Pediatric Herpes Zoster (Shingles)

What is herpes zoster?

Herpes zoster, or shingles, is a reactivation of the varicella-zoster virus (chickenpox). The virus causes a painful rash of small blisters on a strip of skin anywhere on the body. On some occasions, the pain may continue for a prolonged period of time even after the rash is gone.

After a person has had chickenpox, the virus lies dormant in the nerves. If the virus reactivates, however, it causes shingles. Herpes zoster is more common in people with depressed immune systems or over the age of 50. It is very 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, however.

What are the symptoms of herpes zoster?

Herpes zoster most often occurs on the trunk and buttocks, but can also appear on the arms, legs, or face. Each child may experience the symptoms differently. The most common symptoms may include:

• Skin hypersensitivity in the area where the herpes zoster appears
• Mild rash, which appears after five days and first looks like small, red spots that turn into blisters
• Blisters that turn yellow and dry
• Rash which usually goes away in one to two weeks
• Rash localized to one side of the body

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

How is herpes zoster diagnosed?

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

• Skin scrapings (gently scraping the blisters to determine if the virus is shingles)
• Blood tests

What is the treatment for herpes zoster?

Specific treatment for herpes zoster will be determined by a physician based on:

• The child's age, overall health, and medical history
• Extent of the condition
• The child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the condition
• Child or parent’s opinion or preference

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