Shingles (Zoster)

What is shingles?

Shingles is a disease caused by the chickenpox virus. Your child can only get shingles if he or she has already had chickenpox or the chickenpox (varicella) vaccine. With shingles, your child will have a rash.

The rash:

• Is in a line and follows the path of a nerve
• Occurs on only one side of the body
• Starts with clusters of red bumps, changes to water blisters, and finally becomes dry crusts (looks like small groups of chickenpox sores)
• Is most commonly found on the back, chest, or abdomen
• Usually doesn't burn or itch in children (as it does for adults)

Your child will not have a fever or feel sick.

What is the cause?

Shingles (zoster) is caused by the chickenpox virus. The disease is not caught from other people who have shingles or chickenpox. The chickenpox virus stays inactive (dormant) in the bodies of some people and is reactivated for unknown reasons as shingles, not as chickenpox. Children with shingles are usually over age 3 years.

The vaccine strain of chickenpox can also cause shingles, but this type of shingles is less severe than the shingles that people get after the wild-type of chickenpox. Because many children have now received the chickenpox vaccine, shingles from the vaccine-strain is becoming more common, but a child’s relative risk of shingles is still higher if the child has had the wild-type varicella infection. So getting the varicella vaccine reduces the risk and the severity of later shingles.

How long does it last?

New rashes continue to appear for several days. All the rash dries up by 7 to 10 days. Complications do not occur unless the shingles affect the eyes. If zoster involves the nose, the cornea is usually also affected. Most people have shingles just once. A second attack occurs in only 5% of children.

How can I take care of my child?

• Relief of symptoms

  Most children have the rash but no symptoms. For pain, give acetaminophen (Tylenol) or ibuprofen (Advil) as needed. Do not give aspirin because of the possible link of aspirin with Reye's syndrome in children. Discourage scratching or picking the rash. The rash does not need any cream.

• Contagiousness

  Children with shingles can transmit chickenpox (but not shingles) to others. Transmission occurs by touching the rash. Although they are far less contagious than children with chickenpox, children with shingles may need to stay home from school for 7 days unless they can keep the rash covered until it crusts over. Children or adults who have not had chickenpox should avoid visiting a child with shingles (again unless the rash is covered).

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

• The rash is near the eye or nose.

Call during office hours if:

• The rash becomes very painful or very itchy.
• The rash lasts more than 14 days.
• The rash looks infected (pus or soft yellow scabs).
• You have other questions or concerns.