Herpes and shingles share a common ancestry in the family of viruses known as herpesviridae, so it's not surprising that they share many of the same characteristics. According to the 2008 edition of "Harrison's Principles of Internal Medicine," both exhibit latency, the ability to survive asymptomatically within the roots of sensory nerves. Upon reactivation, herpes and shingles also produce many of the same symptoms.
Skin Rash
Herpes and shingles both cause a blistering skin rash that crusts, then heals without scarring. In the case of herpes, the lesions are larger about 1 to 2 mm--compared to 0.5 to 1 mm for shingles---and feature a central dimple, say the authors of a 2008 report in the "Archives of Internal Medicine."
Patients with shingles typically develop new lesions over the course of three to five days, followed by crusting at seven to 10 days. Herpes usually adheres to a faster time frame, with new lesions appearing for one or two days, followed by crusting at three or four.
Herpes and shingles also usually affect different areas. Herpes typically strikes the mouth or genitals. Shingles, says the National Institute for Neurological Disorders and Stroke, comes from the Latin word "cingulum" which means belt or girdle because this is area where shingles skin symptoms typically arise. However, there can be overlap. According to "Harrison's Principles of Internal Medicine," lesions from both viruses have been described on almost every surface of the body.
Pain & Itching
Herpes and shingles make their homes in the roots of nerves that carry signals about pain, light touch and temperature. Patients with either condition frequently report burning, tingling, soreness or unusual sensitivity one to five days before lesions appear, according to the Centers for Disease Control and Prevention (CDC). Blisters are often extremely painful, giving way to severe itching when the lesions crust. One key difference, however, is that patients with shingles often report persistent pain, even after the skin rash subsides. Doctors call this condition post-herpetic neuralgia and the CDC estimates that it occurs in 8 to 70 percent of people with shingles. The risk of post-herpetic neuralgia increases with age and, in people over 60, approaches 50 percent, says the CDC.
Flu-Like Illness
Some patients with herpes and shingles complain of a flu-like illness, on or around the time that the characteristic skin rash appears. Common symptoms, according to "Harrison's Principles of Internal Medicine," include fever, headache, muscle pain, sensitivity to light and generalized feeling of malaise. Unlike "true" flu, characteristic respiratory symptoms such as dry cough, runny nose and nasal congestion never appear. Symptoms usually resolve when the skin lesions crust, signaling the immune system's control over the virus.
References
- "Harrison's Principles of Internal Medicine, 23rd Edition;" A.S. Fauci et al. (Eds.); 2008
- "Archives of Internal Medicine"; The Treatment of Herpes Simples: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
- National Institute of Neurological Disorders and Stroke: Shingles: Hope Through Research
- Centers for Disease Control and Prevention: Herpes Zoster Disease: Q & A's for Providers
