Shingles vs Eczema: Skin Rash and Symptom Differences - Healthline

Shingles and eczema are both skin conditions that can cause areas of inflamed skin. The areas of inflamed skin can vary in size and be itchy or painful. Because of some of the similarities, it can be easy to mistake one condition for the other.

Shingles and eczema aren't the same. They have different underlying causes, which require different treatments. Since both conditions can cause complications without proper treatment, it's important to differentiate between the two.

Read on to learn more about the differences between shingles and eczema.

Shingles, or herpes zoster, is a disease caused by the latent varicella-zoster virus (VCV).

The VCV is the same virus that causes chickenpox, or varicella, in children. It stays inactive in the body after a chickenpox infection.

Anyone can get shingles. However, it's more likely to appear if you're feeling stressed, are dealing with an illness, or your immune system is weakened. If your immune system becomes weakened or compromised, the virus can reactivate and trigger shingles.

What causes shingles?

Several factors can weaken the immune system and causes shingles. This includes:

Shingles can affect people of any age, but it's more common in adults ages 50 and older.

Symptoms of shingles

With shingles, symptoms typically begin with a tingly, itchy rash that's limited to one side of the body. The rash starts out as a pink itchy patch with small blisters that form on top of the rash. Once the blisters open up it can be painful.

The rash can occur anywhere on the body, but it most often appears on one side of your head, trunk, or face, which might involve the eyes or mouth.

Along with an itchy, tingly rash, other early symptoms of shingles include:

• fever
• chills
• headache
• upset stomach

If shingles affects your eye, it can make it difficult to see out of the affected eye. If shingles develops on the side of your face or neck, it can cause dizziness or ringing in the ear on the affected side.

The blisters that form on the rash typically start to scab in 7 to 10 days, eventually clearing up in 2 to 4 weeks.

However, the pain can last for months or years, even after the blisters have cleared up. This pain is called postherpetic neuralgia, and about 10 to 18 percent of people who get shingles go on to develop this condition.

How to prevent shingles

The best way to prevent shingles is to get the shingles vaccine, or the recombinant zoster vaccine. It's known by the brand name Shingrix.

The shingles vaccine is given in two doses, about 2 to 6 months apart. The Centers for Disease Control and Prevention (CDC) recommends the vaccine for healthy adults ages 50 and older.

The vaccine is more than 90 percent effective against shingles. People who have had the vaccine may still get shingles, but the condition is less severe and they are less likely to develop postherpetic neuralgia.

Here's what shingles looks like on different parts of the body:

Eczema is a term that's used to describe several types of skin conditions that cause inflamed, itchy, irritated skin. Atopic dermatitis is the most common form of eczema.

Eczema is chronic, meaning it can last a long time. It can cause repeated inflamed itchy skin, which can lead to skin infections if not properly managed.

The condition often affects children, but it can develop in adults too.

What causes eczema?

There isn't one clear cause of eczema. It appears to be related to genetics and environmental factors. This may include a genetic mutation that affects your body's production of filaggrin — a protein that keeps your skin strong and moisturized.

With eczema, the gene responsible for making filaggrin doesn't produce enough of it, and as a result causes dry and irritated skin.

Eczema might also be caused by an overreactive immune system. When the body interacts with an external substance — such as certain chemicals, pollen, or mold, for instance — the immune system overreacts and causes inflammation.

Symptoms of eczema

Eczema causes an irritating rash. This may include:

• extremely dry skin
• severe itching
• fluid-filled bumps
• red or brown patches
• thickening or peeling skin (caused by scratching)
• swelling

How to prevent eczema

Since eczema may have a genetic component, it's not possible to completely prevent it.

But there are some steps you can take to limit or prevent eczema flare-ups. This includes avoiding common eczema triggers, such as:

• irritating chemicals
• fragrances or dyes
• rough, scratchy materials
• pollen
• mold
• dust mites
• animal dander
• extreme temperatures
• emotional stress
• certain foods
• dry skin

Here's what an eczema rash might look like:

There are some key differences between shingles and eczema symptoms. Let's look at what they are.

