Shingles vs. Chickenpox: How Are They Connected?

Shingles (varicella-zoster) and chickenpox (varicella) are infectious diseases that are both caused by the same virus called the herpes-zoster virus (HZV). Although some symptoms of chickenpox and shingles are similar, they are not considered the same illness.

Chickenpox is typically a childhood disease that is usually less severe than shingles. When a child gets chickenpox, the body fights off the symptoms of the virus, but the virus does not completely go away; it goes into the base of a nerve and stays there in a dormant stage for life. This is called latency. 

If the HZV virus becomes reactivated (changed from the latent state to an active state), it can cause shingles. If reactivation of the HZV (from the latent stage of chickenpox) occurs, it typically happens at about age 50 or older. That said, most people don't ever experience reactivation, and when they do, shingles is limited to one small area.

Symptoms of Shingles vs. Chickenpox

Signs and Symptoms of Chickenpox

The symptoms of chickenpox usually last approximately four to seven days; the most common symptom is an itchy, painful rash with fluid-filled vesicles, or blisters, that turn into scabs. The rash often breaks out on the chest first, then it may spread to other areas of the body (including the back, face, eyelids, mouth, and even the genital area).

It typically takes about seven days for all the blisters to turn into scabs. Eventually, much of the skin may be entirely covered with blisters and scabs.

Symptoms that often occur a day or two before the rash starts to develop include:

• Fatigue
• Loss of appetite
• Fever
• Headache

Note: In children, the rash is usually the initial sign of the disease, and symptoms such as fatigue and loss of appetite often do not occur before the rash breaks out.

Signs and Symptoms of Shingles

Symptoms of shingles include:

• Hypersensitive area of the skin where the rash is preparing to break out that may itch or feel tingly
• Headache
• Fatigue (may occur during the initial phase of shingles, before the rash occurs)
• Rash that appears on the trunk of the body
• Blisters that appear in clusters
• Mild itching or discomfort from mild to intense pain
• Vesicles turn yellow and begin to dry and crust over (approximately seven to 10 days after the initial breakout)

The rash that develops from shingles typically heals in two to four weeks, often leaving pigment changes and pitted scarring.

Other Symptoms/Complications

The most common complication of shingles is a condition called postherpetic neuralgia (PHN), which involves pain that persists (more than 90 days after the onset of the rash) in the area where the rash once was. This pain can last for up to weeks, months, or sometimes even years.

As a person ages, the risk of having PHN after a shingles breakout increases.

Approximately 10% to 13% of people 60 years and older with shingles will get PHN. PHN is rare in people younger than 40 years old.

Are Chickenpox and Shingles Contagious? 

Once a person is exposed to chickenpox or shingles, the incubation stage (the time it takes from initial exposure to the start of symptoms) ranges from 10 to 21 days.

Chickenpox and shingles are the most contagious after the incubation period, when symptoms of blisters occur.

How Contagious Is Chickenpox?

Chickenpox is considered a very contagious viral infection. The virus is airborne, spread by breathing in particles that arise from the blisters. It can also be contracted by directly touching the fluid that comes from the vesicles (skin lesions).

Chickenpox is considered contagious from one to two days before the rash breaks out until the blisters have all formed scabs. Once all the scabs have formed, the disease cannot be spread.

How Contagious Is Shingles?

Although shingles cannot be spread from one person to another, a person who has an active breakout (in the vesicle or blister stage) of shingles can spread the chickenpox virus to a person who has not had chickenpox before.

It’s important to note that the only way to get shingles is from a reactivation of the chickenpox virus that has gone dormant; it is not contagious as far as being spread from person to person as shingles.  

In other words, if you have never had chickenpox, you cannot contract shingles from someone who has it, but the person with shingles could transmit the chickenpox virus to you.

Vaccination and Prevention

Chickenpox Vaccination

There are two vaccine options for chickenpox:

1. Getting two doses of the chickenpox (varicella) vaccine
2. Getting a combination vaccine called the MMRV (which includes a vaccine for measles, mumps, rubella, and varicella/chickenpox)

Shingles Vaccination

At age 50 and older, the Centers for Disease Control and Prevention (CDC) recommends that healthy adults should get a shingles vaccine called the recombinant zoster vaccine (RZV, Shingrix) to prevent shingles and long-term complications from shingles.

Prevention

There are several preventive measures to avoid infection from the chickenpox virus, including:

• Get vaccinated (this is the best prevention method).
• Avoid direct contact with anyone infected with shingles or chickenpox.
• If you have shingles or chickenpox, cover the rash area when having contact with other people.
• If you have shingles or chickenpox, avoid scratching or otherwise touching the rash.
• Follow strict handwashing guidelines according to the CDC.