You're feeling itchy and uncomfortable and probably have a blistering rash. What could it be — shingles vs. poison ivy? These are two common causes of skin rashes, and people often don't know how to tell them apart.
While they may appear similar at first glance, their symptoms, causes, treatments, and prevention methods differ. In this article, we explore these two conditions, focusing on how to know which one you have. Without further ado, let's jump right in!
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Though the common cold is the most common viral illness, shingles are high on the list of viruses that older adults may experience. It's estimated that about 1 in 3 people in the US will have shingles during their lifetime.¹
Shingles are caused by a virus called varicella-zoster, the same one that causes chickenpox. The first time someone is exposed to this virus, it causes chickenpox. But the virus never goes away completely, even after treatment. It remains inactive in the body without causing any symptoms. But the virus can reactivate years later and cause shingles.
The reason for the virus reactivating later isn't entirely clear. But triggers could include stress and a weakened immune system.
People with HIV, certain cancers, or those taking immunosuppressive medications are also at a higher risk of shingles.
Some people may have had mild chickenpox or don't remember having it at all. Even if you had the chickenpox vaccine, you could still get shingles. That's because the vaccine introduces a weakened form of the virus into the body that could reactivate to cause shingles.
The first signs of this condition will appear 1–5 days before the rash appears. They include itching, tingling, burning, and pain in the affected area. As a viral infection, it will also bring virus symptoms such as headache, fever, muscle aches, etc.
The affected area will feel so sensitive to touch that even a brush of fabric can cause significant pain.
What follows is the most common and clear sign of shingles: a painful rash of fluid-filled blisters. The rash generally affects one side of the body and doesn't cross over the midline. It's mostly common on the chest and torso but could also appear on the neck, face, and eyes.
The painful rash will itch and burn until the blisters start scabbing over and later become smaller and disappear. A shingles rash will typically last between 2–4 weeks.
People with shingles can develop some complications. Some may experience lingering pain months and even years after the shingles rash has healed.
This chronic pain is called postherpetic neuralgia, which occurs due to damaged nerves in and under the skin. Other people feel a chronic itch in the once-affected area.
In some severe cases, the chronic itch and pain can be bad enough to cause weight loss, depression, and even insomnia.
If the shingles rash appears on the forehead or around the eyes and is left untreated, it could cause eye infections and loss of vision. The same is true when the rash attacks the ear; it could lead to hearing or balance problems.
Bacterial skin infections are also a possibility. Though rare, untreated shingles can result in an inflammation of the brain called encephalitis.
Last but not least, shingles are contagious, but having shingles will not trigger a shingles outbreak. The virus can, however, cause chickenpox in a child who's not been vaccinated or had chickenpox before. So if you have shingles, it is best to keep your shingles rash covered and avoid contact with people at risk of getting it.
There's currently no cure for this condition. The good news is that several treatment options are available to reduce the symptoms and severity of the infection. These include:
Antiviral medications to stop the virus from multiplying, thus making your case of shingles shorter and milder
Anti-inflammatory medications like ibuprofen help reduce pain and inflammation
Creams to apply on the skin
Home treatment, such as cool compresses to the skin to ease the pain
One effective vaccine is available to help with shingles: the Shingrix vaccination. Vaccination may not prevent infection, but it prevents severe symptoms and long-term complications.
The poison ivy plant contains an oily resin called urushiol. This oil is known to cause an allergic reaction in those sensitive to it. When your skin comes into contact with this oil, you may experience an allergic reaction that results in a red, itchy, blistery rash. The rash usually occurs on the exposed areas of the skin, like the legs, face, and arms, and will form straight lines.
Poison ivy rash is a common skin condition in the US. Up to 50 million people are affected each year.²
Anyone who works or plays outside can encounter poison ivy, as it's found virtually everywhere. People often associate this plant with forests and train areas, but you can also find it in your backyard.
The most common signs that you have an allergy to poison ivy is intense itching and redness in the affected area. You'll also develop a rash that is characterized by fluid-filled blisters. The rash may appear red, skin-colored, or dark, depending on your skin tone. While this rash is incredibly itchy, it's not as painful as the shingles rash.
You can easily manage a mild allergic reaction to poison ivy at home. Start by washing the skin. Then take an oral antihistamine to help reduce the itchiness. Lastly, soothe the affected area with oatmeal baths, wet compresses, and topical creams.
Be sure to avoid topical antihistamine creams, as they can make the rash worse. You also want to avoid scratching the rash despite it being very itchy, as this can lead to infection.
The poison ivy rash will typically clear within a week. But if the poison ivy rash is severe and widespread or you experience other symptoms, it may be best to visit a doctor.
The first step to preventing poison ivy rash is avoiding contact with the poison ivy plant. It would be helpful to familiarize yourself with what the plant looks like. When outdoors, avoid touching the poison ivy plant. It would also be helpful to wear long sleeves and pants and clean any clothing or object that comes into contact with the plant.
On the bright side, poison ivy is not contagious. But if the sap is present on someone else's clothing or skin and you come into contact with it, you could get the rash.
It can be challenging to determine the cause of a blistering rash. When comparing shingles vs. chickenpox vs. poison ivy, consider the following:
Have you had chickenpox before?
Have you recently been exposed to a poisonous plant?
Where is the rash
Is the rash made up of blisters, and is it painful or just itchy?
Do you have more symptoms like headache, fever, muscle pain, an upset stomach, and so on?
The answers you get here will help you determine what condition you have, thus making treatment much easier. If you're unsure about a rash you have developed, talk to your healthcare provider for a diagnosis and treatment plan.
Several skin conditions may resemble poison ivy rash, including eczema, psoriasis, hives, and fungal skin infections. That's because they cause a rash and blisters, which can be mistaken for shingles.
You may also want to know about contact dermatitis. This occurs when the skin comes into contact with an allergen or irritant, including:
Soaps and hand sanitizers
Solvents, paints, or glues
Contact dermatitis causes a rash, blisters, itching, and burning, all symptoms of poison ivy.
The varicella-zoster virus that causes chickenpox lies dormant in your immune system. But when something compromises your immunity, the virus can be reactivated to cause shingles.
With that in mind, poison ivy doesn't compromise immunity, so it will not trigger shingles.
A poison ivy rash is caused by an allergic reaction, and symptoms appear hours or days after coming into contact with the allergen. When the rash first starts, it's usually inflamed, swollen, and itchy. Blisters will then begin to form that are fluid-filled and oozing.
The rash will last several days but will soon begin to heal following treatment. As this happens, the rash becomes flatter and scaly and will have different colors depending on your skin tone.
Because this condition causes intense blistering and itching, a skin infection is possible if you scratch the rash.
Shingles (Herpes zoster) | National Foundation for Infectious Diseases
Poison ivy, sumac and oak | American Skin Association
Prevention and treatment | Centers for Disease Control and Prevention
Complications of shingles | Centers for Disease Control and Prevention
Vaccination | Centers for Disease Control and Prevention
Clinical considerations for use of recombinant zoster vaccine (RZV, shingrix) in immunocompromised adults aged ≥19 years | Centers for Disease Control and Prevention
Vaccines by disease | HHS.gov
Shingles | National Institute on Aging
Shingles vaccine (2010)