Shingles in Children: What Is It and How Does It Affect Them?

Shingles in children is rare. Although its incidence increases with age, it usually occurs in immunocompromised children.
Shingles in Children: What Is It and How Does It Affect Them?

Last update: 24 August, 2022

Shingles in children isn’t a very common condition. However, when it appears on the skin, it’s usually very annoying and painful, affecting the child’s quality of life.

There are ways to prevent it and therapeutic options to soothe the discomfort. Discover everything you need to know about it in the following article.

What is shingles?

Herpes zoster, also known as shingles, is a disease caused by the reactivation of the varicella zoster virus (VZV). In fact, it can be triggered at any time after vaccination against chickenpox or natural infection with this virus.

It can be said that the incidence of shingles increases with age, although children who’ve had chickenpox within the first year are more likely to develop it.

In general, shingles isn’t a very common dermatological disease in children. However, some little ones are more likely to get it, especially when they meet the following conditions:

  • The mother had chickenpox disease in late pregnancy.
  • The child had chickenpox before the age of one year.
  • There’s a deficiency in the child’s immunity, either due to a medical condition or certain drugs (such as cancer medications).
A child with red spots on her skin lying in her mother's arms.
Children with shingles usually experience nausea, headache, fever, and chills. However, symptoms in children are usually milder than in adults.

Clinical manifestations of shingles in children

When infection is triggered early in life, symptoms tend to be less severe and last, on average, 1 to 3 weeks. In general, reactivation appears initially with intense pain and paresthesia (tingling sensation), followed by the appearance of a cluster of vesicles at that location.

It’s important to note that the rash is limited to a specific dermatome and to only one side of the body. After some time, the vesicles break up, crust over, and after a few weeks, the lesions disappear completely. In most cases, itching, paresthesia, and pain persist as long as the blisters are present.

In addition to the skin lesions, the child may also manifest any of the following symptoms:

  • Nausea
  • Headache
  • Fever
  • Chills

It’s not a good idea to implement any home remedies to treat the clinical picture. Rather, it’s best to consult a physician to obtain an accurate diagnosis and the most effective treatment for this condition.

Proper skin hygiene should be encouraged, as the vesicular rash of shingles can become infected with bacteria and cause cellulitis.

Vaccination is the most effective method of prevention

Although cases of shingles in children have decreased significantly since the introduction of the vaccine against VZV, when it affects children, it resolves quickly. Therefore, vaccinated children don’t usually develop chickenpox as they used to, although the virus remains latent in the neural ganglia and can be reactivated in stressful situations.

Chickenpox is a highly contagious disease. According to the Centers for Disease Control and Prevention, two doses of the VZV vaccine are more than 90% effective in preventing the disease. Therefore, the incidence of shingles is significantly lower after mass vaccination.

Treatment options for shingles

Treatment options are based on the patient’s immune status, age, symptom presentation, and duration. In general, management consists of the use of antiviral agents if the rash is acute, which decreases the duration of the condition and the intensity of pain.

Oral acyclovir at a dose of 20 to 40 mg/kg body weight, four times daily, is indicated as the first line of treatment for shingles in children. At the same time, a study conducted by The Journal of Infectious diseases suggests that the use of acyclovir in healthy children isn’t clearly justified and should be limited to specific cases that require it.

A child taking medicine.
To initiate treatment against shingles in children, oral acyclovir 4 times a day is recommended. This is an antiviral agent that stops the spread of herpes in the body.

Is shingles in children associated with malignancy?

Shingles in children has long been considered an indicator of oncological disease, especially acute lymphoid leukemia. However, recent studies suggest that neoplasms account for only 3% of cases of shingles in children.

Diagnosing shingles is essential for children

In conclusion, although chickenpox in early childhood is a risk factor, shingles is a rare disease in children. Furthermore, the appearance of symptoms in a young child doesn’t always determine underlying malignancy or immunosuppression.

In general, the prognosis of shingles in healthy children is good and its diagnosis is important to consider the management of shingles.

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  • Centers for Diseases Control and Prevention. Vaccination. [Internet] Disponible en: https://www.cdc.gov/chickenpox/vaccination.html
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