Eczema Vs Shingles: A Comprehensive Look At Their Differences

Eczema and shingles are medical conditions that inflame the skin, resulting in a rash. Due to their shared similarities, such as itchy, blistering rashes, many people struggle to tell them apart and often wonder if eczema and shingles are related.   

This guide will cover everything you need to know about eczema and shingles and their distinct differences.  

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What are shingles? 

Also known as herpes zoster, shingles is a viral infection that causes a painful rash on one side of the body. It’s caused by the varicella-zoster virus (VSV) reactivation, a virus that also causes chickenpox. 

After you recover from a chickenpox infection, VSV remains dormant in the nervous system. For some people, VSV remains inactive forever, but for 1 in 3 people in the US,¹ the virus will be reactivated, resulting in shingles.  

Anyone who’s had chickenpox can get shingles, but it’s more common in people with a compromised immune response. This can be due to age; nearly half of all shingles cases are in adults aged 60 or older, and the risk of getting shingles becomes much more significant by age 70. 

Additionally, medical conditions and therapies that weaken the immune system increase your risk of developing shingles. This includes: 

  • Cancers such as lymphoma and leukemia 

  • Human immunodeficiency virus (HIV)  

  • Chemotherapy   

  • Transplant-related immunosuppressive medications  

  • Steroids like prednisone  

Symptoms of shingles   

Shingles rash usually occurs along a dermatome, an area of the skin supplied by a single spinal nerve that sends information like pain, burning, pressure, and temperature to the brain. There are dermatomes all over the body, which means that the shingles rash can appear almost anywhere, including the waist, chest, abdomen, buttocks, back, face, eyes, mouth, and ears.

Symptoms can vary depending on where on the body they appear and the phase of shingles.   

Prodromal phase

During this phase, you may feel itching, burning, stabbing, tingling, or shooting pain and a red rash on a particular area of your body. In some cases, shingles can cause intense sensitivity, making it painful even to wear clothes, while in other cases, your skin may feel numb. 

You may also have flu-like symptoms like fever, chills, headache, upset stomach, and severe fatigue (malaise). The prodromal stage usually lasts between 1–5 days.   

Active phase

A few days after the rash appears, painful blisters filled with fluid will start to form. After 7–10 days, the blisters gradually dry up and form scabs or crusts. Your skin will slowly heal, and the scabs will disappear over the next few weeks.  

Postherpetic neuralgia (PHN)

This is also known as the chronic phase and is the most common complication of shingles affecting 10%–18%² of people who get shingles. 

PHN is long-term nerve pain in the areas where the shingles rash was. It can last for weeks, months, and even years after the rash disappears. The pain can be so excruciating and disabling that it interferes with your daily life.   

How to treat shingles

Currently, there’s no cure for shingles. However, antiviral medications such as acyclovir, valacyclovir, and famciclovir can help shorten the duration and severity of the infection and reduce your chances of developing PHN. 

These medications are most effective when taken within three days after the rash appears, so if you notice any symptoms of shingles, visit your healthcare provider as soon as possible for treatment.   

You can also use natural treatments at home to alleviate the symptoms of shingles and promote healing. This includes cool baths, cold compress, soothing creams and lotions, herbal remedies, honey, a healthy diet, and vitamin supplements.   

Shingles prevention

A shingles vaccine is the best way to protect yourself from getting shingles. The CDC recommends Shingrix (recombinant zoster vaccine) to prevent shingles in people over 50 and adults over 19 with compromised immune systems. 

Shingrix is also highly effective in preventing shingle-related complications. It has a 91%³ effective rate in preventing PHN in adults over 50.   

Understanding eczema

Eczema is a common skin condition affecting over 30 million people⁴ in the US. Eczema describes several skin conditions that cause inflamed, dry, irritated and itchy skin. 

The most common type of eczema is atopic dermatitis, but others include contact dermatitis, dyshidrotic eczema, discoid eczema, seborrheic eczema, and nummular eczema.   

This chronic (long-term) condition typically starts during early childhood or even infancy, but it can manifest anytime during your lifetime. However, most children eventually outgrow the condition. 

There are times when the condition gets worse (called flare-ups), which is often followed by remission, where the skin heals, and signs of eczema disappear. Remission can last for weeks, months, or even years.   

What causes eczema?

The exact cause of eczema isn’t well understood, but many factors may trigger its onset, such as the following:   

Genetics

You’re more likely to have eczema if your family has a history of the condition.   

Abnormal functioning of the immune system

Most people with eczema have a sensitive immune system that overreacts to everyday things, such as pollen and pollution, leading to flare-ups.  

Environmental factors

Environmental triggers like smoke, pollen, pet dander, dust, soaps, fragrances, and change in seasons or extreme weather can cause the skin to be more sensitive.   

Emotional stress

There’s a scientific link⁵ between eczema and stress. When you’re under stress, the body goes into fight-or-flight mode and responds by increasing the production of stress hormones like cortisol. It can suppress the immune system and cause an inflammatory response in the skin. 

That’s why you might be more likely to notice a flare-up during particularly stressful periods.  

