Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0

Shingles (Zoster)

SYMPTOMS AND CHARACTERISTICS

  • A linear rash that follows the path of a nerve.
  • The rash occurs on only one side of the body.
  • The rash starts with clusters or red bumps, changes to water blisters, and finally becomes dry crusts (looks like small groups of chickenpox sores).
  • The back, chest, and abdomen are the most common sites.
  • The rash usually doesn't burn or itch in children (in contrast to the adult form).
  • Your child does not have a fever or feel sick.
  • Your child had chickenpox in the past.

CAUSE

Shingles (zoster) is caused by the chickenpox virus. The disease is not caught from other people who have shingles or chickenpox. The chickenpox virus lies dormant in the bodies of some people and is reactivated for unknown reasons as zoster. Children with zoster are usually over age 3 years.

EXPECTED COURSE

New rashes continue to appear for several days. All the rash dries up by 7 to 10 days. Complications do not occur unless the shingles affect the eyes. If zoster involves the nose, the cornea is usually also affected. Most people have shingles just once; a second attack occurs in 5% of children who get zoster.

HOME CARE

  1. Relief of symptoms

    Most children have the rash but no symptoms. For pain, give acetaminophen or ibuprofen as needed. Avoid giving aspirin for zoster because of the possible link of aspirin and viral infections with Reye's syndrome. Discourage scratching or picking the rash. The rash does not need any cream.

  2. Contagiousness

    Children with zoster can transmit chickenpox (but not zoster) to others. Transmission occurs by touching the zoster rash. Although they are far less contagious than children with chickenpox, children with zoster should stay home from school for 7 days unless they can keep the rash covered until it crusts over. Children or adults who have not had chickenpox should avoid visiting a child with zoster (unless the rash is covered).

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

  • The zoster rash involves the eye or nose.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS 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 have other questions or concerns.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems