Shingles And Pregnancy: Causes, Signs, Precautions, And Treatment

Pregnant women often take precautions when it comes to their health. Many avoid sick people, fearing that various health conditions may impact their unborn children.

One out of every three Americans is expected to develop shingles at a certain point in their lives. And it’s one of the many viral conditions pregnant women should avoid.¹

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What are shingles?

Shingles, also referred to as herpes zoster, refers to a viral condition that causes itchy and painful rashes. This infection is caused by the same causative agent as chickenpox, the varicella-zoster virus (VZV). While you can't get chickenpox again after you get it in childhood, shingles certainly can.²

For those who have had chickenpox, VZV is still present but dormant in their bodies. In some people, this virus never becomes active again. However, in others, it can reactivate, causing shingles. Many people with this condition are over 50, but anyone, including children and pregnant women, can contract it.

Exposure risk

Chickenpox is contagious, and those who didn’t have it previously can get it at any age. Shingles itself is not contagious because a person can only get shingles if they have previously had chickenpox. This means you can’t directly catch shingles from a person who has shingles.

However, if you’ve never had chickenpox and have not been vaccinated against it, you can potentially catch it from someone who has shingles. This can occur through direct contact with an infected person's rash that has not yet healed fully. 

Shingles and pregnancy concerns

Catching chickenpox during pregnancy can be very dangerous. A baby born to a mother who had chickenpox during the first half of her pregnancy is more likely to be born with low birth weight and congenital disorders involving the brain, eye, limb, and skin.

This is known as congenital varicella syndrome.

When a mother catches chickenpox between 13 and 20 weeks of pregnancy, there’s about a 2% chance that the baby will have congenital varicella. Babies whose mothers were infected earlier in the pregnancy also have a risk of this condition.³

If you’ve never had chickenpox and have not been vaccinated against it, you must avoid exposure to it during pregnancy. 

If you previously had chickenpox before your pregnancy or have received the vaccine, you and your unborn baby are safe since you cannot contract it again. If you’re unsure whether you had this disease in childhood, your doctor can do a blood test to look for antibodies against VZV.

If you’ve had chickenpox before, you can get shingles while pregnant. Luckily, your unborn child is still safe if you get shingles.

If you are expectant and notice any skin rashes on your body, you should inform your doctor immediately. It could be chickenpox or shingles, and other possibilities could cause serious problems for you or your unborn child. Thus, it’s important to get a proper medical evaluation.

Your healthcare professional can order a blood test to determine whether you have antibodies against the virus that causes chickenpox. If these antibodies are found, then it means that you either had chickenpox in the past or received the vaccine against it. This indicates that you’re immune to chickenpox, and neither you nor your unborn child is at risk for the infection. 

If your blood test does not show that you possess antibodies against the chickenpox virus, and you may have been exposed to it, you may need an immunoglobulin injection. This has antibodies against the virus that causes chickenpox. 

Receiving this injection may help you prevent developing chickenpox or result in a milder episode of the disease. It can help protect your baby from developing serious health issues due to the infection. This injection must be administered within 96 hours (four days) of exposure to shingles or chickenpox to be as effective as possible.

Before getting any shot, ensure that your doctor knows you are pregnant. It’s always important to be cautious about what medications you’re getting during pregnancy.

What shingles and chickenpox symptoms should I watch out for?

 Some common symptoms of shingles or chickenpox include:

  • An itchy or inflamed rash on the body (people with chickenpox have the rash on the whole body, while those with shingles usually have a rash that appears as a stripe or band on one side of the face or body)

  • A tingling or burning sensation, which often begins before the appearance of the rash

  • Headache

  • Fever

  • Nausea

  • Diarrhea

  • Difficulty urinating

In both shingles and chickenpox, the rash generally begins as reddish bumps that are painful and tingly. After a few days, the bumps develop into fluid-filled blisters, which scab over in 7–10 days. The rashes will eventually heal and disappear within 2–4 weeks. There may be temporary discoloration on the infected areas after the rashes disappear. 

