From the Guidelines
Yes, children can get shingles, though it's relatively uncommon. Shingles (herpes zoster) occurs when the varicella-zoster virus, which causes chickenpox, reactivates after lying dormant in nerve tissues. Children who have previously had chickenpox or received the chickenpox vaccine can develop shingles 1. The risk is higher in children with weakened immune systems due to certain medications, illnesses, or treatments like chemotherapy.
Key Points to Consider
- Symptoms include a painful, blistering rash that typically appears on one side of the body, often accompanied by itching, tingling, or burning sensations.
- Treatment for children with shingles usually involves antiviral medications like acyclovir, valacyclovir, or famciclovir, which work best when started within 72 hours of rash appearance.
- Pain management may include acetaminophen or ibuprofen at age-appropriate doses.
- Parents should keep the rash clean and covered to prevent spreading the virus to others who haven't had chickenpox. While shingles in children is typically milder than in adults, medical attention is important for proper diagnosis and treatment, as noted in recent studies on herpes zoster vaccination 1.
From the FDA Drug Label
The use of VALTREX for treatment of chickenpox in pediatric subjects aged 2 to less than 18 years is based on single‑dose pharmacokinetic and multiple‑dose safety data from an open‑label trial with valacyclovir and supported by safety and extrapolated efficacy data from 3 randomized, double‑blind, placebo‑controlled trials evaluating oral acyclovir in pediatric subjects Valacyclovir is also not recommended for the treatment of herpes zoster in children because safety data up to 7 days’ duration are not available
Shingles (Herpes Zoster) can occur in kids, but valacyclovir is not recommended for the treatment of herpes zoster in children due to lack of safety data.
- The FDA drug label does provide information on the treatment of chickenpox in pediatric patients, but it does not support the use of valacyclovir for the treatment of shingles in this population 2.
From the Research
Can Kids Get Shingles
- Herpes zoster, also known as shingles, is a viral infection that can occur in anyone with a history of chickenpox 3.
- Although it is more prevalent and usually more severe in older patients, shingles can occur in individuals of all ages, including children 3.
- Varicella-zoster virus (VZV) causes two clinical illnesses, varicella (chickenpox) and herpes zoster (shingles), and antiviral therapy can be used to treat VZV infections in healthy and immunocompromised children 4.
- Acyclovir is the drug of choice for varicella and herpes zoster, and its clinical impact is related directly to its use early in the clinical course and to the likely susceptibility of the patient to severe or life-threatening VZV infection 4.
- The introduction of live-attenuated vaccines has decreased the incidence of VZV diseases, including varicella and herpes zoster, but antiviral agents are still necessary for treatment, especially in immunocompromised hosts 5.
Treatment of Shingles in Kids
- Antiviral drugs such as valacyclovir, famciclovir, and acyclovir can be used to treat herpes zoster in children 4, 6, 7, 5.
- Valacyclovir is more effective than acyclovir and equally effective as famciclovir at hastening the healing of zoster-associated pain and postherpetic neuralgia (PHN) 6, 7.
- The efficacy of valacyclovir and famciclovir in herpes zoster has been compared in several studies, with valacyclovir showing significant benefits in reducing pain scores and accelerating the resolution of zoster-associated pain 7.