What Is Shingles?
Shingles, referred to as herpes zoster, is a viral infection caused by the varicella-zoster virus that affects the nerves just beneath the skin. It causes painful rashes on the skin. Any child who had previously developed chicken pox or got a vaccine can develop shingles when the herpes virus reactivates. Shingles is an uncommon condition in children. It cannot develop in children without prior exposure to varicella-zoster virus. As the incidence of shingles increases with age, teenagers are more likely to develop shingles than children.
Following chickenpox infection, the inactive virus remains within nerve cells of the body. The virus can become reactivated after several years when the immune system is compromised, stress, trauma, or other triggers occur. The reactivated virus causes shingles instead of chicken pox. The virus transmission can occur from fluids leaking from the blisters.
What Are the Risk Factors for Developing Shingles in Children?
According to studies, the Whites or non-Hispanic children are more prone to develop shingles than Blacks. Risk factors that increase susceptibility to developing shingles in children are:
- The fetus gets exposed to chicken pox during pregnancy. Babies exposed to the virus 21 to 5 days before birth are at risk for developing chicken pox soon after birth and shingles later in life.
- Children who develop chickenpox before one year can develop shingles later.
- Children who have health complications that weaken the immune system or those on medication to lower immunity are at risk for developing shingles.
- Children who developed an allergic reaction to the first dose of the chicken pox vaccine did not receive the second dose.
Children with chicken pox vaccine are still at risk for developing shingles, but the symptoms could be less severe.
What Are the Symptoms of Shingles in Children?
Children develop itching, tingling, or stabbing pain sensation as a first sign on some body parts or face, leading to discomfort. The discomfort develops along the nerve path of one side of the trunk, which includes the stomach, chest, back, or buttocks. The involvement of nerves causes pins and needle sensation under the skin. The severity of symptoms can be mild or severe.
After five days of initial symptom onset, the rash appears on the skin, which becomes red and irritated. Two weeks after shingles, the child develops fluid-filled blisters. The blisters appear clustered and resemble rashes of chickenpox or burn. After several days, the rash becomes dry and forms a crust. Additional symptoms include fever, headache, flu-like symptoms, burning, nausea, and chills. The rashes resolve within 10 to 15 days. If the symptom persists for two weeks, seeking medical help is essential.
How Are Shingles Diagnosed in Children?
The doctor records the child’s medical history and presenting symptoms. Physical examination of the rashes helps with shingle diagnosis. Additionally, the doctors can advise PCR (polymerase chain reaction) tests of scrapping and scabs of rashes for a confirmed diagnosis.
How Are Shingles Treated in Children?
No specific treatments are available for shingles. Children with shingles cannot pass the varicella-zoster virus to others but can transmit chickenpox. The mainstay of treatment is to reduce the disease severity and make the child comfortable during infection. Most children with shingles are treated based on their health, age, and symptoms.
Children who develop shingles can take antivirals within 24 hours to 3 days of symptom onset. Commonly prescribed antivirals for children are Acyclovir, Valacyclovir, and Famciclovir. These medications help shorten the disease course and reduce pain. The medication helps only when taken early, but its efficacy post 72 hours post symptom onset needs to be studied. Immunocompromised children who develop shingles are treated with Acyclovir. Topical medications like creams, sprays, or skin patches help numb the skin. Children’s nerve pain can be managed with over-the-counter medication like Tylenol. Other medications for managing shingles in children are antihistamines like Benadryl cream and anti-itch medication like Caladryl.
What Are the Home Remedies for Managing Shingles in Children?
Children must cover their rash and wash their hands frequently to lower virus transmission. Home care for children with shingles is:
- Taking a bath with cool water helps ease the pain and skin itchiness. Oatmeal bath soothes the skin.
- The rash must be washed with mild soap and water.
- Providing a cool compress with a wet cloth thrice daily helps with pain relief.
- Children with shingles must wear loose-fitting clothes or natural fibers like cotton to soothe their skin.
- Distracting children with books, games, crafts, or television can prevent children from scratching.
- Calamine lotion helps dry skin lesions and soothe the child’s skin.
What Complications Occur Due to Shingles in Children?
Shingles in most children are of a mild type and do not pose any risk. However, children who develop shingles in the upper half of their face must seek medical attention as the lesions could damage their eyes and lead to vision loss, which could be temporary or permanent.
Individuals with a higher risk of developing shingles complications are babies less than one month, unvaccinated pregnant women, children with HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency virus), and immunocompromised children such as those undergoing chemotherapy or recovering from organ transplants.
Other complications of shingles include pneumonia, hearing issues, skin infection, nervous system complications, vision problems, encephalitis (brain inflammation), meningitis, postherpetic neuralgia (nerve pain), and stroke. Children rarely develop severe complications like post-herpetic neuralgia. It is a long-term complication causing constant pain and sensitivity in the area where rashes initially formed, which lasts for months. When shingles occur near the eye, it could cause vision problems. Bacterial infection of skin lesions causes impetigo or cellulitis. A shingles outbreak on the face involving nerves that connect to the brain causes facial paralysis, hearing problems, and problems with balance.
How Are Shingles Prevented From Developing in Children?
Shingles cannot be prevented in children. However, infection severity is reduced with the chickenpox vaccine. To avoid virus transmission to others, the child must avoid direct contact with others, cover the rash, avoid itching or touching the rash, and clean the hands frequently.
Conclusion
Shingles result in painful rashes on the skin. The condition is rare among children. It can affect children with a history of chickenpox or its vaccine. Most cases result from reactivation of herpes zoster virus. The symptoms resolve within a few weeks, but some children might develop complications. Vaccination is an effective strategy against shingles.
