Chickenpox versus shingles—What’s the difference?

Did you know? The same virus that causes chickenpox also causes shingles. Although shingles and chickenpox are caused by the same virus, they are not the same illness. Chickenpox is usually a milder illness that affects children. Shingles results from a reactivation of the virus long after the chickenpox illness has disappeared.

The chickenpox virus stays in the body even after recovery. Later in life, the virus can reactivate and cause shingles. If you have shingles, you can spread the varicella virus to people who have never had chickenpox or never received the chickenpox vaccine. These people will develop chickenpox, not shingles. It takes from 10 to 21 days after exposure to chickenpox or shingles for someone to develop chickenpox.

What are the symptoms?

Chickenpox (Varicella)

  • Initial symptoms include sudden onset of fever, headache, and feeling tired.
  • An itchy blister-like rash, usually starting on the face, chest or back, follows 1-2 days later.
  • The rash then spreads to the rest of the body, and new blisters continue to appear for about 3-4 days.
  • Generally, within 1 week, the blisters dry out and scabs form and fall off.

Shingles (Herpes Zoster)

  • The first sign is often a tingling feeling on the skin, itchiness, or a stabbing pain.
  • After several days, a rash appears, beginning as a band or patch of raised dots on the side of the trunk or face or other areas of the body.
  • It then develops into small, fluid-filled blisters which begin to dry out and crust over within a few days.
  • When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain.
  • The rash and pain usually disappear within 3-5 weeks.

How contagious is it?

Chickenpox (Varicella)
Chickenpox is very contagious. The virus can spread by breathing in the viral particles that come from the blisters. It can also be spread by direct contact with the fluid of skin lesions. A person with chickenpox can spread the disease from 1 to 2 days before they get the rash, until all their chickenpox blisters have formed scabs.

Shingles (Herpes Zoster)
Shingles cannot be passed from one person to another. Someone with an infectious shingles rash can spread chickenpox if the other person has never had chickenpox. However, someone with shingles will not cause another person to develop shingles.

Is there a vaccine?

Chickenpox (Varicella)
There are two vaccine options:

  • Two doses of the varicella vaccine.
  • A combination vaccine called MMRV (measles, mumps, rubella, and varicella). 

Shingles (Herpes Zoster)
The Centers for Disease Control and Prevention (CDC) recommends that healthy adults 50 years and older get the shingles vaccine.

How can these diseases be prevented?

The best way to prevent chickenpox and shingles is to get vaccinated.

  • Avoid direct contact with a person infected with chickenpox or shingles.
  • Cover the rash.
  • Avoid touching or scratching the rash.
  • Clean your hands often.