A bout of chickenpox
used to be a rite of passage during childhood. With the vaccine to protect against
varicella zoster virus (VZV) now available, though, most kids can now avoid this infection.
But anyone who has had chickenpox may later develop shingles — even
children. The good news is that shingles is pretty rare in kids and teens with healthy
Shingles, also called zoster or herpes zoster,
is a skin rash caused by a viral infection of the nerves just below the skin. Shingles
usually appears as a stripe of irritated skin and blisters on one side of the chest
or back, but it can occur anywhere on the body, including on the face and near the
Many cases of shingles have mild symptoms, but more severe cases can be very painful.
Luckily, kids and teens almost always have mild cases; the severe cases usually only
happen in older people.
Shingles is caused by the same virus that causes chickenpox, which is highly
contagious. So it can be easy for a child to pass the virus to others who aren't immune
to chickenpox (those who have never had chickenpox or didn't get the chickenpox
vaccine). Someone who is infected this way will develop chickenpox, though,
While most cases of shingles will run their course and disappear in less than
a month, treatments are available that can lower a child's risk of complications
and speed healing.
Shingles and chickenpox are both caused by the varicella zoster virus.
This virus is related to (but not the same as) the herpes viruses that cause cold
sores and genital
herpes, which is why shingles is sometimes called herpes zoster.
After someone has had chickenpox, the virus stays dormant (sleeping) in that person's
nervous system for the rest of his or her life, even though the chickenpox goes away.
In many people, the virus will never come back. But in about 1 million Americans a
year, it flares up and causes shingles. It is possible to get shingles more than once,
but this is not common.
Doctors aren't sure why the virus suddenly flares up again after months or years
of inactivity. It could be because our immune systems become more vulnerable to infections
as we age, which might explain why shingles is more common in older adults.
Children who've had chickenpox face a greater risk of developing shingles if their
immune systems have been weakened by diseases such as AIDS
or cancer, or by certain
In many cases, the first symptom of shingles will be tingling, itching, and sometimes
pain in the area where the rash is going to appear. This can be frustrating: Your
child may feel itchy, but you'll have no idea what's causing it.
When the rash finally shows up, it starts as groups of pimples on one side of the
body or face. The pimples change to pus-filled blisters that break open and scab over
in about 7 to 10 days. Once the blisters are scabbed over, they begin to heal. The
scabs usually heal and fall off about 2 to 4 weeks after the rash starts.
Some kids with shingles also may have a fever, headache, tiredness, or general
achiness. In rare cases, a child can have the pain of shingles without the rash.
Some people will have more severe symptoms, but these usually happen in people
over age 50.
Most cases of shingles will heal on their own, with or without treatment, and won't
lead to any other problems. In rare cases, shingles can lead to complications, including:
Ongoing pain (post-herpetic neuralgia): Damaged nerve fibers
in the skin send confused messages to the brain, leading to pain that can go on for
a long time after a shingles rash has disappeared.
Vision problems: If shingles happens near or in an eye, it can
lead to vision loss.
Skin infections: A shingles rash can become infected with bacteria,
leading to impetigo
Nervous system problems: Shingles on the face can involve different
nerves that connect to the brain. This can lead to nerve-related problems such as
facial paralysis, hearing problems, and problems with balance. In very rare cases,
shingles can lead to encephalitis
(inflammation of the brain).
If you think your child might have shingles, call your doctor. If there's a chance
your child might have shingles on the face, it's really important to get a doctor's
help immediately to keep the infection from spreading to the eyes.
If your child has a weakened immune
system, call your doctor right away to avoid complications.
Usually, a doctor can diagnose shingles just by examining the rash and blisters.
In rare cases, the doctor may remove a small sample of the infected tissue to be examined
in a laboratory.
Not all kids who get shingles need treatment. But if the doctor decides a treatment
may help, it should be started as soon as possible.
Antiviral drugs can't rid the body of the virus, but they can lower the chances
of complications and help speed the healing process. The earlier treatment starts,
the more effective it will be, and the less risk there will be of complications. Talk
with your doctor about whether treatment might help your child.
To treat the pain associated with shingles, doctors may prescribe a cream, spray,
or skin patch to numb the skin and make it hurt less. Some prescription and over-the-counter
medicines also can help ease pain. Don't give your child or teen aspirin, though,
as it can lead to a rare but serious illness called Reye
If shingles causes itching, the doctor may recommend medicated lotions or
medicines called antihistamines.
To help manage symptoms at home, keep the affected area clean. Wash it with water
and a mild soap, and apply cool, wet compresses to the blisters several times a day
to ease pain and itching. Oatmeal baths also can bring relief.
To prevent the virus from spreading to other people, keep your child's rash covered
at all times.
It's not possible to prevent shingles entirely. But the chickenpox vaccine can
make a case of shingles less serious. So if your child hasn't had chickenpox, it's
not too late to ask your doctor about getting the chickenpox vaccine.
There is a vaccine against shingles, but doctors usually only give it to older
adults. That's partly because the older someone is, the more severe shingles can be.
Kids are unlikely to be seriously affected by shingles.
Children who get a shingles rash that can't be completely covered should be kept
out of school and childcare until the blisters are scabbed over and dry.
Newborn babies, pregnant women, people with weakened immune systems, and anyone
who is not immune to chickenpox should avoid close contact with anyone who has shingles
until the rash is completely healed./p>