Chickenpox vs. Shingles: Causes, Symptoms, and Treatments

Can you get shingles if you never had chickenpox? And can you get chickenpox as an adult? All your questions are answered.

Chickenpox and shingles are viral infections that cause red, bumpy, or blistery rashes on the skin. The varicella-zoster virus (VZV) causes both chickenpox and shingles.

Although the infections are intricately related, there are key differences between chickenpox and shingles. And if you're not careful, you could end up with both.

Here's what you need to know about chickenpox and shingles, including symptoms, causes, and treatments for both illnesses.

What Causes Chickenpox and Shingles?

VZV causes both chickenpox and shingles. People commonly come into contact with the virus during childhood. Once you've had chickenpox, VZV hangs around in your body, dormant in the nerve cells of your spinal cord.

If VZV reactivates, a person develops shingles. Shingles is a condition affecting skin areas supplied by spinal nerve cells in which the virus lays dormant. Shingles causes a painful red rash.

Symptoms of Chickenpox and Shingles

Despite sharing a viral cause, chickenpox and shingles have decidedly different symptoms. But remember that you should closely monitor both chickenpox and shingles symptoms for signs of healing. You're potentially contagious and can pass both viral conditions to others until your rash heals.

Chickenpox Symptoms

Chickenpox causes an itchy rash of pink fluid-filled blisters. Those blisters first appear on the chest, back, and face and then spreads all over the body. Eventually, the blisters form scabs. 

Additionally, chickenpox causes other symptoms, usually lasting four to seven days, like:

  • Fatigue
  • Fever
  • Headache
  • Loss of appetite

Shingles Symptoms

In contrast, a shingles rash is very painful. The rash usually develops in areas where spinal nerve cells supply the skin. Several days before the rash appears, people often have pain, itching, or tingling in the area where the rash shows up.

Additionally, other shingles symptoms, which last about five days, include:

  • Fever
  • Chills
  • Headache
  • Upset stomach

A few days after the rash forms, small, fluid-filled blisters pop up on the skin. The blisters ooze and then eventually dry out and crust over. The blisters form scabs in seven to 10 days.

Keep in mind that you should closely monitor both chickenpox and shingles rashes for signs you're healing. You're potentially contagious and can pass both skin conditions to others until the blisters scab over.

Treatment for Chickenpox and Shingles

Treatments for chickenpox and shingles help manage painful, itchy spots on the skin. Those treatments may include home remedies, antiviral medications, or pain medicines, depending on your illness and the severity of your symptoms.

Chickenpox Treatments

There's no specific treatment for chickenpox. But some remedies can relieve symptoms and prevent skin infections. Some potential home remedies include:

  • Using calamine lotion to reduce itching
  • Taking a cool bath with baking soda, uncooked oatmeal, or colloidal oatmeal added to the water
  • Keeping fingernails trimmed short to avoid scratching the blisters

Shingles Treatments

In contrast, treatments and remedies for shingles include:

  • Antiviral medicines, like acyclovir, valacyclovir, and famciclovir
  • Over-the-counter (OTC) or prescription pain medicines
  • Wet compresses
  • Calamine lotion
  • Baking soda, uncooked oatmeal, or colloidal oatmeal baths

Usually, people recover from shingles in a few weeks to a few months. According to the AAD, early treatment with antiviral medicines can shorten the length and severity of illness. Also, antiviral medication can help avoid any complications.

One of the most common complications of shingles is post-herpetic neuralgia (PHN). PHN causes long-term nerve pain, lasting as long as several years after shingles. PHN occurs in about 10% to 18% of people with shingles, mostly impacting older adults. OTC capsaicin cream and some prescription medications, like gabapentin, may be helpful for PHN.

Can Vaccines Prevent Chickenpox and Shingles?

Both chickenpox and shingles vaccines contain a live, weakened strain of VZV. So, some people may experience symptoms after getting vaccinated. 

People with weak immune systems from a health condition or certain medications should consult a healthcare provider. They can help determine whether it's safe to receive either of the vaccines.

Also, you could, in theory, be contagious after getting the chickenpox or shingles vaccine. According to one study published in 2020 in Pediatrics, researchers found that vaccinated people who developed a rash could transmit VZV to others.

So, if you receive the chickenpox or shingles vaccine, monitoring your symptoms and avoiding contact with high-risk people is important.

Chickenpox Vaccine

During the mid-1990s, the chickenpox vaccine became available. The CDC recommends that children receive the first dose between 12 and 15 months and the second between 4 and 6 years old. When children receive both doses, the vaccine is over 90% effective at preventing illness.

The CDC also suggests that children, adolescents, and adults who have never had chickenpox get the vaccine. Anyone 13 and older can get their two doses anytime, as long as they're at least 28 days apart.

Per the CDC, from 1995 to 2020, the chickenpox vaccine prevented about 91 million illnesses and 2,000 deaths. Before mass vaccination campaigns, there were about four million cases of chickenpox yearly. In contrast, as of 2020, there are less than 150,000 cases of the illness yearly.

Shingles Vaccine

Beginning in 2006, the vaccine Zostavax, aimed at preventing those who had chickenpox from later getting shingles, became available for older adults. And in 2017, the Food and Drug Administration approved a second two-dose vaccine called Shingrix. Shingrix is over 90% effective at preventing shingles.

The CDC recommends that all healthy adults aged 50 and older receive Shingrix. To be effective, you will require two doses, anywhere from two to six months apart. 

Developing shingles after receiving the vaccine is possible. Still, the vaccine usually decreases the severity of the illness.

Can You Get Shingles If You've Never Had Chickenpox?

Not everyone who gets chickenpox ends up later getting shingles. Generally, you can't get shingles if you haven't had chickenpox first. But some people immunized with the chickenpox vaccine may develop shingles.

In the United States, about one in three adults will develop shingles in their lifetime. Researchers do not completely understand why some people develop shingles while the virus lies dormant in others. 

The chances of getting shingles and having complications increase after age 50. Additionally, people are more likely to get shingles if they have the following conditions:

  • Cancer, especially leukemia or lymphoma
  • Human immunodeficiency virus (HIV)
  • Bone marrow or organ (kidney, heart, liver, and lung) transplant recipients
  • Medications that suppress the immune system

Can You Get Chickenpox as an Adult?

Mostly, chickenpox occurs in children younger than 10. But if you never had chickenpox and come into contact with VZV as an adult, you can still come down with the illness.

Chickenpox is usually milder in children than in adults. Chickenpox may lead to complications in some adults, especially those with weak immune systems. Although rare, some chickenpox complications include pneumonia, brain swelling, or sepsis.

Can You Get Chickenpox a Second Time?

While unusual, a person can get chickenpox a second time. In most cases, once you've had chickenpox, you have lifelong immunity. In fact, since the widespread use of a chickenpox vaccine, many children don't get chickenpox at all.

Can You Get Shingles More Than Once?

You can develop shingles more than once. As with chickenpox, VZV lays dormant and may later reactivate. A healthcare provider may recommend Shingrix for high-risk adults older than 50 who have already had shingles.

For others, health insurance may not cover Shingrix before 50. So, you'll have to discuss the risks and benefits with a healthcare provider.

A Quick Review

Although VZV causes both chickenpox and shingles, the symptoms are very different. With vaccines available for both illnesses since the mid-1990s, fewer people have developed chickenpox than before. Eventually, the chickenpox vaccine can help reduce the number of people who can develop shingles. 

And if you've had chickenpox, Shingrix can reduce your risk of shingles. Talk with a healthcare provider if you have questions about whether you should get the chickenpox or shingles vaccine.

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