Shingles in Children

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Shingles is the name for an infectious disease involving an itchy, sometimes painful rash that results from a viral infection in the nerves just beneath the skin. The medical term for shingles is herpes zoster. The virus that causes shingles—varicella-zoster virus (VZV)—is the same one that causes chickenpox.

shingles on back

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Risk Factors

Shingles is not typically thought to affect children. It usually occurs in adults over age 60, but the risk of shingles continues to increase as a person ages, so teenagers are at a higher risk of shingles than are small children.

In fact, a study reports that shingles is 10 times more likely to occur in adults over age 60 than in kids under age 10.

That said, there are certain factors that pose an increased risk in kids. These include children who:

  • Contracted chickenpox before age 1
  • Have a mother who had chickenpox in the late stage of pregnancy
  • Have had an allergic reaction to the vaccine (therefore did not receive the second vaccine dose)
  • Have a weakened immune system (such as during cancer treatment) and have had chickenpox or received the vaccine for chickenpox

If Your Child Receives the Chickenpox Vaccine, Can They Still Get Shingles?

Children who get the chickenpox vaccine still have a small risk of shingles. But it may be a lower risk than after a chickenpox infection. And the symptoms may be less severe.

Infants can also be exposed to the virus that causes shingles. However, shingles cannot be passed from one person to another. Rather, the virus that causes shingles can be spread from a person with active shingles (in the form of chickenpox) to a baby (or a child) who has not been fully vaccinated or who has not yet had chickenpox.

Symptoms

Children with shingles often develop initial symptoms including:

  • Headache
  • Flu-like symptoms
  • Pain
  • Burning
  • Tingling
  • Itching on one part of the body, such as the torso, face, or buttocks

Shingles is often experienced as a pins and needles sensation under the skin. This is because the nerves are involved.

Within five days of initial symptoms, a rash appears as a strip of skin that is reddened and irritated with blisters. The rash typically occurs in the area where the symptoms of burning or itching began.

Children Experience Milder Shingles Symptoms Than Adults

Symptoms of shingles are usually milder in children than in adults. Kids rarely develop post-herpetic neuralgia (PHN), which is a serious, long-term complication involving constant pain and sensitivity in the area that the shingles rash initially occurred.

Diagnosis

A diagnosis of shingles may involve:

  • A history and physical examination, which is often enough to diagnose shingles
  • Skin scrapings of the blisters to remove tiny tissue samples, which are sent to the lab to be tested for the presence of the VZV (this test is rarely needed)

Treatment

The treatment of shingles depends on the child's overall health, age, and symptoms. The severity of symptoms will also dictate the type of treatment prescribed.

Treatment for shingles may include:

  • Antiviral medication: This is usually given as soon as possible to shorten the duration and reduce the severity of symptoms.
  • Over-the-counter pain medications: This can include acetaminophen or ibuprofen.
  • Prescription pain medication: This may be given if symptoms are severe.

Pain Medications and Children

Be sure to discuss pain medication with a pediatrician, and keep in mind that aspirin can cause a serious condition called Reye's syndrome in children and that ibuprofen should never be given to a child under 6 months of age (without the approval of the healthcare provider).

Home Remedies

Home remedies often used to treat shingles include:

  • Washing the rash with mild soap and water
  • Applying wet, cool compresses to the blisters three times per day for itching and pain
  • Oatmeal baths for relief of itching
  • Covering the rash to prevent the spreading of the virus                

Consult with the pediatrician before administering any over-the-counter medications or home remedies.

Medication

Medications prescribed by the healthcare provider for shingles may include:

  • Antiviral medication such as acyclovir, valacyclovir, and famciclovir
  • Topical medication such as a cream, a spray, or a skin patch to numb the skin
  • Over-the-counter pain medication such as Tylenol
  • Antihistamines
  • Topical (on the skin) antihistamine such as Benadryl cream
  • Topical anti-itch medication such as Caladryl

Prevention

Although shingles cannot always be prevented, the chickenpox vaccine can help to decrease the severity of symptoms when a child does get shingles. Be sure to consult with your pediatrician about your child's chickenpox vaccine schedule if your child has not yet been vaccinated.

Complications

Usually, shingles resolves with or without medical intervention. Rarely, complications (additional symptoms or conditions) may occur. Complications that may occur as a result of a child having shingles include:

  • Long-term pain: From a complication called post-herpetic neuralgia, but is rare in children
  • Vision problems: When the shingles rash appears near the eye
  • Skin infections: From bacteria that could lead to impetigo or cellulitis
  • Nervous system complications: Such as facial paralysis, hearing problems, problems with normal balance. Note: Nervous system problems are usually linked with a shingles outbreak on the face, when the nerves involved (the facial nerves) connect to the brain. 

A Word From Verywell

If your child has symptoms of shingles, it is important to contact a healthcare provider right away. The pediatrician will advise you as to when your child is contagious and when they can return to school or daycare. The blisters from the shingles rash should be completely covered when possible. Your child is contagious until the blisters are dry and scabbed over. Avoid close contact with those who are most at risk, including:

  • Neonates (newborns)
  • Pregnant women
  • Those with a weakened immune system
  • Anyone who is not immune to chickenpox
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Article Sources
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  1. National Institute of Neurological Disorders and Stroke. Shingles: hope through research. Updated March 23, 2020.

  2. University of Rochester Medical Center. Shingles (herpes zoster) in children.

  3. Centers for Disease Control and Prevention. Shingles. Updated August 6, 2019.

  4. Stanford Children's Health. Reye syndrome.

  5. Kids Health from Nemours. Shingles for parents. Updated September 2019.