Shingles vs chickenpox: have you ever been curious about the difference? They are often confused, but knowing what they are can be crucial.

Shingles and chickenpox are two viral infections caused by the varicella-zoster virus. While they share some similarities, such as a characteristic rash, these conditions have their own distinct symptoms, patterns of transmission, and potential complications.

Understanding the differences between shingles vs chickenpox is crucial for accurate diagnosis and appropriate treatment.

In this article, we’ll explore the key features of each infection so that you can identify which one you may be experiencing or learn how to prevent them from occurring in the first place.

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What are Shingles vs Chickenpox?

Chickenpox is a contagious viral infection that causes a blister-like rash that spreads all over the body. It is caused by the varicella-zoster virus, which is the same virus that causes shingles.

In the 1990s, chickenpox was quite common, with research showing that up to 4000 million people in the US could contract the virus each year.

Thank goodness, this is not the case today since vaccines have been introduced, and the number has dropped to about 350,000 people each year.

According to research, chickenpox is most common in children under the age of 10 but can occur at any age, including in adults.

Adults are, however, often immune (up to 90%) since they developed the condition in childhood. Most affected adults are those that have never had chickenpox before.

Once you’ve had chickenpox, the virus stays dormant in the body. Shingles occurs when the virus is reactivated.

What Causes Chickenpox vs Shingles?

Chickenpox:

Chickenpox is caused by varicella-zoster virus after coming into contact with other people that have the virus.

The virus can move from one person to another through sneezing, breathing, and coughing. When someone sneezes or coughs, they release droplets that contain the varicella virus.

If you’ve never had chickenpox or have never been immunized and you inhale the droplets, they enter the lungs and move to the bloodstream, then travel to the skin resulting in various symptoms.

Doctor examining patient with chickenpox isolated on white background

Shingles:

Shingles is also known as herpes zoster. When you have chickenpox, your immune system fights it until the symptoms fade away.

However, the virus always remains in the body and often hides in the nerve tissues near the spinal cord and the brain, where it stays inactive for years, often a lifetime.

Years later, the virus can be reactivated and travels along the nerve fibers to the skin, where it now causes shingles.

The reactivation of this virus is often common in adults with weak immune systems. The risk also increases with age, with about half the cases occurring in adults above the age of 50.

That being said, only 10 percent of people that have had chickenpox at an early age will develop shingles.

The good news, though, is that shingles cannot be transmitted from one person to another, whether through direct contact or in the air. However, exposure during the blister phase can cause chickenpox in susceptible individuals.

Only a few people can escape the infection after exposure if not immunized. That’s how contagious the virus can be!

Symptoms of Shingles vs Chickenpox:

Here are some key differences between the symptoms of shingles and chickenpox:

1. Rash

Both shingles and chickenpox cause a rash on the skin. However, the appearance of the rash differs between the two illnesses.

Chickenpox typically presents as small, itchy blisters all over the body that eventually scab over and heal.

In contrast, shingles usually cause a more localized rash that follows a nerve pathway on one side of the body.

2. Pain

One of the hallmark symptoms of shingles is severe pain or burning in the area where the rash is located. This pain can be intense enough to interfere with daily activities and may persist even after the rash has healed.

By contrast, while some children with chickenpox may experience mild discomfort or itching from their blisters, it is usually not as severe or long-lasting as shingles pain.

3. Fever

Many people with chickenpox will develop a fever along with their other symptoms. Shingles may also cause fever in some cases, but it tends to be less common than with chickenpox.

4. Fatigue

Both illnesses can leave you feeling tired and run down, but this symptom tends to be more pronounced in people with shingles than in those with chickenpox.

5. Average age

Chickenpox is usually a childhood disease, while shingles often occur in adulthood after the reactivation of the varicella-zoster virus that causes chickenpox. It usually occurs later in life when the immune system weakens due to age or illness.

6. Severity

While both illnesses can cause discomfort and pain, most cases of chickenpox are mild and self-limited.

On the other hand, some individuals with shingles may experience long-term nerve pain called post-herpetic neuralgia, which can last for months or even years after an episode.

7. Infection duration

Chickenpox typically lasts about 5-7 days, while shingles can last for 2-4 weeks.

8. Sensory changes

Shingles can cause tingling, numbness, or increased sensitivity in the affected area before the rash appears.

close up of skin with shingles, herpes zoster

Risk Factors of Shingles vs Chickenpox:

Shingles

Shingles can affect anyone who has previously had chickenpox. However, certain factors can increase your risk of developing it:

  • Age: The CDC states that those who are 50 years of age and older are at a higher risk for developing shingles. This is because as we age, our immune system begins to weaken. One study also found that adults 65 years old and more had an increased risk of shingles by up to 3 times compared to those with less than 65 years.
  • Weakened immune system: If your immune system is weak due to conditions like HIV/AIDs or certain medical treatments (such as radiation therapy or chemotherapy), you may be more susceptible to developing shingles. 
  • Stress: High levels of stress can weaken your immune system and make you more vulnerable to infections like shingles.
  • Gender: Women tend to have a slightly higher risk of developing shingles than men. Pregnant and post-menopausal women are the most culprits.
  • Genetics: Some people may be genetically predisposed to developing shingles. Although it’s not well understood, research shows that if a family member has had the condition before, it increases your chances of developing it. Other studies have, however, do not show the same results.

