Shingles In Kids: Symptoms, Causes, And Treatment

Shingles (herpes zoster) is a painful condition caused by the varicella-zoster virus (VZV). This virus causes chickenpox and stays in your system for life. VZV can reactivate and cause shingles.

About 30% of people in the United States will get shingles in their lifetime.¹ Shingles in children are rare but possible. It requires close attention and proper, timely treatment of the symptoms.

Let's take a closer look at pediatric shingles.

What are pediatric shingles?  

Pediatric shingles are simply shingles that occur in kids. The condition occurs when the varicella-zoster virus reactivates in the body and causes a painful and itchy rash.

The risk of shingles increases as you get older. The longer it’s been since you had chickenpox, the higher your risk of shingles. That's why childhood shingles are rare. However, if your child had chickenpox, there is always a chance of them developing the disease.

The symptoms of shingles in children can vary from mild to severe. In any case, at the first signs of a rash, contact a doctor. Shingles often respond well to early treatment with antiviral medication. So the earlier you speak to a doctor, the better.

What are the symptoms of shingles in a child?

Children experience the same symptoms of shingles as adults do.² One of the first symptoms occurs in the area where the rash is about to appear. A child may experience tingling, itching, or mild pain before a rash develops. When it does, the pain can become severe.

The shingles rash begins as a group of small pimples on the body. The most common spot for the shingles rash is at one side of the waistline, but it can also occur on the face and genitals.

Over time, pimples turn into pus-filled blisters and eventually break open. The rash disappears within two to four weeks.³ Besides the rash, a child may also experience:

• Fever

• Upset stomach

• Shooting pains

Symptoms of children's shingles can vary from mild to severe. Even if your child’s symptoms are mild, they may scratch the blisters, which risks infection.

Contact a doctor immediately if the rash appears on your child’s face. Close proximity to the eyes and brain could lead to serious consequences, including blindness and brain inflammation.

How to diagnose shingles in kids

Shingles diagnosis is usually straightforward. A doctor can tell your child has the condition by reviewing their medical history and examining the rash. In some cases, a doctor may order a skin scraping test.

During the test, they gently scrape your child’s rash to get a small sample for the laboratory. Once they confirm the diagnosis, the doctor can develop an effective course of treatment.

How to treat shingles in kids

Not all children require treatment for shingles. Mild cases of the condition resolve without treatment. However, take your child to see their doctor if you have any concerns. A doctor can prescribe antiviral medication and pain relievers if your child has symptoms interfering with their quality of life.

Antiviral medication

Antiviral meds, such as acyclovir, valacyclovir, and famciclovir, can heal the rash, stop the virus from spreading, and offer pain relief. These medications usually work best within three days of the rash appearing.

Pain medication

Since shingles can be painful and itchy, your child’s doctor may prescribe drugs to relieve these symptoms. Pain medication can also reduce inflammation. While pain medication doesn't fight the virus, it alleviates symptoms and reduces the chances of complications.

Symptom relief

If antiviral and pain relief therapy doesn't yield satisfactory results, the doctor may recommend symptom relief methods. These may include wet compresses, calamine lotion, and a warm bath with ground oatmeal to soothe the itching.

The course of treatment depends on the severity of the symptoms and your child's age. Even if symptoms are mild, don't try to treat shingles on your own. You could unwittingly increase the chances of complications. Speaking to your child’s doctor is the best way to ensure appropriate treatment. 

In most cases, you can treat your child's shingles at home with a doctor’s advice. In severe situations, some may require hospitalization.

What are the possible complications of shingles in a child?

Most of the time, shingles go away without any consequences, especially if you seek timely medical assistance. However, complications are possible. They can include:

Post-herpetic neuralgia (PHN)

Shingles can damage nerve fibers in the skin. These fibers continue sending pain messages to the brain even when the rash is gone. Around 20% of people get PHN after shingles.⁴ It can go away within weeks or last for many years.

It's possible to reduce the risk of PHN by using antiviral meds at the earliest stages of shingles.

Eye problems

If shingles develop on your child's face, it can cause serious complications. Around 20%⁵ of shingles cases involve nerves in the person's head.⁵ If this happens, it could affect different parts of the eye. In rare cases, it may cause vision impairment or loss.

That's why it's imperative to watch where shingles develop and contact a doctor as soon as possible. Timely treatment can prevent severe complications.

Neurological problems

When shingles occur on the face or near the head, they may affect nerves near the brain. This could lead to problems like facial paralysis and hearing impairment. Very rarely, shingles may cause brain inflammation (encephalitis).

Infection

Since blisters are itchy, children often scratch and break them open. This could lead to an infection. Your child may develop impetigo or cellulitis if the rash gets infected with bacteria. Talking to the doctor about first aid for broken blisters is imperative to prevent infection.

Preventing childhood shingles

Adults in the United States can take advantage of the shingles vaccine called Shingrix.⁶ Depending on the person's age, it can be 91–97% effective for shingles prevention. However, the vaccine is only available for people older than 19.

Children can benefit from the chickenpox vaccine. Besides reducing the chances of your child developing chickenpox, it offers protection against shingles and PHN. However, if your child already had chickenpox, doctors aren't likely to recommend vaccination.

Around 15% to 20% of people vaccinated against chickenpox will still get it.,⁷ However, the symptoms are likely to be mild.

If your child already had chickenpox, there isn't much you can do to prevent shingles. Thankfully, it’s relatively rare in children. 

Risk factors

Some kids are more likely to develop shingles than others. 

Risk factors include:

• A child had chickenpox before 12 months old (in this case, a doctor may still recommend a chickenpox vaccine).

• A child's mother developed chickenpox at the latest pregnancy stages.

• A child has a weak immune system.

If your child is at risk of developing childhood shingles, you need to monitor their health closely to not miss the first symptoms.

Are shingles in a child contagious?

If a child who doesn't receive a chickenpox vaccine comes into contact with the varicella-zoster virus, they are highly likely to get sick. This virus is extremely contagious. It spreads through respiratory contact. So even if the child only talks to someone with chickenpox, they are likely to catch the virus.

Once the infection passes, the virus stays in its system. It can lie dormant for a lifetime or manifest as shingles in just a few years.

If you or your child have shingles, you can’t spread shingles to other people. Shingles only occur in people when the dormant varicella-zoster virus activates: You cannot catch it.

However, if you have shingles and come into contact with someone who has not had chickenpox, they may develop chickenpox. This could cause shingles for them later on in life. 

The lowdown

Shingles in kids are rare but possible. If your child had chickenpox in the past, they might be at risk of developing shingles. The majority of childhood shingles cases are mild. However, it's crucial to begin treatment as soon as possible.

Contact your healthcare provider as soon as you notice signs of shingles in your child. A doctor can offer an effective course of treatment to alleviate symptoms and improve your kid's quality of life.