If you notice a new rash or itchy area on your skin, you might wonder if it’s from psoriasis or a different skin condition, like shingles. Research has found that people with psoriasis may be more likely to develop shingles and vice versa. Learning about both skin conditions can help you understand your symptoms and treatment options.

“If you have psoriasis and one of your flare-ups looks different than usual, you should see a doctor to rule out shingles or another serious rash or allergy,” said a MyPsoriasisTeam member.

In this article, we compare psoriasis and shingles, two common skin diseases that have similar symptoms but different causes and treatments.

What Are Psoriasis and Shingles?

Psoriasis is a chronic (long-lasting) skin condition that causes cells to build up rapidly on the surface of the skin. Psoriasis usually affects the knees, elbows, and scalp, but symptoms can develop anywhere on the body.

One of the most common symptoms is raised, scaly patches or plaques that may flake, itch, burn, or sting. Psoriasis isn’t curable, but treatments can help you manage your symptoms and improve your quality of life. It’s also not contagious — you can’t spread it to others.

Shingles, or herpes zoster, is a viral infection caused by the same virus that causes chickenpox. This virus is called varicella zoster. If you get chickenpox, the virus stays in your body after you heal. It can reactivate later in life as shingles. The most common skin symptom of shingles is a painful, blistering rash in a clearly defined area on one side of the body, often on the torso but can be on the face or the limbs as well.

According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 3 people in the United States will develop shingles. A person’s risk of developing shingles increases with age.

Although shingles isn’t contagious, the virus is. If you have shingles blisters and spread the varicella-zoster virus to someone else, they may develop chickenpox if they haven’t already had the illness or the chickenpox vaccine. Then, there’s a chance that the virus will activate again later, and they may develop shingles. Once the blisters have scabbed over and healed, the virus isn’t contagious anymore.

What Causes Psoriasis and Shingles?

Psoriasis is a condition that develops when the immune system, which normally protects the body from illness, mistakenly attacks healthy skin. This kind of condition is called an autoimmune disease and may be caused by genetic and environmental factors that disrupt the immune system. Researchers do not yet fully understand what causes psoriasis, but they have identified some causes and triggers that can lead to flare-ups.

Causes of Psoriasis

Psoriasis causes and triggers include:

• Family history
• Stress
• Injuries to the skin, like cuts, scrapes, or sunburns
• Certain illnesses, like bronchitis or tonsillitis
• Some infections, like a skin infection or strep throat
• Cold, dry weather
• Heavy alcohol consumption
• Smoking

Causes of Shingles

Shingles is caused by the varicella-zoster virus. Anyone who has had chickenpox can get shingles. It less commonly affects people under 40. Most people who get shingles develop it in their 50s or later.

Shingles risk factors include:

• Getting older
• Having a weakened immune system
• Undergoing cancer treatments, like chemotherapy or radiation
• Using steroids, like prednisone, long term
• Taking medications that suppress the immune system

You can reduce your risk of developing shingles by getting the zoster vaccine (Shingrix). It’s a recombinant vaccine, which means it’s made using a small part of the virus to safely train your immune system to fight it. The CDC recommends the two-shot vaccine for adults 50 and older. Getting the vaccine is the only way to protect against shingles and serious complications like postherpetic neuralgia, a shingles complication that can cause burning pain in the nerves and skin. If you have questions about the shingles vaccine, ask your healthcare provider for guidance.

Can You Have Shingles and Psoriasis Together?

Although research has found that people with psoriasis may have an increased risk of developing shingles, it’s unclear what’s responsible for this potential connection. One study discovered that the risk appears to be highest for people treated with immunomodulatory therapy or phototherapy and those with severe psoriasis.

The opposite association also appears to be true. In another study, people with no history of psoriasis were nearly 1.66 times more likely to develop the skin condition after a shingles diagnosis. While researchers didn’t suggest what may cause the connection, they did note that in all cases, when psoriasis appeared, it developed in the same places as the shingles lesions.

Talk to your healthcare provider if you have questions about how psoriasis affects your risk of getting shingles.

What Are the Symptoms of Psoriasis and Shingles?

Both psoriasis and shingles can cause a rash and itchiness, but they have other symptoms, too.

How Do You Know If Your Rash Is Psoriasis?

Psoriasis symptoms include:

• Raised scaly patches or plaques
• A rash that varies by skin tone (often red or pink with silvery white scales on lighter skin and violet or dark brown with gray scales on darker skin)
• Areas of thickened skin from a buildup of skin cells
• Dry skin
• Cracked skin that may bleed
• Itching
• Burning
• Stinging

Other types of psoriasis, like nail psoriasis and scalp psoriasis, can create additional symptoms. Unlike shingles, psoriasis usually affects both sides of the body.

How Do You Know If Your Rash Is Shingles?

A common sign of shingles is a painful, blistering rash that appears quickly on one side of the body. The rash often affects the torso, but it can develop anywhere on your skin. It can also infect the eyes and may cause blindness, or affect the ears and hearing.

Other symptoms of shingles include:

• Blisters or lesions that may open, bleed, and scab
• A stripe or “shingles band” on the face or body
• A widespread rash similar to chickenpox
• Pain
• Itching
• Burning
• Tingling
• Flu-like symptoms (headaches, fever, chills, and upset stomach)

Active shingles blisters or lesions are infectious. Cover them and avoid skin-to-skin contact with friends and family until the lesions dry and scab over.

How Can You Tell If You Have Psoriasis or Shingles?

If you have symptoms of psoriasis or shingles, or suspect you might have another skin disease or a skin infection, you should see a dermatologist.

To figure out what’s going on, they might:

• Perform a physical exam
• Gather details about your symptoms
• Ask about your medical history and family history
• Send fluid from a blister to a lab for analysis and viral culture
• Do a biopsy (take a small skin sample to check under a microscope)

Once your healthcare provider knows which skin condition you have, they can recommend effective treatment options. It’s possible to have psoriasis and shingles at the same time, but they still need different treatments.

How Are Psoriasis and Shingles Treated?

Psoriasis is an autoimmune disease, so your healthcare provider will likely recommend treatments that target the immune system. For shingles, they’ll likely prescribe antiviral medication.

Psoriasis Treatment

Treatments for psoriasis include:

• Synthetic vitamin D
• Corticosteroid creams or steroid injections
• Light therapy (phototherapy), including sunlight and artificial ultraviolet light
• Topical calcineurin inhibitors
• Retinoid pills, gels, or creams
• Methotrexate
• Cyclosporine
• Biologics
• Janus kinase (JAK) inhibitors

You and your healthcare provider may need to try different drugs or therapy combinations until you find something that works. Before starting any psoriasis treatments, ask about the risks of side effects and allergic reactions.

Shingles Treatment

If you have shingles, treatment can help ease your pain, shorten the duration, and reduce your risk of complications.

Treatments for shingles include:

• Antiviral medications
• Anticonvulsants
• Corticosteroid injections
• Topical numbing cream, spray, or patches
• Tricyclic antidepressants
• Over-the-counter pain medications

It’s best to start treatment for shingles within three days of noticing symptoms. This gives you a better chance of avoiding serious complications and long-term nerve pain. Starting treatment after three days can still help, so don’t delay.

Seeing a rash or blister on your skin can be concerning. If you have symptoms of psoriasis, shingles, or another skin disease, make an appointment with your doctor as soon as possible. Getting the right diagnosis and treatment early can help you feel better faster and prevent the condition from getting worse.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 134,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Do you have psoriasis or shingles? Did you have trouble telling one type of rash from the other? Share your experience in the comments below, or start a conversation by posting on your Activities page.