Shingles vs. Chickenpox. What’s the Difference?

You may have heard that only kids can get chickenpox, while only older adults can get shingles. Or perhaps you’ve heard it said that it’s the same virus, but it’s given a different name, whether the patient is a child or a senior. We’re here to set the record straight on the differences between shingles and chickenpox so that you can protect your loved ones, of all ages, from the discomfort that comes from this itchy, painful condition.

What is Chicken Pox?

The varicella-zoster virus causes the infection we know as chickenpox. Symptoms include an itchy rash marked by tiny, fluid-filled red blisters. The rash often appears 10 to 21 days after virus exposure and typically lasts from five to ten days. During the total period in which symptoms are present, the rash typically evolves through three distinct phases:

  • During the first several days, the rash often appears as raised pink or red papules (bumps)
  • Next, small fluid-filled vesicles (blisters) form over a day, which then break and leak
  • The broken blisters then scab over, taking several days to heal

Since new bumps continue to form until the virus is destroyed, patients may have bumps on their skin in all three phases at once.

Other symptoms of chickenpox include:

  • Fever
  • Loss of appetite
  • Headache
  • Tiredness and malaise

Chickenpox patients can spread the virus to others up to 48 hours before the rash appears and remain contagious until all broken blisters have scabbed over. The infection is highly contagious for those individuals who have never had chickenpox or who have never been vaccinated against it, which is why the U.S. Centers for Disease Control and Prevention (CDC) recommends routine vaccination of children against the varicella-zoster virus.

While chickenpox is often thought of as a childhood illness, adults can contract the virus too, and when they do, their symptoms may be more severe.

What is Shingles?

Like chickenpox, shingles is a viral infection caused by the varicella-zoster virus that creates a painful rash. Unlike the chickenpox rash, which can form all over the body, the shingles rash typically appears as a single stripe of blisters around one side of the torso.

In addition to the painful rash, shingles symptoms may include:

  • A painful, burning, numbness or tingling that for some is intensely uncomfortable
  • Sensitivity to touch
  • An itchy, red rash that begins a few days after the first pain symptoms
  • Fluid-filled blisters that break and scab, as with chickenpox
  • Fever
  • Headache
  • Sensitivity to light
  • Fatigue

It is possible for someone who had chickenpox to develop shingles later in life. In patients who have had chickenpox, the varicella-zoster virus lies dormant in nerve tissue near the spinal cord and brain. It can reactivate in the form of the shingles virus years later.

If not properly treated, shingles can result in health complications, including a condition called postherpetic neuralgia, in which a patient experiences shingles pain for a long time after the blisters have healed.

Also, like chickenpox, there is a CDC-recommended vaccine for shingles; however, it is recommended for seniors rather than children.

When to Talk to Your Doctor

If you or a loved one has developed a red, painful rash, talk to your doctor. Whether it is chickenpox, shingles, or another condition, your doctor will diagnose the cause and recommend a treatment plan. Further, if you have any questions regarding recommended vaccines for chickenpox and shingles, and when you, your child, or senior parent may be eligible, talk to your doctor.

Common Triggers for Hives and When to Get Help

It starts as a mindless tickle on the side of your neck. You find yourself itching the spot casually. A few minutes later, you’re rubbing your side along your ribs with more persistence, moving to scratch the back of your hand next. You look down and recognize, in a second, the telltale sign of a larger issue than just an itchy sweater or pesky few mosquito bites.

Hives.

The unsightly red, itchy spots are noticeably appearing like unwanted house guests, and you feel helpless and desperate for relief. If you’ve ever developed an allergic reaction to a food item or an insect that has resulted in a hive breakout on your skin, then you know all too well the discomfort and stress of these little red spots. What causes hives, and if you’re susceptible, how can you avoid them? More importantly, when is the appearance of hives the first indication of a potentially dangerous allergic reaction, and when should you receive urgent treatment?

What are Hives?

Urticaria, or hives, are a skin rash that appears as welts or raised bumps on the skin. They are often red and uncomfortably itchy. They can range in size from small to large bumps, up to 8 inches in diameter at their largest, and may appear on one body part or all over the skin. When you press on a hive, it will appear white in the middle. Like their size, the duration of an outbreak of hives may vary as well. For some patients, hives may appear for a few minutes or last for several months, with most people experiencing hives finding them to last at least 24 hours.

What are the Most Common Causes of Hives?

Anyone at any age can develop hives if exposed to an irritant that causes an autoimmune response in the body. About 20 percent of people will develop hives at least once in their lifetime. The most common triggers of hives include:

  • Infections, including the common cold and other viruses
  • Food allergies, most commonly including eggs, shellfish, and nuts
  • Medications, such as aspirin, antibiotics such as penicillin, and sulfa
  • Insect stings or bites
  • Blood transfusions
  • Other autoimmune conditions, such as thyroid disease

Some patients experience chronic episodes of hives that can last over six weeks. In these cases, doctors cannot always determine the underlying cause of the outbreak.

Another form of hives is dermatographia, a condition in which light scratching of the skin causes raised, uncomfortable red lines at the scratch site. Delayed pressure urticaria occurs when skin under constant pressure, such as from constrictive clothing, swells and becomes irritated.

Other hive triggers may include:

  • Exposure to low temperatures followed by re-warming—a potentially life-threatening situation if there is a generalized body cooling
  • An increase in body temperatures during exercise, a hot shower, or an anxiety-inducing situation, known as cholinergic urticaria
  • Sun-exposure

When to Seek Urgent Medical Care?

Hives can often be treated with a topical or oral antihistamine medication. However, in more severe cases, hives are one symptom that appears during anaphylaxis. This potentially dangerous allergic reaction can cause swelling of the tongue or throat and difficulty breathing. If anaphylaxis occurs, call 911 immediately. If your doctor diagnoses you with a severe allergy to a specific food or other substance, they may prescribe you an epinephrine pen which can be administered during a severe allergic reaction to immediately abate swelling that can make it difficult to breathe.

Otherwise, if you often experience hives that do not cause respiratory issues and you believe you may be allergic to a food item or medication, talk to your doctor. They can conduct tests to help you identify the cause of your outbreaks. If you are experiencing chronic urticaria, your doctor may refer you to an allergist or immunologist for more specialized testing and treatment.