Both shingles and psoriasis affect large skin areas by causing itchy, painful rashes. Yet they differ significantly in terms of causes, diagnosis, and treatment.

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Shingles occurs from a virus, the same virus that causes chickenpox. Psoriasis, on the other hand, is an autoimmune disorder.

It’s possible for a person with shingles to transmit the virus. Psoriasis is not an infectious disease.

Read on to learn the differences between shingles and psoriasis.

Shingles is a viral infection that causes a painful rash on one side of the body. The same virus that causes chickenpox also causes shingles. The virus can reactivate after lying dormant in the body.

A person with shingles can transmit the virus to someone who has not had chickenpox or been vaccinated against it.

Transmission can occur through contact with blister fluid on the rash or from breathing in the viral particles.

That said, active chickenpox infections are more contagious than shingles.

Prevalence and risk

According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 people will develop shingles at some point in their lives. The CDC also estimates there are 1 million cases of shingles each year in the United States.

The risk of developing shingles increases with age, especially at age 50 years.

According to the CDC, the current shingles vaccine is generally about 90% effective. Immunity stays strong for at least 7 years following vaccination.

Psoriasis is a chronic autoimmune disorder. It’s not an infectious disease.

People with psoriasis experience periods of remission followed by flare-ups. The condition is associated with rapid skin cell turnover.

There are different types of psoriasis, and you can have more than one type. Psoriasis can appear in different places on the body at different times throughout your life.

Prevalence and risk

According to the National Psoriasis Foundation, more than 7.5 million people in the United States have psoriasis.

Many people begin to see symptoms at 5–30 years old. Another peak time for psoriasis symptoms is between ages 50 and 60 years. People who have psoriasis typically have at least one other family member with the condition.

There’s no cure for psoriasis, but treatment helps. Steroids and drugs that suppress the immune system can help treat flare-ups.

Shingles

A shingles rash can appear anywhere on your body. The rash is often painful, itchy, and sensitive to touch. It may be preceded by skin pain.

The early lesions are usually discolored compared with the surrounding skin and vary in color depending on skin tone. Other symptoms may include fever, fatigue, and headache. The fluid-filled blisters eventually crust over.

Learn how to identify shingles on skin of color.

Psoriasis

Psoriasis can appear on the scalp, knees, and elbows as well as fingernails and toenails.

The symptoms vary depending on the type and may appear differently depending on skin tone.

It may look like raised, red plaques with silvery scales on light skin, salmon-colored plaques on medium skin, and violet or dark brown plaques on dark skin. Plaques can also occur with psoriatic arthritis.

Learn more about the appearance of psoriasis on dark versus light skin.

A doctor must diagnose each condition before they can treat it. Here are the methods a doctor may use to diagnose shingles and psoriasis.

Shingles

Shingles symptoms can be mistaken for hives, scabies, or other skin conditions.

On light skin, the shingles rash is typically red, inflamed, fluid-filled blisters. The rash may be less apparent on dark skin.

A doctor may diagnose shingles based on skin appearance and accompanying symptoms without further testing. According to the American Academy of Dermatology, they may also order the following tests:

  • Viral culture: A healthcare professional takes a sample of fluid from a blister to check for the virus.
  • Antibody test: A healthcare professional takes a blood sample to test for the presence of antibodies.
  • Skin biopsy: A healthcare professional removes a section of skin containing the rash. The sample is evaluated under a microscope.

Psoriasis

Diagnosing psoriasis is similar to diagnosing shingles. Doctors can typically diagnose psoriasis with an examination of your scalp, nails, and skin, along with your medical history.

Sometimes a doctor may order a skin biopsy of the rash to diagnose psoriasis and rule out other conditions. This can also help diagnose the exact type of psoriasis.

If you’re experiencing a persistent rash that doesn’t go away alongside pain or fever, consult a doctor.

Since shingles and psoriasis are caused by fundamentally different things, they require different treatments.

It’s important for a healthcare professional to correctly diagnose your condition so you can receive the appropriate treatment.

Shingles

While there’s no cure for shingles, treatment can make people more comfortable. The rash usually clears in 2–4 weeks. Some pain may persist for a few months.

According to the American Academy of Dermatology, treatment can include antiviral medication to speed up healing and reduce complications as well as nerve pain medication.

Shingles is most contagious when blisters are present, but treating them properly can prevent transmission as well as bacterial infections and scarring.

Psoriasis

Psoriasis is a chronic condition. It can be more complicated to treat than shingles. However, it’s possible to manage psoriasis symptoms when flares occur.

According to the American Academy of Dermatology, treatment options include:

  • topical medications
  • tar shampoo
  • oral medications
  • biologic medications
  • phototherapy

A trigger, such as stress or cold, dry air, typically causes psoriasis flare-ups. A flare-up can last from a few days to a few weeks.

You can prevent shingles but not psoriasis.

Shingles

The risk of developing shingles increases as you age. The CDC recommends adults over age 50 get the vaccine, even if they’ve had chickenpox.

The CDC notes the vaccine is estimated to be 90% effective and lasts for at least 7 years.

Complications from shingles are more serious as you age, so it’s important to stay protected. If you’ve already had shingles, getting the vaccine can prevent future occurrences.

In addition, if shingles is left untreated, you have a higher chance of getting postherpetic neuralgia (PHN). PHN is a debilitating and painful condition. Getting antiviral treatment within 3 days of first noticing symptoms that might be shingles can prevent PHN.

Psoriasis

While you can’t prevent psoriasis, you can take steps to reduce your symptoms. The American Academy of Dermatology suggests avoiding and managing triggers like stress, irritation, and skin injuries.

Quitting smoking and limiting alcohol consumption with guidance from a doctor as well as doing your best to avoid other infections can also help you prevent or manage flare-ups.

The risk factors for shingles and psoriasis differ.

Shingles

According to the CDC, the risk factors for shingles include being older than age 50 and having a condition that weakens the immune system, such as cancer or HIV.

Cancer treatments can also lower your resistance, making an inactive shingles virus more likely to become active.

Psoriasis

Psoriasis risk factors tend to be more related to family history, suggests a 2019 review of research. If you have a close relative with psoriasis, your odds of also having the condition increase.

Like shingles, psoriasis is more likely to occur in people with a weakened immune system.

Other risk factors include:

  • smoking
  • stress
  • obesity
  • alcohol use

What other diseases can be mistaken for shingles?

Other than psoriasis, conditions that may be mistaken for shingles include:

What other diseases can be mistaken for psoriasis?

Other conditions that may be mistaken for psoriasis include:

Can shingles and psoriasis occur together?

According to a 2017 study, people living with psoriasis were 29% more likely to get shingles, though not necessarily at the same time. While there’s no data on the prevalence of both conditions flaring up simultaneously, it’s not impossible.

Shingles and psoriasis are skin conditions that can both cause an itchy and painful rash. Since the symptoms are not always easy to tell apart, it’s best to contact a doctor at the first sign of a rash, blisters, or plaque. They may refer you to a dermatologist if the condition is severe.

If it appears you have psoriasis, you may need to talk with a rheumatologist. This healthcare specialist treats autoimmune conditions, such as psoriatic arthritis or rheumatoid arthritis (RA).

Do not ignore the symptoms of either shingles or psoriasis. Early diagnosis and treatment can often manage symptoms.