Shingles recovery in children

Overview

Shingles, also called herpes zoster, is a painful rash that appears when the chickenpox virus (varicella-zoster) becomes active again in the body. Anyone who has had chickenpox can get shingles, including children.

Shingles is not common in children. Most cases occur in adults over 50, but children can get it if their immune system is weakened or if they had chickenpox at a very young age.

Shingles can affect any child who has had chickenpox or received the chickenpox vaccine. It is more likely in children with weakened immune systems, such as those taking certain medicines or with health conditions like cancer or HIV.

Symptoms

Common symptoms

• Pain, burning, or tingling in one area of the skin before the rash appears
• A red rash that turns into clusters of fluid-filled blisters
• Blisters that crust over and heal in 2 to 4 weeks

Symptoms in children

• The rash may be less painful than in adults, but children can still feel discomfort.
• Sometimes children only have a mild rash without much pain.
• Fever, headache, or tiredness may occur along with the rash.

Symptoms in older adults

• Pain is often more intense and can last long after the rash heals (postherpetic neuralgia).
• Blisters may be more widespread and take longer to heal.
• Older adults have a higher risk of complications like eye infections or nerve damage.

Causes

Main causes

• Shingles is caused by the same virus that causes chickenpox (varicella-zoster virus).
• After a child has chickenpox, the virus stays inactive in nerve cells. Years later, it can reactivate and cause shingles.

Risk factors

• Had chickenpox before age 1
• Weakened immune system due to illness (like cancer or HIV) or medicines (like steroids or chemotherapy)
• Stress or fatigue can sometimes trigger reactivation, but this is less common in children

When to see a doctor

See a doctor urgently if:

• Rash on the face, especially near the eyes or nose
• Severe pain that does not get better with over-the-counter pain relief
• Signs of infection in the rash (redness, warmth, pus, or fever)

Book a routine appointment if:

• If you think your child has shingles, see a doctor as soon as possible. Early treatment can help the rash heal faster and reduce pain.
• If the rash is mild and your child is otherwise well, a routine appointment is fine.

Diagnosis

Doctors usually diagnose shingles by looking at the rash and asking about symptoms. The rash has a very typical appearance – a band of blisters on one side of the body.

Tests that may be done

• In some cases, a swab or scraping from a blister can be sent to a lab to confirm the virus.
• Blood tests are not usually needed but may be done if the diagnosis is unclear.

What to expect at your appointment

The doctor will examine your child’s skin, ask about pain and other symptoms, and check if the rash is near the eyes. They may also ask about your child’s medical history, including past chickenpox or vaccination.

Treatment

Treatment for shingles in children focuses on relieving pain, helping the rash heal, and preventing complications. Antiviral medicines can help if started within 72 hours of the rash appearing.

Self-care at home

• Keep the rash clean and dry to prevent infection.
• Apply cool, damp compresses or take oatmeal baths to soothe the skin.
• Cover blisters with a loose, non-stick bandage to reduce irritation.
• Encourage your child to rest and avoid scratching the blisters.

Medical treatments

Doctors may prescribe antiviral medicines to fight the virus, which work best when started early. For pain, over-the-counter pain relievers like paracetamol or ibuprofen can be used as directed by a doctor. In some cases, medicated creams or lidocaine patches may be recommended, but always follow the doctor's advice.

Living with this condition

During recovery, help your child stay comfortable. Keep the rash covered while it blisters to avoid spreading the virus to others who haven't had chickenpox. Your child can return to school once the blisters have crusted over and they feel well enough, usually after about 5-7 days.

Lifestyle tips

• Ensure plenty of rest and quiet activities like reading or puzzles.
• Avoid tight clothing over the rash.
• Wash hands often to prevent spreading the virus.

Diet and exercise

Offer a healthy, balanced diet with plenty of fluids to support healing. Light exercise like gentle walks can help if your child feels up to it, but avoid strenuous activity until the rash heals.

Mental health and emotional wellbeing

Shingles can be painful and upsetting for a child. They may feel frustrated or scared. Reassure them that the rash will heal and they will feel better soon. If pain or anxiety continues, talk to your doctor or a child counselor.

Prevention

Shingles cannot always be prevented, but the chickenpox vaccine can reduce the risk of getting chickenpox in the first place, which lowers the chance of shingles later. For children who already had chickenpox, there is no vaccine to prevent shingles – the shingles vaccine is only recommended for adults over 50.

Vaccines

The chickenpox vaccine (varicella vaccine) is part of routine childhood immunization in many countries. It is very effective at preventing chickenpox and can also reduce the risk of shingles. The shingles vaccine (herpes zoster vaccine) is not given to children.

Complications

If left untreated

• Bacterial infection of the rash (if scratched and not kept clean)
• Scarring or changes in skin color after healing
• Eye problems if the rash touches the eye area (rare in children)
• Postherpetic neuralgia – long-term nerve pain – is very rare in children but possible

Long-term outlook

The outlook for children with shingles is excellent. Most recover fully within 2 to 4 weeks with no lasting problems. Complications are uncommon, and the pain usually goes away as the rash heals. With good care and support, your child will be back to normal activities in no time.

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