Springdale Mason Pediatrics

Shingles (Zoster)

Definition

  • Shingles is a rash that looks like a stripe or band
  • It's only on one side of the body
  • It's caused by the chickenpox virus
  • The medical name is Herpes Zoster

Call or Return If

  • The rash becomes very painful or very itchy
  • The rash lasts more than 14 days
  • The rash looks infected (pus or soft yellow scabs)
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Rash is in a stripe or band. It follows the path of a nerve
  • Occurs on only one side of the body
  • Starts with clusters of red bumps and changes to water blisters. It finally becomes dry crusts. It looks like small groups of chickenpox sores.
  • Is most commonly found on the back, chest, or abdomen
  • Usually doesn't burn or itch in children (as it does for adults)
  • Your child will not have a fever or feel sick.
  • Shingles rarely occurs before 3 years old

Cause

  • Shingles (zoster) is caused by the chickenpox virus (varicella virus).
  • In some people the chickenpox virus stays inactive (dormant) in their bodies. For unknown reasons, the virus can re-appear as shingles, not as chickenpox.
  • Your child can only get shingles if he or she has already had chickenpox.
  • Shingles can also happen in children who had the chickenpox vaccine. These cases of shingles are mild compared to regular shingles.
  • The disease is NOT caught from other people who have shingles or chickenpox.

Prevention

  • The chickenpox vaccine decreases the shingles rate by 40%.

After Care Advice

Overview:
  • Most children with shingles have the rash, but no other symptoms.
  • Sometimes the rash itches. Rarely it's a little painful.
  • The main problem is that the rash contains the chickenpox virus.
  • Your job is to protect other people from getting chickenpox.
  • Here is some care advice that should help.
Calamine Lotion for Itching:
  • Zoster usually doesn't need any cream or lotion.
  • If itching occurs, use calamine lotion (no prescription needed). Put it on the spots that itch the most. Do this 3 times per day, as needed.
  • You can also rub an ice cube on the itchy spots for 10 minutes.
Benadryl Medicine for Itching:
  • If itching becomes severe or interferes with sleep, give Benadryl by mouth.
Try Not to Scratch:
  • Try not to let your child pick and scratch at the sores. This can lead to infected sores.
  • Trim fingernails.
  • Wash hands often with soap.
Pain Medicine:
  • To help with any pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
  • Never give aspirin to children. Reason: possible link of aspirin with Reye's syndrome.
What to Expect:
  • The red bumps and blisters in the stripe get worse for several days.
  • The rash dries up by 7 to 10 days.
  • About 20% of adults with shingles have chronic nerve pain after the rash is gone. The pain can last for 6 months or longer. Children do not get this complication.
Return to School:
  • The shingles sores contain the chickenpox virus. So children with shingles can transmit chickenpox (but not shingles) to others. Spread occurs by touching the rash.
  • Prevention of spread: Cover the shingles rash.
  • Children can go to school if the rash can be kept covered by clothing.
  • If it can't be covered (such as on the face), children need to stay home until it crusts over. That takes 7 days on average.
  • Avoid contact with anyone who has never had the chickenpox disease or vaccine. Also avoid contact with anyone who has a weak immune system.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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