What is the difference between cold sores and shingles?

Dr. Michael Roizen, MD
Internal Medicine
Colds sores and shingles are distinct viruses, but you can think of them as cousins since they have the same great, great, great-grandparents (belong to the same viral subfamily, Alphaherpesvirinae). They have similar structures, but they cause very different infections. Cold sores (infectious blisters on the mouth and lips) are caused by herpes simplex virus 1 and/or 2.

Herpes simplex virus’s cousin, the varicella zoster virus (aka herpes zoster virus), causes shingles. Shingles is caused by the chickenpox virus that infected you as a child, and then went into hiding in nerve cells near your spinal cord, the dorsal root ganglion. This reappearance of the virus is characterized by blisters along a nerve’s path -- often a curved track on the face and trunk, but usually only on one side -- that follows the nerve on that side as it comes from the spine or central nervous system.

These blisters can be associated with longer-term residual pain that 30 to 50% of cases describe as the worst burning pain of their life. There are medications you can take to reduce the severity of cold sores and the number of outbreaks you have. You need a booster shot of antibodies (from the vaccine) to protect yourself from shingles before that virus reappears. The vaccine provides about 70% protection, and if you’re unlucky enough to have an outbreak, reduces consequent pain by about 50%, but it can still feel horrible.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.