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

Health Information

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%.

Care Advice

1. 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.
2. 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.
3. Benadryl Medicine for Itching:
   • If itching becomes severe or interferes with sleep, give Benadryl by mouth.
4. 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.
5. 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.
6. 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.
7. 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.

Call Your Doctor 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

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. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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