Chickenpox and shingles are both diseases that occur in the herpes zoster family. They are caused by the same virus, which is also called varicella-zoster or just VZV.
There are various differences between chickenpox and shingles, which include:
While transmission of the varicella-zoster virus can occur via droplets, aerosol, direct contact or by touching contaminated items (World Health Organization, 2014) such as dressings, sheets or clothes soiled with discharge from a person who has either chickenpox or shingles, it is not possible for the shingles disease to be transmitted in such a manner. Instead, a newly infected person who has never had chickenpox or received the varicella vaccination before may develop chickenpox. The virus spreads through the bloodstream, which goes on to infect the skin and internal organs. Shingles develop as a result of reactivation of the varicella-zoster virus remaining dormant in the dorsal root ganglia along the spine after symptoms of chickenpox subside. This is usually seen in older adults or people with weakened immune systems (Duff, 2020).
Pattern of rash
Chickenpox usually presents as a rash of itchy blisters on the body, head to toe. In contrast, shingles typically present itself as painful skin lesions on one side of the body following a nerve root distribution along an infected dermatome.
The main stages in chickenpox are:
- Initial symptoms: Feeling unwell, body aches, fever, and headache are common when infected with chickenpox.
- Small red bumps on the body: These usually develop on the torso or face first and eventually cover the entire body.
- Bumps develop into blisters: These bumps will start to fill with fluid and become blisters.
- Blisters scab over and heal: After the blisters scab over, one is no longer contagious.
The main stages of shingles are:
- Initial symptoms: Like chickenpox, it is common to develop fever, headaches, or body aches before developing the rash.
- Tingling pain: It is reported that one will often feel tingles, pain, or itchiness in the area the rash will develop.
- Burning rash: Rashes will start to develop anywhere from 1 to 5 days after the tingling starts
- Blisters: The rash will start to blister and then crust over. One may still suffer from mild or extreme pain after the rash is gone due to a condition called post-herpetic neuralgia (PHN). Additionally, it is possible to develop shingles more than once, but it is rare (Brennan, 2021).
Chickenpox tends to be a milder illness that typically affects children aged 4 to 10, whereas shingles may be more severe and usually seen in older adults aged above 60.
Complications as a result of chickenpox include:
- Bacterial infection of cuts and breaks in the skin lesions
- Inflammation or infection of the brain
- Possible fetal defects in pregnant women
Complications as a result of shingles include:
- Long term nerve pain
- Full or partial blindness (if shingles spread to the eyes)
- Loss of hearing
- Brain inflammation
While the varicella-zoster virus causes both chickenpox and shingles, shingles is caused by the reactivation of varicella-zoster virus in a person who previously had chickenpox. As a result, shingles is known to be more severe as compared to chickenpox. The easiest way to distinguish between chickenpox and shingles is via the pattern in which the rashes present themselves. Chickenpox rashes are usually present over the entire body, while shingles are only present on one side. To prevent complications resulting from either disease, one should seek medical attention as soon as one can.
Brennan, D. (2021, March 1). What’s the difference between chickenpox and shingles? MedicineNet.
Duff, B. L. (2020, March 4). Why Does the Varicella Zoster Virus Reactivate as Shingles? Drug Topics.
World Health Organization. (2014, April 30). Varicella. World Health Organization.