provoked, for example, by cholelithiasis.

And only after the appearance of rashes, the cause of the pain becomes clear. To clarify the diagnosis, the specialist will prescribe a blood test for antibodies to the virus or a PCR test to identify the DNA of the pathogen in the cerebrospinal fluid. Rarely, it may be necessary to examine the contents of the rash. After the onset of a rash, the picture of the disease is quite typical, therefore, as a rule, serological or molecular genetic studies are needed only if the disease occurs with uncharacteristic symptoms or with serious complications. 9.

“To relieve pain, the doctor may additionally recommend non-steroidal anti-inflammatory drugs (only in the erythema period, while there is inflammation), anticonvulsants, nerve fiber repair agents, decongestants, and antihistamines.