Shingles, also known as herpes zoster, is a viral infection that results in a painful rash. It is caused by the varicella-zoster virus (VZV), which is the same virus responsible for chickenpox. While more commonly observed in adults, children can develop shingles.
How Shingles Develops in Children
Shingles develops in children when the varicella-zoster virus reactivates. After a child recovers from chickenpox, the VZV does not leave the body; instead, it becomes dormant, residing in nerve tissue near the spinal cord and brain. This dormant virus can reactivate years later, traveling along nerve pathways to the skin and causing the characteristic shingles rash. A child must have had chickenpox or, in rarer cases, been exposed to the virus through the chickenpox vaccine, to develop shingles. Factors that might trigger reactivation in children include having had chickenpox at a very young age (before age 1), having a weakened immune system due to health conditions, or certain medical treatments.
Signs and Symptoms in Children
The initial signs of shingles in children often include a tingling, itching, or painful sensation in a specific area of the skin before any rash appears. A few days later, a rash typically develops, starting as red patches that quickly transform into fluid-filled blisters, usually appearing on one side of the body, often forming a band or strip along a nerve pathway, commonly on the torso, face, or buttocks. While adults often experience significant pain, children may describe the sensation as milder discomfort or itching. Other symptoms can accompany the rash, such as a fever, headache, fatigue, or nausea.
Treatment and Care for Children
Medical professionals may recommend antiviral medications like acyclovir or valacyclovir to treat shingles in children; these work best if started within 72 hours of the rash appearing, as they can help shorten the duration and severity of the illness by slowing the virus’s spread. Supportive care also helps manage discomfort. Over-the-counter pain relievers such as acetaminophen or ibuprofen alleviate pain and fever, while applying cool, wet compresses to the blisters and using soothing topical treatments like calamine lotion provide relief from itching. Keeping the rash clean and dry helps prevent secondary bacterial infections. Seek medical attention if the rash appears near the eye, if there are signs of infection, or if the pain is severe.
Prevention Strategies
The most effective method for reducing a child’s risk of developing shingles is the chickenpox (varicella) vaccine. By preventing the initial chickenpox infection, the vaccine significantly lowers the likelihood of the varicella-zoster virus becoming dormant in the body and reactivating later as shingles. Vaccinated children have a lower risk of shingles. Although a shingles vaccine exists, it is primarily recommended for adults, and the widespread chickenpox vaccination program indirectly benefits the entire community by reducing the overall circulation of VZV. To prevent transmission, children with shingles should avoid close contact with vulnerable individuals, such as infants, pregnant women, or those with weakened immune systems, until all blisters have crusted over. The virus can spread through direct contact with fluid from the blisters.