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Shingles in a Seven-Year-Old
Q: My seven-year-old daughter has shingles. The doctor said it is unusual for a child to get this. Should I be worried that it's occurred because of an underlying problem more serious than shingles? Is it OK for children to take the medication that adults get for this? My daughter doesn't seem to be in a lot of pain, but it does itch.
A: I do not believe there is cause for alarm. It is true that shingles is much less common in children under ten years of age, and that we do see shingles more often in people whose immune systems are suppressed or not functioning normally. However, assuming your child has been healthy up to this point, there is little reason to think that your child necessarily has a problem with her immune system.
Someone with shingles usually has had chickenpox in their past. This same virus hangs around in certain nerve roots in the body after chickenpox and then is reactivated. The rash tends to be localized and follows the direction of a nerve. The typical course of the disease is mild, so using medication in generally healthy children is not usually necessary. The medication is reserved for those individuals with known immune problems and/or severe disease involving more than just the skin. The severity of shingles increases as patients age. We rarely see the pain or eye problems that can complicate the disease in children.
Treating the symptoms usually is all that is necessary. Supportive treatment with soothing, drying lotions may be helpful. Medicine by mouth to relieve itching works well. Watch for superinfection with bacteria germs caused by scratching the skin. Remember, too, that someone with shingles is contagious to someone who has never had chickenpox.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.