Additionally, nerve pain may linger at the rash's site, a condition called postherpetic neuralgia. This condition affects about one in five individuals who get shingles. Most people see total relief from the pain four months after the rash initially appears.

As long as the rash is visible and the blisters have not scabbed over, it is a sign that the disease is highly contagious.

How to diagnose shingles

It is usually fairly easy for your doctor to diagnose shingles based on the appearance of the rash. Often, there is no need for lab testing. However, your doctor may suggest confirming your diagnosis of shingles through a skin culture.

This involves taking some skin from one of the blisters caused by the rash and analyzing it in a lab. The results of the culture will be used to identify whether it is shingles or not.

What is the treatment for shingles?

It is important to consult your doctor immediately when you notice signs of shingles. You must treat these rashes within 24 hours after their appearance for the best results. 

Common treatments for this condition include over-the-counter or prescription antiviral medication. These will help by reducing the symptoms or shortening the duration of your condition.

Popular prescription drugs for shingles include valacyclovir (Valtrex), famciclovir (Famvir), and acyclovir (Zovirax). These medications are generally considered safe for use during pregnancy, but make sure your doctor knows you’re pregnant before they write you any prescription. 

It is crucial to take antiviral medications exactly as prescribed by your doctor. Often, they are taken once every day for a few days.

There are also several over-the-counter (OTC) drugs and self-care techniques for shingles pain and itching relief and infection prevention. These include the following:

  • Cool baths and a cold compress for pain relief

  • Using clean gauze coverings on infected spots and wearing loose clothing to hasten the healing of the blisters and avoid further infection

  • Oatmeal baths, calamine baths, and antihistamines like Benadryl to minimize itching and inflammation

  • Acetaminophen (Tylenol) for pain relief

It’s recommended that pregnant women avoid taking NSAIDs, like naproxen or ibuprofen, late in their pregnancy, as it could cause complications.⁴

Shingles and pregnancy precautions

Although VZV is highly contagious, the chances it will affect your unborn child are, fortunately, small. Even if you get it while pregnant, there’s only about a 2% chance your child will be affected. Still, the effects can be very severe if this does occur. 

In addition, the pain and discomfort are likely to make your pregnancy more challenging. So, if you are wondering, 'should a pregnant woman avoid someone with shingles,' the answer is yes. People who have never had chickenpox, including pregnant women as children, should avoid contact with infected persons. 

If you get shingles while pregnant, there’s generally no risk to your baby. The risk only occurs if you get infected with chickenpox for the first time during pregnancy.

Can pregnant women get the shingles vaccine?

If you have never had chickenpox and intend on becoming pregnant, you should consult your doctor about getting the vaccine at least three months before trying to conceive. This vaccine is not considered safe to administer during pregnancy, so if you haven’t had it before your pregnancy, you’ll have to wait until afterward to consider getting it.

Some people get a vaccine against VZV when they’re older to reduce the risk of shingles. This shingles vaccine is somewhat different from the chickenpox vaccine given to children and younger adults, even though it works against the same virus. The Centers for Disease Control and Prevention recommends the shingles vaccine for everyone over 50 years. However, it’s not recommended for pregnant women.⁵

The lowdown

The same virus causes shingles and chickenpox. Shingles can occur during pregnancy if the mother has been previously infected with chickenpox. This may cause discomfort but isn’t dangerous to the baby.

However, getting chickenpox for the first time during pregnancy poses a small risk of severe complications in the baby. 

If you have never had chickenpox and intend to get pregnant soon, ensure that you speak to your doctor about getting the shingles vaccination. If you are already pregnant, keep away from people who have chickenpox or shingles and practice healthy habits such as washing your hands regularly. 

Early detection and treatment of chickenpox can minimize complications, so consult a doctor if you experience any rashes during your pregnancy.

  1. About shingles (Herpes zoster) | Centers for Disease Control and Prevention

  2. Varicella zoster virus (VZV) (2009)

  3. Consequences of varicella and herpes zoster in pregnancy: Prospective study of 1739 cases (1994)

  4. FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid | U.S. Food and Drug Administration

  5. Shingles vaccination | Centers for Disease Control and Prevention

Other sources:

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