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Itchy & Scratchy: Understanding Chickenpox & Shingles

 

There are two types of people in the world: Those who had chickenpox as kids and those who didn’t. If you fall into the first group, you probably think you’re off the hook — but you’d be wrong. Anyone who’s had chickenpox is at risk for developing shingles, a more painful version of chickenpox, later in life. Fun times, right? And what about those lucky ones who escaped catching chickenpox in elementary school? Well, if you weren’t vaccinated, then you could still get chickenpox as an adult (hey, at least you’d get to stay home from work for a few days). Keep reading for everything you need to know about adult chickenpox and shingles and how each are treated.

Refresh my memory: What is chickenpox again?

Chickenpox (also called varicella) is a mild yet super-contagious viral infection, whose medical name is varicella-zoster. (We should clarify that in some cases, chickenpox can be fatal — usually in infants or seniors.) You’ll know you have chickenpox if you have a mild fever and body aches, then develop an itchy rash made up of tiny blisters full of fluid. The infection will make its presence known on your skin two to three weeks after you’ve been exposed to it.

What does chickenpox look like?

The rash, which typically lasts from 5 to 10 days, changes as it heals. You’ll first notice raised red or pink bumps popping up over the course of a few days. These bumps will become filled with fluid and then they’ll burst open. Finally, they’ll crust and scab over before healing. You’ll continue to be contagious until all of the bumps have crusted over — so load your Netflix queue to entertain yourself while you’re stuck inside!

Eek! I’ve never had chickenpox before. What should I be aware of?

The chickenpox virus doesn’t waste any time—it’s highly contagious and spreads ridiculously fast. It’s transmitted via direct contact—say, you touch someone’s rash—or via droplets from coughing or sneezing that get into the air. If you’ve never had chickenpox or the vaccine—and you work with kids or have kids at home—you’re at a higher risk for catching the varicella-zoster virus.

How do I prevent chickenpox?

The vaccine is the best way to protect yourself against chickenpox, and all children are now recommended to be vaccinated at age 1 and age 5. Vaccination is to prevent severe cases that lead to hospitalization, and will prevent shingles later on. Now, if you had chickenpox as a child, the good news is you can’t get it again (the bad news is, you can get shingles — more on that in a minute).

So, I didn’t get the vaccine and I ended up with chickenpox. How do I treat it?

Chickenpox is uncomfortable but not the end of the world. You can take Tylenol and/or Advil for aches and fever, and an antihistamine to alleviate some of the itchiness until the infection is gone. Cool oatmeal baths and calamine lotion may also help. Just don’t scratch! This will delay healing and may even leave you with scars.

OK, enough about chickenpox. What the heck is shingles?

Shingles (also called herpes zoster) is another infection caused by the varicella-zoster virus. Basically, once you’ve had chickenpox, the virus never really goes away. Um, what?! The virus actually lies dormant within your body — more specifically, in the nerve tissue near your spinal cord and brain. Certain factors can cause the virus to reactivate later on in life, leaving you with shingles.

Just because I had chickenpox doesn’t mean I’ll necessarily develop shingles, does it?

No—not everyone who’s had chickenpox will get shingles. Whew. That being said, experts aren’t 100% sure why some people get shingles. It’s possible that the virus can be reactivated as your immune system weakens with age—that’s why people over 50 and those who have immune-lowering diseases like HIV are at higher risk.

How will I know if I have shingles?

Think of shingles as a souped-up version of chickenpox. If the virus reactivates, it’ll travel along your nerve pathways until it reaches your skin. You’ll develop an intensely painful, itchy, tingly, and sensitive rash that’s confined to one side of your body. Shingles most commonly shows up as a band around the right or left side of the torso, but it can appear anywhere on your body — including on your face or in your eyes and ears. Like with chickenpox, the bumps will fill with fluid, burst open, and crust over. You may even notice pain in that area a few days before the rash actually forms.

Can I pass shingles on to someone else?

Here’s where things get a little complicated. You can’t give someone else shingles, but you can give them chickenpox. If you have shingles and you come into contact with someone who’s never had chickenpox or hasn’t been vaccinated against chickenpox, they could get it from you. As with chickenpox, it’s a good idea to stay holed up until your rash crusts over, at which point you won’t be contagious anymore.

How do you treat shingles?

If you think you have shingles, head to your M.D. pronto. They’ll prescribe you an oral anti-viral med that will make the virus heal more quickly. You’ll want to start that dose of meds ASAP because shingles can lead to some pretty nasty complications when left untreated, including pain that lasts even after the rash fades (this is known as postherpetic neuralgia). Because shingles is often painful, your doc may give you a numbing cream with lidocaine. Applying cool compresses or taking cool baths may also help.

Shingles sounds pretty crappy — is it at least a one and done deal like chickenpox?

Sadly no. While you probably won’t get it more than once in your life, it is possible that the virus could reactivate again.

Is there anything I can do to prevent getting shingles?

If you’ve had chickenpox before, there’s not really much you can do. While there is also a shingles vaccine, it’s only available to people over 50. Womp, womp. But if you’ve never had chickenpox or the vaccine, getting the vaccine will curb your risk of chickenpox and shingles. (Remember: You can’t get shingles if you’ve never had chickenpox.)

Dr. Betty Yan, a dermatology resident at Southern Illinois University School of Medicine (SIU), helped contribute to the accuracy of this story.

1 Comment
  1. I hate to disagree with Dr. Pimple Popper, but I think there are some inaccuracies in your article. My understanding is that anyone who has had chickenpox OR the vaccine, can develop shingles. I think at first everyone thought you couldn’t get shingles if you had the chickenpox vaccine, but my 25 yo brother has been diagnosed twice with shingles, once as a child and again a few years ago. He had the chickenpox vaccine as a preschooler. Both episodes of shingles were diagnosed by a pediatric infectious disease specialist we have known our whole lives.

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