Shingles is a viral infection caused by the varicella-zoster virus (VZV). A person can only have shingles if they have had chicken pox.

A person with shingles may transmit VZV, which can cause chickenpox in someone who has never had chickenpox or has not received the chickenpox vaccine.

In rare cases, a person can get shingles from another person with shingles if they have direct contact with the shingles rash. However, only a person who has had chickenpox can develop shingles later in life.

This article explores shingles and chickenpox in more detail, including their differences, and who can get them. It also discusses treatment, prevention, and when to consult a doctor.

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Shingles and chickenpox are both caused by VZV, but they are not the same illness.

Chickenpox is a highly contagious disease. It typically occurs in children, but anyone can get it.

Shingles is also known as herpes zoster. It is a viral infection caused by the reactivation of VZV that has remained in the person’s body after they have recovered from chickenpox. It commonly affects older adults and is rare in children.

Unlike a chickenpox rash that typically spreads throughout the body, a shingles rash spreads through a limited area. The blistery rash follows one or two adjacent stripes of skin area supplied by a nerve, typically on one side of the body or face.

Shingles can be painful and may cause complications, such as vision loss. However, it is rarely life threatening.

In contrast, chickenpox can be more serious and potentially life threatening. Some serious complications of chickenpox include:

However, the Centers for Disease Control (CDC) state that healthy people are at a lower risk of developing complications from chickenpox. Furthermore, the risk of death is much lower due to the success of the chickenpox vaccine program.

A person can get VZV, which causes chickenpox, from someone with shingles if they have never had chickenpox or the chickenpox vaccine.

People cannot get shingles without having recovered from chickenpox. The reactivation of VZV in a person’s body causes shingles.

There is also a low risk of a person developing shingles after having direct contact with a shingles rash.

The chickenpox virus is more likely to spread VZV to others than shingles.

People who have never had chickenpox or received the chickenpox vaccine have the highest risk of contracting chickenpox regardless of age.

Chickenpox is highly contagious and spreads very easily, especially in close contact areas such as daycares and schools. A person with chickenpox affects up to 90% of the people in close proximity who are not immune to chickenpox.

If a child is in close proximity to another child with chickenpox, they may still be protected if they receive a chickenpox vaccination within 3–5 days of exposure. One dose of the vaccine is 85% effective at preventing varicella infection and almost completely protects a child from severe infection.

The following individuals are at a high risk of severe varicella infection:

  • people who are immunocompromised, such as those with leukemia and lymphoma, as well as individuals taking immunosuppressive medications such as steroids and chemotherapy drugs
  • newborn children of parents with varicella, 5 days prior and up to 2 days after delivery
  • premature babies
  • pregnant people

Once a person has had chickenpox, they will have lifelong immunity, meaning they will not get chickenpox again.

About 1 in 3 Americans will get shingles in their lifetime. Everyone who has had chickenpox or has had a varicella vaccination is at risk of getting shingles.

However, the risk of developing shingles increases as a person’s VZV-specific cell-mediated immunity declines. This decline in immunity may be due to increasing age and medical conditions and medications that can affect a person’s immune system. These include:

It is also important to note that females are more likely to develop shingles than males. Furthermore, Black people are about 50% less likely to develop shingles than white people.

Both shingles and chickenpox have no cure and tend to be self-limiting. Most people can allow the infections to run their course and wait for them to resolve entirely over several days without complications.

Chickenpox tends to resolve within 4–7 days, while shingles typically lasts 2–4 weeks. People may consider taking non-aspirin medications, such as acetaminophen, to help manage fever from chickenpox. Doctors may also prescribe antihistamines to help relieve itching.

Antiviral medications for shingles, including acyclovir, famciclovir, and valacyclovir, can shorten the length and intensity of the condition. Furthermore, antiviral medications are most effective when taken within 72 hours after a rash appears.

Doctors may also advise a person takes medications to relieve pain and discomfort caused by shingles.

Calamine lotion, wet compresses, and cool baths with colloidal oatmeal or baking soda can also help reduce itching from chickenpox and shingles.

The best prevention against chickenpox and shingles is receiving a vaccine. The recombinant zoster vaccine (RZV), called Shingrix, can protect a person against shingles, post-herpetic neuralgia (PHN), and other complications.

The CDC recommends Shingrix for healthy adults 50 years and older. It also recommends that adults aged 19 and above with weak immune systems be vaccinated.

The CDC also advises that children, adolescents, and adults who have never had chickenpox should receive 2 doses of the chickenpox vaccine. There are two vaccines for chickenpox available in the United States: Varivax and ProQuad.

The CDC recommends that a person who has chickenpox or shingles should seek prompt treatment if they:

  • are at a higher risk of complications. This may be due to:
    • pregnancy
    • having a weakened immune system
    • being younger than 1 year or older than 12 years
  • have a high fever that rises above 102°F (38.8°C) or lasts longer than 4 days
  • have a rash that may be infected — for example, very red, warm, tender, or leaking pus
  • have difficulty walking
  • have a severe cough
  • have a stiff neck
  • vomit frequently
  • have difficulty waking up or feel confused
  • have difficulty breathing
  • have severe abdominal pain
  • have a rash with bleeding or bruising

Shingles and chickenpox are two conditions caused by VZV. However, their course and symptoms are not the same.

Shingles can spread VZV, which causes chickenpox. In rare cases, a person may contract shingles from another person with shingles.

Not everyone is at risk of getting chickenpox. Those who have never had it or have not received a vaccine are most likely to get it.

The best way for people to prevent chickenpox and shingles is to get vaccinated. A person should consider speaking with a healthcare professional if they are at higher risk of complications from either condition.