Can Telemedicine Treat Shingles (Herpes Zoster) - Triage?

Audience: pediatric

Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. It happens when the chickenpox virus becomes active again in the body. In children, shingles can cause discomfort and sometimes serious complications. Telemedicine can help by allowing doctors to see the rash and symptoms through video calls, provide advice, and suggest treatments. However, some cases need in-person care, especially if the rash is near the eyes or if the child has a weakened immune system. Early treatment is important to reduce pain and prevent problems. Telemedicine offers a safe and convenient way to get initial help and guidance for shingles in children, but it does not replace the need for physical exams when necessary.

Red flags — go in person / ER

• Rash near or on the eyes — seek emergency care immediately to prevent eye damage.
• High fever (above 38.5°C or 101.3°F) with rash — get urgent medical evaluation.
• Severe pain that does not improve with usual care or signs of infection such as pus, increased redness, or swelling — contact healthcare provider promptly.

What telemedicine can do

• Initial evaluation of rash and symptoms through video consultation.
• Providing advice on symptom management and home care.
• Determining if antiviral medications or pain relief may be appropriate.
• Guidance on when to seek in-person care.

What telemedicine cannot do

• Physical examination needed for rash near eyes or sensitive areas.
• Treatment of severe or complicated cases requiring injections or intravenous medications.
• Emergency situations like eye involvement, high fever, or spreading infection.
• Procedures such as blister drainage or skin biopsy.

What is Shingles (Herpes Zoster)?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a child recovers from chickenpox, the virus stays inactive in nerve cells. Sometimes, it can reactivate years later, causing shingles. The main sign is a painful rash that usually appears on one side of the body or face. The rash often forms blisters and can be very uncomfortable.

How Telemedicine Can Help with Shingles

Telemedicine allows healthcare providers to look at the rash and ask about symptoms through video calls. Doctors can guide parents on how to care for the rash, manage pain, and when to seek further care. They can also decide if antiviral medicines or other treatments might be needed. This approach is helpful when the rash is mild and not near sensitive areas.

When In-Person Care is Needed

Some situations require a physical exam, such as if the rash is near the eyes, if the child has a weak immune system, or if the rash is very widespread. Also, if the child has a high fever, severe pain, or signs of infection like pus or swelling, they should see a healthcare provider in person promptly.

Managing Shingles at Home

Parents can help by keeping the rash clean and dry, using cool compresses to ease pain, and giving pain medicines as recommended by a doctor. It is important to avoid scratching to prevent infection. Rest and good nutrition support healing.

Preventing Shingles

Vaccines can reduce the risk of shingles, but they are generally recommended for older children or adults. Good hygiene and avoiding contact with people who have chickenpox or shingles can help prevent spreading the virus.

How to prepare for your tele-visit

• Have a clear, well-lit area to show the rash during the video call.
• Prepare a list of symptoms, including when they started and any pain levels.
• Have a thermometer ready to check for fever.
• List any current medications or allergies your child has.
• Be ready to describe any other health conditions your child has, especially immune problems.

After your tele-visit

• Follow the care instructions provided by the healthcare provider.
• Monitor the rash and symptoms daily for changes or worsening.
• Keep the rash clean and avoid scratching to prevent infection.
• Use pain relief methods as advised, such as over-the-counter medicines or cool compresses.
• Contact healthcare provider if red flags or worsening symptoms appear.

FAQs

Can telemedicine diagnose shingles in my child?

Telemedicine can often help healthcare providers recognize shingles by looking at the rash and asking about symptoms. However, sometimes an in-person exam is needed for a clear diagnosis, especially if the rash is in sensitive areas.

Is antiviral medicine necessary for children with shingles?

Antiviral medicines may be recommended to reduce pain and speed healing, especially if started early. A healthcare provider can advise if these medicines are appropriate based on the child's age, health, and rash severity.

Can shingles be contagious to others?

Shingles itself is less contagious than chickenpox, but the fluid from the rash blisters can spread the chickenpox virus to people who have never had chickenpox or the vaccine. Covering the rash and good hygiene help reduce this risk.

What should I do if my child's rash is near their eye?

Rash near the eye can cause serious complications. Seek in-person medical care immediately to protect your child's vision.

How long does shingles usually last in children?

Shingles rash and pain often improve within 2 to 4 weeks, but some children may have pain that lasts longer. Early treatment can help reduce the duration and severity.

Sources

1. Shingles (Herpes Zoster) — MedlinePlus, U.S. National Library of Medicine.
2. Shingles (Herpes Zoster) Information for Health Professionals — Centers for Disease Control and Prevention (CDC).
3. Herpes Zoster (Shingles) — Mayo Clinic.
4. Herpes Zoster (Shingles) — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or red flags, seek emergency or in-person evaluation promptly.