Chickenpox

  • Age: Young children below the age of 10 are more susceptible to chickenpox
  • Not vaccinated: People who have not received vaccination against chickenpox are at a higher risk of contracting the disease.
  • Close contact with infected persons: Chickenpox spreads through direct contact with an infected person or through respiratory secretions like coughing and sneezing.
  • Weakened immune system: Individuals with weakened immune systems due to chronic illnesses such as HIV/AIDS or cancer treatments such as chemotherapy may be more prone to contracting chickenpox.
  • Pregnancy: Pregnant women who haven’t had chickenpox before may be at risk.

Treatment of Shingles vs Chickenpox:

Treatment approaches for chickenpox and shingles differ slightly. For chickenpox, the focus is mainly on managing symptoms and relieving itching. 

Over-the-counter medications, such as antihistamines and calamine lotion may be recommended. In severe cases or for high-risk individuals, antiviral medications can be prescribed.

For shingles, treatment involves antiviral medications such as acyclovir, valacyclovir, or famciclovir, which can help reduce the severity and duration of the outbreak if taken early. 

Pain medications, anti-inflammatory drugs, and topical creams may also be used to alleviate discomfort. 

For individuals experiencing postherpetic neuralgia, additional treatments like nerve blocks, antidepressants, or anticonvulsant medications may be prescribed.

Complications of Shingles vs Chickenpox:

Chickenpox

In rare cases, chickenpox can lead to severe complications such as:

  • Bacterial infections: Scratching the itchy blisters can lead to bacterial infections on the skin or in other parts of the body. This is especially common in children.
  • Pneumonia: Infection of the lungs can occur in adults or people with weak immune systems.
  • Blood infection (sepsis)
  • Bleeding problems (hemorrhagic complications)
  • Dehydration
  • Encephalitis: This refers to brain inflammation. It can often lead to seizures, coma, or permanent brain damage.
  • Reye’s syndrome: This is a rare but life-threatening condition affecting children and teenagers who take aspirin during a viral infection.

Shingles

While shingles usually go away on their own after a few weeks, some people may experience complications. 

Common complications of shingles can include: 

  • Postherpetic neuralgia (PHN): This is the most common complication of shingles. It occurs when the pain from shingles continues for months or even years after the rash has healed. PHN can be very debilitating and affect daily activities.
  • Vision problems: Shingles can sometimes affect the eyes, causing vision problems such as blurry vision, sensitivity to light, or even blindness if left untreated. 
  • Hearing loss: Shingles can also affect the ears, sometimes leading to hearing loss.
  • Bacterial infections: If shingle blisters are not properly treated, they can result in bacterial skin infections.

Senior woman applying cream and posing at home

Prevention of Shingles vs Chickenpox

Chickenpox can be prevented by vaccination. The varicella vaccine is routinely recommended for children and is highly effective in preventing the disease. Vaccination also reduces the risk of developing shingles later in life.

To prevent shingles, a separate vaccine called the shingles vaccine or herpes zoster vaccine is available. This vaccine is recommended for individuals aged 50 and older and can reduce the risk of shingles and its complications.

It’s important to consult a healthcare professional for accurate diagnosis, treatment options, and preventive measures related to chickenpox and shingles, as they can provide personalized advice based on individual circumstances. 

Frequently Asked Questions (FAQs):

Is shingles more serious than chickenpox?

Shingles are considered to be more serious than chickenpox, especially in adults. Chickenpox is a common childhood illness that typically causes fever and an itchy rash all over the body. It can also lead to complications such as pneumonia or inflammation of the brain, but these are rare.

On the other hand, shingles (also known as herpes zoster) is a viral infection that occurs when the varicella-zoster virus becomes reactivated in adulthood. This usually happens when someone’s immune system weakens due to age, illness, or stress.

The symptoms of shingles include pain and tingling on one side of the body or face, followed by a blistering rash. Shingles can cause severe pain that can last for a prolonged period of time.

Can you get shingles from someone with chickenpox?

No. You cannot catch shingles from someone with chickenpox. However, you can catch chickenpox from someone with shingles if you’ve not been immunized for chickenpox.

Can you get shingles if you’ve never had chickenpox?

When someone has chickenpox, the virus remains dormant in their nervous system for years after they recover. It can reactivate later in life and cause shingles.

Therefore, if you’ve never had chickenpox, you cannot get shingles since the virus is not dormant in your body.

However, it’s important to note that anyone who has had the chickenpox vaccine may still develop shingles because the vaccine does not completely prevent the virus from becoming active again later in life.

Can you get chickenpox twice?

Yes, you can get chickenpox twice. However, it is much less common to get chickenpox a second time than it is to get it the first time.

The reason why it is less common is that the majority of people who get chickenpox will develop immunity to the virus after they have had the disease. This means that their bodies will be able to fight off the virus if they are ever exposed to it again.

However, the virus that causes chickenpox can remain inactive in your body for many years. If the virus reactivates, it can cause a related condition called shingles. Shingles shares some similarities with chickenpox but the 2 are quite different. Plus the effects of shingles may be more severe.

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Final Thoughts

Shingles and chickenpox are both caused by the varicella-zoster virus but present different symptoms and affect different age groups. 

While chickenpox is a common childhood illness that can be prevented through vaccination, shingles mostly affect older adults who previously had chickenpox.

Although there is no cure for either condition, treatment options are available to alleviate symptoms and prevent complications. 

It’s important to seek medical attention if you suspect you have shingles or chickenpox, as prompt diagnosis and treatment can significantly affect recovery time and overall outcome.

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