Shingles is a painful rash caused by the varicella-zoster virus. It’s also known as herpes zoster and can affect people of any age, race, or gender. Shingles is transmitted when the virus that causes chickenpox (varicella) reawakens in someone who has been infected with it before and has not had shingles yet. The symptoms for chickenpox and shingles are similar: fever, headache, fatigue, an upset stomach, and a skin rash on one side of the body. Because these symptoms are identical to those of other health problems, it can be challenging to distinguish them from each other! This blog post will help you figure out if your skin rash is indeed shingles or another skin problem.
Introduction to shingles
Shingles is transmitted when an uninfected person comes into contact with droplets, aerosol, direct contact or by touching contaminated items (World Health Organization, 2014) such as dressings, sheets or clothes soiled with discharge from a person who has either chickenpox or shingles. However, it is not possible for shingles disease to be transmitted in such a manner. Instead, a newly infected person who has never had chickenpox or received the varicella vaccination before may develop chickenpox. The virus spreads through the bloodstream, which goes on to infect the skin and internal organs. Shingles develop as a result of the reactivation of the varicella-zoster virus remaining dormant in the dorsal root ganglia along the spine after symptoms of chickenpox subside. This is usually seen in older adults or people with weakened immune systems (Duff, 2020).
What Can Be Mistaken for Shingles?
Hives/Psoriasis/Eczema
Shingles can sometimes be mistaken for other skin conditions, such as hives, psoriasis, or eczema. The characteristics of a rash may help doctors identify the cause.
Hives are red, with itchy bumps and swollen areas of differing sizes that can appear anywhere on the body. Medications, foods, latex, or a viral infection can cause an allergic reaction resulting in hives. Hives will clear up on their own, but the process can take months.
Psoriasis is an autoimmune disease that also forms rash-like patches with the development of blisters surrounded by red skin. A psoriasis rash typically lasts for a long time, where the skin keeps growing to be more red and scaly and can crack and bleed.
Eczema is a rash that occurs when the skin has an exaggerated inflammatory response to an irritant. Eczema can result in red, dry, and extremely itchy patches on the skin. In some people, eczema will cause oozing bumps, a condition that could be mistaken for the shingles rash. While eczema cannot be cured, it can be controlled by identifying and avoiding the allergic triggers that cause the condition (Jr, 2017).
Typically, the shingles rash appears as small raised dots at first. One difference between shingles and other rashes is the pattern that develops. The shingles rash often only affects one side of the body and therefore develops in a pattern along the nerves of the chest and belly. A rash due to allergies or eczema may develop anywhere, including the legs and the arms. Rashes due to eczema and psoriasis may last longer than the shingles rash, which is known to clear up in a few weeks. However, a shingles rash is usually much more painful than rashes caused by hives, psoriasis, or eczema.
The best way to work out if a rash is shingles is to see a doctor. In most cases, a doctor can diagnose based on medical history, a physical exam, and symptoms (Choi, 2018).
Chickenpox
While it is essentially caused by the same virus, chickenpox usually presents as a rash of itchy blisters on the body, head to toe, whereas shingles typically present with painful skin lesions on one side of the body following a nerve root distribution along an infected dermatome.
The main stages in chickenpox are:
- Initial symptoms: Body aches, fever, and headache are common when one is infected with chickenpox.
- Small red bumps on the body: These usually develop on the torso or face first and can eventually cover the entire body.
- Bumps develop into blisters: These bumps will start to fill with fluid and become blisters.
- Blisters scab over and heal: After the blisters scab over, one is no longer contagious.
The main stages of shingles are:
- Initial symptoms: Like chickenpox, it is common to develop fever, headaches, or body aches before developing the rash.
- Tingling pain: It is reported that one will often feel tingles, pain, or itchiness in the area the rash will develop.
- Burning rash: Rashes will start to develop anywhere from 1 to 5 days after the tingling starts
- Blisters: The rash will start to blister and then crust over. One may still suffer from mild or extreme pain after the rash is gone due to a condition called post-herpetic neuralgia (PHN). Additionally, it is possible to develop shingles more than once, but it is rare
Chickenpox also tends to be a milder illness that typically affects children aged 4 to 10, whereas shingles may be more severe and are usually seen in older adults aged above 60.
Chickenpox also tends to be a milder illness which typically affect children aged 4 to 10, whereas shingles may be more severe and is usually seen in older adults aged above 60.
Choi, N. (2018, January 18). Is it shingles? Symptoms, vs. other conditions, and causes. Medical News Today. Retrieved September 12, 2021
Duff, B. L. (2020, March 4). Why Does the Varicella Zoster Virus Reactivate as Shingles? Drug Topics
Jr, D. T. (2017, December 19). Is it shingles virus or SOMETHING Else?: Everyday Health. EverydayHealth.com. Retrieved September 12, 2021
World Health Organization. (2014, April 30). Varicella. World Health Organization