You can’t get shingles if you’ve never had chickenpox, but some people may have had chickenpox exposure without realizing it. This can make you vulnerable to shingles.

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Shingles and chickenpox are strains of the same virus, the varicella-zoster virus (VZV). Chickenpox is the precursor to shingles. It’s a contagious rash that occurs mostly in young people.

As you age, you’re more susceptible to a shingles outbreak. This outbreak is caused by a reactivation of the previously dormant chickenpox virus.

You can’t get shingles if you’ve never had VZV.

Shingles is a reactivation of the same virus that caused chickenpox. To get it, you need to have had exposure to VZV earlier in life. Reactivation generally occurs because of a dip in the immune system due to aging, exposure to other diseases, or medication.

But it’s possible to have had VZV without a chickenpox rash or without knowing it. Most people born in the U.S. before 1980 have had exposure to VZV. If you don’t think you’ve had chickenpox, a doctor can order a blood test to determine if you have had a past VZV infection.

While you can’t get shingles if you’ve never had chickenpox exposure, you can still get chickenpox as an adult from exposure to VZV from chickenpox or shingles.

Chickenpox tends to be more prevalent in children but can still be a risk for adults. Chickenpox is highly infectious. It often spreads to about 90% of the people close to someone who has it if they don’t have immunity from a previous infection or a vaccination.

Learn more about the differences between shingles and chickenpox.

Risk factors for adults

If you’ve never had chickenpox, you’re at higher risk for contracting it if:

  • you live with unvaccinated children
  • you work in a school or child care space
  • you touch the rash on a person who has chickenpox or the fluid from a shingles blister
  • you touch something a person with chickenpox has used recently
  • you’re in close contact with a person who has chickenpox

You’re at higher risk of complications from chickenpox if:

  • you’re pregnant and have never had chickenpox
  • you have a health condition that impairs your immune system, such as cancer
  • you’re taking steroid medication or other medications that suppress the immune system

When adults develop chickenpox, they may have flu-like symptoms before the rash appears. Adults and adolescents are more likely to have life threatening complications from chickenpox than children are.

According to the CDC, more than 99% of Americans born in 1980 or earlier have had chickenpox. If you’re 50 or older, doctors recommend getting the shingles vaccine, called Shingrix.

You may consider getting the shingles vaccine before turning 50 if you:

  • work in an industry that might have higher exposure to chickenpox, like healthcare or education
  • are pregnant
  • are HIV-positive
  • are older than 19 and have a weakened immune system

If you’re over 50 and confident that you’ve never had exposure to chickenpox, a primary doctor can run a blood test to determine your level of immunity. If it turns out that you’ve never been exposed to chickenpox, a doctor may recommend getting vaccinated against the VZV with the chickenpox vaccine to protect against future exposure.

Chickenpox vaccination warnings

Do not get a chickenpox vaccine if you:

  • are pregnant (until after you give birth)
  • previously had a life threatening allergic reaction to a previous dose of the chickenpox vaccine or any ingredient of the vaccine (like gelatin or the antibiotic neomycin)
  • are moderately or severely ill (wait until you get better)

Talk with a doctor before getting a chickenpox vaccine if you:

  • have a health condition that affects your immune system
  • are taking a medication for 2 weeks or longer that affects your immune system
  • have cancer of any kind or are taking medications for cancer
  • have recently had a blood transfusion
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For both shingles and chickenpox, doctors may recommend antiviral medication to reduce the risk of complications. While the antiviral medication won’t cure you of the varicella virus, it may lessen the severity of symptoms and help your body heal faster.

Treatment for both typically involves managing your symptoms until you recover. You can manage symptoms of the rash and soothe itching skin by:

  • taking lukewarm baths
  • applying unscented lotions
  • wearing lightweight, soft, and loose-fitting clothing

A doctor may also prescribe other medications or ointment to help you manage your symptoms.

According to the Association for Professionals in Infection Control and Epidemiology, blisters from chickenpox will disappear within 1 week. The pain and rash associated with shingles take a little longer to scab over and go away, typically 3 to 5 weeks.

If you’ve never had chickenpox and are vaccinated against it, you can’t get shingles. But most people over 50 years old in the U.S. are vulnerable to developing shingles.

Vaccination efforts for chickenpox have successfully limited the disease. As the years go on, fewer people will be vulnerable to developing shingles.

The best way to protect yourself against developing shingles or adult chickenpox is through vaccination. Talk with a doctor to see if you’re eligible for either vaccine.