I was 16 when I had shingles, and it makes no difference where I had them. Shingles are not contagious unless someone comes in direct contact with the fluid from the rash blisters. Believe me, you definitely know you have shingles when you get them. Once the rash occurs, you are certainly able to take precautions that no one comes in contact with it.
I'm a personal testament to the fact that not all people afflicted with shingles immediately realize they have them and need to take proper precautions while contagious. Since my parents are divorced and remarried, I have four of them instead of just two, and they are all attentive and overly protective, and yet none of them were aware I had shingles until three weeks into suffering from it, and did not find out until the second day of blister eruptions. I'm not an unintelligent person, but I was a misinformed one about shingles. A widely held myth is that only senior citizens can get shingles, so it never entered my mind that as a high school student I could be tormented by them. It's a confusing affliction for many. For me it began with this bizarre, mild pain deep under the surface of the skin on my back that intensified every day. It reminded me of the volume being gradually turned up on a stereo - at first so low you can barely hear it, to it becoming ear-piercingly loud. It started on my back, then snuck around under my arm to a palm-sized area on the right side of my chest. I'm a competitive dancer, and this coincided with training 20 hours a week for YAGP, the most prestigious youth dance competition. I thought the intensive amount of dancing had caused a muscle pull. Then itchiness insidiously began to accompany the pain, and for an entire school week there was no visible explanation for it. I took my top off in the bathroom at school for a friend to inspect my back, and inform me nothing was there. I was baffled. I first thought that it was due to new fabric softener and washed all my leotards with new detergent. When that didn't resolve the issue, I then questioned if it was due to heat. That was a reasonable explanation, and the rash that emerged right where my leotard got the sweatiest seemed to confirm it.
The blisters emerged on a Saturday during a seven hour dance practice with my dance partner. We and our choreographer all thought it was a prickly heat rash. If you look up pictures of this, as we did, you'll see how closely it resembles the shingles rash. My leotard left much of my rash exposed, and my dance partner was bare chested, so had he not received the varicella vaccine, I most definitely would have put him at a high risk of contracting chickenpox from me since much of the dance had us chest-to-chest. When we practiced the next day, I did wear a shirt. We cut the practice very short because it was no longer just a matter of being in pain, or the debilitating tiredness I'd misattributed to the extra dance practice, my eyes were so sensitive to the light in the studio it felt like they were throbbing, I had a brutal headache, and I started to vomit. The day before I'd just have a few blisters that were emerging and erupting, but I then had an entire army of them attacking me. In the agonizing days that followed, the blisters exponentially grew in numbers and the pain became excruciating, with literally hundreds of blisters emerging and exploding on my back and chest. When my dad came and picked me up from the dance studio that Sunday, he instantly knew it was shingles. I'd been wearing a sweatshirt when I left the house, so he hadn't seen them. As soon as he saw them, he knew. But he's a doctor, not a clueless teen. He took me directly from the dance studio to CHLA because I was at a high risk of complications due to having Addison's disease. He was angry with me that I hadn't told any of them about the pain, or the itchiness or the rash, but I defended myself by explaining that I had no idea it was anything serious, and I was worried about them pulling me back from dance training. I was laser focused on the competition, but ended up having to miss it due to problems that arose from shingles causing hospitalization.
One month later, a friend just a smidgen older began to complain to me about this mysterious pain. From her description of the pain and her recent activities, we both thought it was probably a muscle strain caused from her assisting at a book fair. I suggested using a heating pad. When a tormenting rash developed, I thought it was prickly heat. Despite just experiencing shingles, it didn't dawn on me that her symptoms were identical to mine. As someone who's been immunocompromised since birth, I was used to being an oddity, to dealing with health issues most other kids my age didn't. I'd never known anyone to have chickenpox because vaccination for it has always been required by every school I've attended, and I just assumed she'd never had them either. She showed the rash to her mom, who also thought it was probably caused from prolonged use of the heating pad. Eventually the dots were connected and it was realized that she had shingles. Unlike my rashes on exposed areas, hers were confined to an area that was always fully clothed, so that was a grace. When I told my stepmom about the friend having shingles she thought they were in an exposed area, and was worried because the girl had an infant and toddler sister she often picked up and would cuddle with. She'd just that month had a parent accidentally expose his toddler to chickenpox. The dad slept just in boxers and picked up his crying daughter in the middle of the night, when he was too drowsy from sleep to think anything of it. His natural instinct was to pick her up and soothe her against his chest. Fortunately, his daughter had already received the first varicella vaccine dose, and it protected her.
The CDC provides a letter to notify parents of childcare workers when there's been a reporting of shingles at daycare centers, urging that if their children haven't been vaccinated yet to get them vaccinated. I'm not the first person to be confused by shingles and misidentify them at first. Others, especially those under the age of 50, have thought it was prickly heat, due to ant bites, poison ivy, or a really evil acne outbreak, and not taken the necessary precautions simply because they didn't realize they needed to be taken. It's much harder to keep the shingles fully covered while you're contagious if they're on your face than if they're on a clothed area such as your lower back. Small children in particular are far more likely to directly touch a rash than an adult would, and those afflicted by shingles in an area they can reach are far more likely to touch and scratch the area, sometimes mindlessly, and then immediately return to a task.
The area where you have shingles most definitely makes a difference, in regards not only to chances of infecting others, but its level of risk, and the impact it has for work, school, and social engagements. Shingles on your face poses a risk of infecting the eye and damaging vision. It's much more difficult to cover up. And it's far more psychologically distressing since they are so visible and can leave scars. I still have scars on my back from shingles. I'm just grateful they are hidden most of the time.
Edit to add some PSAs:
. A new shingles vaccine with an extremely high efficacy rate is now available:
A New Shingles Vaccine Is Now Available Nationwide
. If you're under the age of 50 and you get shingles, but aren't immunocompromised and have not experienced abnormally high levels of stress recently, you may want to get your vitamin D levels checked because a deficiency has been linked to higher shingles risk.
. Shingles increases your risk of a heart attack or stroke at a young age, so it's definitely wise to see your doctor and have a checkup.