Shingles (Herpes Zoster) in Children

What is shingles in children?

Shingles (herpes zoster) is a painful skin rash. It’s caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox.

What causes shingles in a child?

After a person has chickenpox, the virus stays in the body’s nerve cells but is inactive. Years later, the varicella-zoster virus can become active again. The virus can then cause a red rash or small blisters, usually on one side of the body. The rash or blisters spread along a nerve pathway where the virus was living.

Which children are at risk for shingles?

Shingles in children is not common. A child is more at risk for shingles if either of these are true:

  • He or she had chickenpox before age 1.
  • The child’s mother had chickenpox very late in pregnancy.

Children who get the chickenpox vaccine still have a small risk for shingles. But it may be a lower risk than after a chickenpox infection. And the symptoms may be less severe. The risk of shingles increases with age. A child with a weak immune system may have the same, or more severe, symptoms as an adult.

What are the symptoms of shingles in a child?

The symptoms start with pain, burning, tingling, or itching on one part of the face or body. The rash can appear up to 5 days after these symptoms.

The shingles rash most often occurs on the torso and buttocks. It may also appear on the arms, legs, or face. The rash starts as small, red spots that turn into blisters. The blisters turn yellow and dry. The rash is usually only on one side or part of the body. It goes away in 2 to 4 weeks.

Your child may also have symptoms such as:

  • Fever and chills
  • Headache
  • Nausea 

The symptoms of shingles can be like other health conditions. Make sure your child sees a provider for a diagnosis.

How is shingles diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. Your child will have a physical exam. Your child may also have tests, such as:

  • Skin scrapings. The blisters are gently scraped to remove tiny samples. The samples are examined to look for the virus.
  • Blood tests. These are to check for signs of virus in the blood.

How is shingles treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment right away with antiviral medicine may help lessen how long the symptoms last and how serious they are. These antiviral medicines work better the sooner they are started. Your child may be given acyclovir, famcyclovir, or valacyclovir. Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

Ask the healthcare provider about over-the-counter pain medicine. You may be able to give acetaminophen or ibuprofen for fever and discomfort. Don't give ibuprofen to a child younger than 6 months old, unless your healthcare provider tells you to. Don't give aspirin to children. Aspirin can cause a serious health condition called Reye syndrome.

If your child’s pain is severe, the healthcare provider may prescribe stronger pain medicine.

What are possible complications of shingles in a child?

After the shingles rash is gone, the pain may continue for a long time. This is a complication called postherpetic neuralgia (PHN). Talk with the healthcare provider if your child’s pain stays after the rash goes away.

How can I help prevent shingles in my child?

There is a shingles vaccine for older adults, but not for children. This is because shingles is more severe in older adults. But a child who has had the chickenpox vaccine may have milder symptoms of shingles. If your child has not had chickenpox, talk with the healthcare provider about the chickenpox vaccine. 

Online Medical Reviewer: Liora C Adler MD

Online Medical Reviewer: Pat F Bass MD MPH

Online Medical Reviewer: Raymond Kent Turley BSN MSN RN

Date Last Reviewed: 1/1/2019

© 2000-2019 StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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