• Pre-rash symptoms. With shingles, you might feel tingling or burning several days before the rash appears. With eczema, although it's possible to have itchy skin without a rash, you won't have the tingling nerve pain that's common with shingles.
• Rash coverage. A rash caused by shingles usually appears on one side of the body. In contrast, rashes caused by eczema affect both sides.
• Skin irritation. A shingles rash can cause pain, burning, numbness, or tingling of the skin and be sensitive to the touch. Shingles can start with an itch, and then become tender and then painful. An eczema rash is very itchy, with dry, scaly patches. It's not usually painful unless the skin is extremely dry and cracked.
• Fatigue. If you have shingles, you'll likely feel very tired. Although eczema can disrupt your sleep and cause fatigue, it won't cause the same type of fatigue that's common with shingles.
• Thickened skin. With eczema, constant rubbing and scratching can thicken the skin. This typically doesn't happen with shingles.
• Duration of pain. Shingles typically clears up within a few weeks. A small percentage of people develop chronic nerve pain. Eczema isn't usually painful unless the skin is cracked. Once it's treated, though, the pain resolves.
• Frequency of rashes. Shingles usually involves a single episode, but it's possible to get shingles more than once. Eczema can cause flare-ups that come and go, especially without treatment.

To diagnose shingles, a doctor or other healthcare professional will use the following tools:

• Physical examination. A doctor will look at your rash and blisters. This is often enough to make a diagnosis.
• Medical history. Knowing your medical history allows a doctor to better understand your risk of developing shingles.
• Lab tests. If necessary, your doctor will take a sample of your skin or fluid from your blisters. They'll send the sample to a lab, where it will be checked for the virus.

There's no cure for shingles. However, early treatment can help resolve the rash faster and lower the risk of long-term complications, especially if the eye or inner ear is involved.

Shingles treatment includes:

• Antiviral medication. Antiviral drugs can reduce the severity and length of a shingles episode. Your doctor might prescribe acyclovir, valacyclovir, or famciclovir.
• Pain medication. Over-the-counter pain relievers can help ease your symptoms. If your pain is severe, your doctor might suggest opioids, topical lidocaine, or gabapentin, a medication that helps with nerve pain.
• Topical steroid. A topical steroid can help decrease inflammation and reduce pain and itching.
• Topical capsaicin. If the pain continues after the rash has cleared, applying capsaicin cream may help.

See a doctor if you develop eczema symptoms for the first time. Your doctor can examine your skin and confirm if eczema is causing your symptoms.

If your doctor thinks you have eczema, they'll explain how to manage your symptoms. This might include consulting a dermatologist.

Similarly, if you've already been diagnosed with eczema, be sure to continue following your medical professional's recommendations.

Like shingles, eczema has no cure, but treatment and self-care can help decrease flare-ups and protect your skin. This may include:

• Daily moisturizing. This is a main component of eczema treatment. It's best to use an ointment without fragrances or preservatives.
• Corticosteroids. If your eczema is mild, you can apply a hydrocortisone ointment to reduce inflammation. If you have severe eczema, your doctor might recommend prescription topical or oral corticosteroids.
• Antihistamine medications. Antihistamines, which are available over the counter, may ease eczema caused by allergies.
• Avoid scented products. Try to avoid any products that have a fragrance added to them. Instead, use unscented detergent, soap, shampoos, and other unscented personal care products.
• Avoiding triggers. One way to limit or prevent eczema is to identify the triggers that cause flare-ups. Triggers may include anything from certain soaps, detergents, or perfumes, to fabrics, specific foods, or high levels of stress. If you can pinpoint your triggers, you can take steps to avoid these triggers in the future.

Although shingles and eczema both cause skin rashes, they're very different conditions. Shingles is an infection caused by the reactivation of the VCV. It typically involves a painful, blistering rash that appears on one side of the body.

On the other hand, eczema is an inflammatory skin condition. It's likely caused by an overreaction of the immune system to external substances, like chemicals, fragrances, or dry weather. The rash, which can appear on both sides of the body, is usually itchy, and may involve peeling and blistering.

There's no cure for either condition, but early treatment can reduce the risk of complications. If you develop an irritating skin rash that doesn't go away, be sure to contact a healthcare professional.