Foods

If you have food allergies, you may have eczema flare-ups when you eat certain foods. Dairy products, eggs, nuts and seeds, soy products, and wheat can cause or worsen your eczema.  

Defects in the skin barrier

A healthy skin barrier is responsible for helping your skin retain moisture and protecting your body from outside elements. When the skin is weakened, it allows moisture out and germs in.   

Symptoms of eczema

Eczema can appear anywhere on your skin, but some sites are more common in certain age groups. 

In infants, eczema commonly affects the face (especially cheeks), scalp, body, arms, and legs. In older children and adults, eczema tends to occur more on the hands, elbow creases, ankle, and back of the knees. 

Different types of eczema can look different and appear in various places, but they all share classic signs and symptoms that characterize the condition. 

Eczema will look different depending on your skin color. For example, if you have a dark skin tone, an eczema rash can be purple, brown, or gray, but if you have a light skin tone, an eczema rash can look pink, red, or purple.  

Common eczema symptoms include:  

  • Dry, scaly, or cracked skin  

  • Itching  

  • Rash that varies in color depending on your skin color  

  • Oozing bumps that crust over   

  • Areas of redness   

  • Skin discoloration, either lighter or darker after the rash has healed  

  • Raw, sensitive skin from scratching   

  • Thickened, leathery skin, especially in adults 

Treatment for eczema

There is no cure for eczema, but treatments can help keep the condition from worsening. In cases of moderate to severe eczema, your doctor may recommend prescription oral medications and injections, including steroids and antihistamines, to ease inflammation and antibiotics if the area becomes infected.   

Milder cases of eczema may be treated with ointments, such as moisturizers and topical anti-inflammatory medications. Other treatments include phototherapy, immunosuppressive medications, immunotherapy, and topical calcineurin inhibitors. 

Be proactive to keep your flare-ups at bay, and talk with your doctor about the best treatment.

Eczema prevention

Preventing eczema can be difficult because the cause is unknown. Fortunately, there are steps you can take to prevent eczema flare-ups, including:   

  • Avoid your eczema triggers like foods, temperature, and harsh soaps and detergents  

  • Keep the skin hydrated with moisturizers and emollients    

  • Take steps to manage the stress in your life  

  • Stay hydrated, as water helps keep your skin moist  

  • Take short baths or showers using lukewarm water  

  • Avoid rough, scratchy fibers and tight-fitting clothing and opt for cotton and soft fabrics  

Eczema vs shingles difference

What are the key differences between eczema and shingles? Here are the main ones:

Rash appearance and coverage

Unlike eczema, the shingles rash is usually a painful, blistering rash confined to a specific area of the body and appears in a single band rather than on both sides of the body. With eczema, the rash can occur on both sides of your body and is usually itchy, oozing, and peeling. 

Eczema rashes aren’t typically painful unless the skin has been overly scratched and a sore appears.  

Risk factors

Eczema often begins at an early age and affects people with a family history, defects in the skin barrier, and an overactive immune system. On the other hand, shingles mainly affect adults over 50 and those with a weakened immune system due to disease and medication.  

Possible complications

Potential complications of eczema include skin infections caused by bacteria, viruses, or fungi and permanent scars. Meanwhile, the most common possible complication of shingles is long-term nerve pain.   

Disease recurrence

Eczema is a chronic condition that comes and goes, while most people only get shingles once.   

Prevention

It’s nearly impossible to prevent eczema as the exact cause of eczema is unknown, so you can only treat it and take steps to manage flare-ups. On the other hand, the shingle vaccine is highly effective in preventing shingles and resulting complications.     

Eczema vs shingles: Are they contagious?

Shingles aren’t contagious. However, you can transmit the VSV virus to someone who has never had chickenpox if they come in direct contact with the fluid in the shingles blisters. They will get chickenpox and may eventually develop shingles. That’s why it’s essential to cover the blisters until they crust over.   

Eczema is also not contagious, so you can’t pass the condition to someone else even if you have an active rash. However, if you scratch your skin, bacteria, viruses, and fungi can enter your skin, causing secondary infections that can then be contagious.  

The lowdown

Shingle is a viral infection that causes an itchy, painful blistering rash in one part of the body. It can happen to anyone who previously had chickenpox, but it’s more common in older and immunocompromised individuals. 

There’s no cure for shingles, but early treatment with antiretroviral medications can help lessen the severity and length of the infection, and a vaccine can prevent the condition. 

On the other hand, eczema is a chronic skin disorder that causes dry, itchy, scaly patches on the skin. While there’s also no cure for eczema, many eczema flare-ups can be prevented if you can identify and avoid triggers. There are also medical treatments available to help manage the condition.

Are eczema and shingles related? No. Although both conditions cause skin rashes, they are not related.

  1. About shingles (Herpes zoster) | Centers for Disease Control and Prevention

  2. Complications of shingles | Centers for Disease Control and Prevention

  3. Shingles vaccination | Centers for Disease Control and Prevention

  4. Eczema stats | National Eczema Association

  5. Psychoneuroimmunology of psychological stress and atopic dermatitis: Pathophysiologic and therapeutic updates (2012)

Other sources:

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