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Herpes Zoster (Shingles)

Herpes Zoster (Shingles)

Programs that treat this condition

	Children's Hospital Primary Care Center		Infectious Diseases
	Children's Hospital AIDS Program

What is herpes zoster?

Herpes zoster, or shingles, is a common viral infection of the nerves, which results in a painful rash of small blisters on a strip of skin anywhere on the body. Even after the rash is gone, the pain may continue for months.

Herpes zoster is caused by the reactivation of the varicella-zoster virus, which causes chickenpox. After a person has had chickenpox, the virus lies dormant in certain nerves for many years. Herpes zoster is more common in persons with a depressed immune system and in persons over the age of 50. It is quite rare in children and the symptoms are mild compared to what an adult may experience. Children who have weakened immune systems may experience the same, or more severe, symptoms as adults.

Children most at risk for herpes zoster are those who had chicken pox during the first year of life or whose mothers had chicken pox very late during pregnancy.

What are the symptoms of herpes zoster?

Herpes zoster most often occurs on the trunk and buttocks. However, it may appear on the arms, legs, or face. The following are the most common symptoms of herpes zoster. However, each child may experience symptoms differently. Symptoms may include:

skin hypersensitivity in the area where the herpes zoster is to appear
mild rash, which appears after five days and first looks like small, red spots that turn into blisters
blisters which turn yellow and dry, often leaving small, pitted scars
rash which usually goes away in one to two weeks
rash is usually localized to one side of the body

The symptoms of herpes zoster may resemble other skin conditions. Always consult your child's physician for a diagnosis.

The Chickenpox Vaccine

Since 1995, a chickenpox vaccine has been available for children 12 months of age and older. Adolescents and adults who have never had chickenpox can also get the vaccine. The vaccine has proven very effective in preventing severe chickenpox. The CDC Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians recommend that all children be vaccinated with the chickenpox vaccine between 12 and 18 months of age.

A booster vaccination is recommended again between 11 and 12 years of age. Many schools now require vaccination prior to entry into preschool or public schools.

How is herpes zoster diagnosed?

Diagnosis usually involves obtaining a medical history of your child and performing a physical examination. Diagnosis may also include:

skin scrapings - gently scraping the blisters to determine if the virus is shingles or another virus.
blood tests

Treatment for herpes zoster:

Specific treatment for herpes zoster will be determined by your child's physician based on:

your child's age, overall health, and medical history
extent of the condition
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
coexisting disease
your opinion or preference

Medication may help alleviate some of the pain, but the disease has to run its course. Immediate treatment with antiviral drugs may help lessen some of the symptoms and minimize nerve damage. Use of medication will be determined by your child's physician based on the age of the child and the severity of the symptoms.


					Children's Hospital Boston is the primary pediatric teaching hospital of Harvard Medical School

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