Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus (VZV).

It causes an itchy, painful skin rash that primarily affects adults over age 50. That said, any adult or child who has previously had chickenpox may develop shingles if the virus is reactivated.

Children are 10 times less likely to develop shingles than adults over age 60. The following groups may be at a higher risk:

  • people who are immunocompromised
  • individuals who are taking medications to suppress the immune system
  • people who had chickenpox as infants

Shingles is caused by a reactivation of VZV. This means that for a child to get shingles, they must have previously had the chickenpox virus, or, less commonly, had the chickenpox vaccine.

Shingles cannot occur without prior exposure to VZV. The first time somebody is exposed to this virus, that person will develop chickenpox and not shingles.

The inactive virus stays inside the body, specifically in the nerve cells, after the chickenpox infection passes. It can become reactivated years later by having a weakened or compromised immune system, stress, trauma, or some other trigger.

When the virus is turned back on, a person gets shingles instead of chickenpox.

Your child may experience discomfort like itching, tingling, or pain on some part of the body or face as the first sign of shingles. The discomfort may be in a band (or nerve path) across one side of the trunk, including the stomach, chest, back, or buttocks. The sensation can range in intensity from mild to severe.

A few days up to 2 weeks after these first signs appear, your child may develop a rash of fluid-filled blisters. The blisters may look similar to chickenpox, but they’re generally clustered in a band or may even look like a burn. Chickenpox blisters, on the other hand, can be found all over the body and are not clustered in this same way.

Along with the pain and rash, your child may have other signs of viral illness, including:

  • fever
  • headache
  • nausea
  • chills

The rash generally goes away within 10 to 15 days.

Shingles is uncommon in children. But there are a few situations where children may be more at risk for getting shingles. They include children who:

  • were exposed to chickenpox through pregnancy (babies who were exposed to the virus within 21 to 5 days before birth may be at the highest risk of developing chickenpox after birth and shingles later in childhood)
  • contracted chickenpox as a baby (children who had chickenpox before age 1 also have an elevated risk)
  • have weakened immune systems (including kids who have health conditions that affect their immunity and those who take medications or treatments that lower immunity)

A note on race and ethnicity

One study found that race and ethnicity may play a role in which children are more likely to develop shingles. Black children had the lowest risk. White, non-Hispanic children had the highest risk, followed by Hispanic children, according to the study. It’s important to note that other factors may play a part in developing the disease beyond genetics.

Shingles is generally mild in children. If your child has shingles anywhere on the upper half of the face, however, you should seek medical attention. Even mild shingles in this area may damage the eyes or lead to vision loss that can be temporary or permanent.

Other possible, but rare, complications include:

Children who are immunosuppressed or on immunosuppressants may be at the highest risk of developing complications.

There’s no cure for shingles. Treatment is about making the child comfortable and possibly shortening the course and severity of the infection.

There are several antiviral medications available that may help if taken within 24 hours to 3 days of symptom onset. Antiviral medications can help shorten the overall course of shingles and reduce the level of pain. The key here is to get the medication as soon as possible. More research is needed to determine if taking antivirals 72 hours after onset is useful.

Depending on your child’s age, your pediatrician may also suggest using over-the-counter (OTC) pain or prescription pain medications to ease nerve pain.

You should let your pediatrician know if you suspect your child may have shingles, even if the symptoms are mild. The location of the rash is important with regard to what complications may happen. Getting antiviral treatment within 72 hours may prevent complications and reduce the severity of the infection.

Other reasons to call your child’s doctor might include if your child develops new or worsening symptoms, or if their rash and other symptoms don’t go away within 2 weeks.

At your appointment, your child’s doctor will ask about their health history and about any symptoms they have. From there, the doctor may perform a physical exam to look at the rash and other symptoms.

While a physical exam of the rash is generally enough to diagnose shingles, a doctor may also order a PCR test using scrapings or scabs from the lesions to make a firm diagnosis.

Your child may experience pain and discomfort with shingles. First and foremost, call their doctor to see if antiviral treatment is appropriate for your child.

Other home care measures for shingles focus on managing pain and keeping your child comfortable.

  • Offer a cool bath. Cool water can help ease the pain and itchiness on the skin. You might also consider an oatmeal bath for even more soothing power.
  • Use a cool compress. A moist, cool compress (like a wet washcloth) can provide pain relief.
  • Dress your child in loose-fitting clothing. Natural fibers like cotton allow your child’s skin to breathe.
  • Provide distractions. Your little one may be better able to cope with discomfort if they’re distracted by a book, game, craft, or television show.
  • Ask your doctor about anti-itch creams. Calamine lotion, for example, may help dry out blisters and soothe your child’s skin.

And be sure to cover your child’s rash and wash their hands frequently to lower the chance of transmission. This is only important if you and others you’re around haven’t had chickenpox before, as you cannot catch shingles from another person.

If your child has had chickenpox, there’s a chance they may develop shingles. Here’s what you need to know about prevention, sending your child to school, and how shingles differs from chickenpox.

Can children with shingles go to school?

Children who have shingles can pass on the chickenpox virus to children who haven’t had it or who haven’t been vaccinated against it. For this reason, it’s important to keep your child home from school, particularly when the rash is present.

Any fluid from the rash can pass the virus to another person. The Centers for Disease Control and Prevention (CDC) says that if the shingles rash is properly covered, the risk of transmission is low.

Speak with your school nurse about when your child can return to school and what measures you might take to lower the risk of transmission to others.

Is it possible for your child to get shingles if they never had chickenpox?

If your child has had the chickenpox vaccine, there’s a small chance the virus may be reactivated years later and cause shingles (even if they haven’t had chickenpox).

It’s uncommon for this scenario to happen, though, and a child is much more likely to get shingles after having chickenpox.

What’s the difference between shingles and chickenpox?

Both the chickenpox and shingles are caused by the varicella-zoster virus (VZV). The difference is that chickenpox is the infection you get with a first exposure to the virus, and shingles is the infection you get when something reactivates the dormant virus.

The rash also looks different. Chickenpox blisters can be found throughout the entire body. Shingles tends to be clustered in one area of the body, usually on the trunk or face.

Can you prevent pediatric shingles?

There’s no method to completely prevent shingles if you have already had exposure to VZV.

Researchers say that getting the chickenpox vaccine may provide protection against both chickenpox and shingles before age 17. In a 2019 study, children who had the chickenpox vaccine were 78 percent less likely to develop shingles than children who hadn’t had the vaccine.

While uncommon, children can develop shingles if they have previously had exposure to VZV.

Most people will only have one episode of shingles in their lifetime, though it’s possible to have repeat infections.

If you have concerns, speak with your child’s doctor about measures you can take to prevent shingles, such as getting a chickenpox vaccine.