Chickenpox

Overview

Chickenpox is a common infection that causes an itchy rash with red spots and blisters. It is usually mild, especially in children, but can be more serious in adults, pregnant women, and people with weakened immune systems.

Chickenpox is very common, especially in children under 10 years old. Before the vaccine was introduced, almost everyone got it. Now it is less common in countries with routine vaccination.

Chickenpox mostly affects children, but anyone who has not had it before or has not been vaccinated can get it. It is more severe in adults, pregnant women, and people with weakened immune systems.

Symptoms

Common symptoms

• An itchy rash that starts as small red spots and turns into blisters that eventually crust over
• Mild fever (high temperature)
• Feeling tired and generally unwell
• Loss of appetite
• Headache

Symptoms in children

• The rash usually appears first on the face, chest, and back, then spreads to the rest of the body.
• Children may have only a few spots or hundreds.
• They may be irritable and have a mild fever.

Symptoms in older adults

• Symptoms are often more severe, with a higher fever and more extensive rash.
• Adults are more likely to develop complications such as pneumonia (lung infection) or encephalitis (brain inflammation).
• The illness may last longer and be more painful.

Causes

Main causes

• Chickenpox is caused by the varicella-zoster virus, which is highly contagious.
• The virus spreads through droplets from coughs or sneezes, or by touching the fluid from the blisters.
• It can also be spread by touching objects that have the virus on them, like toys or bedding.

Risk factors

• Not having had chickenpox before or not being vaccinated
• Living with or caring for someone with chickenpox
• Having a weakened immune system due to illness or medications
• Being pregnant (can be serious for both mother and baby)

When to see a doctor

See a doctor urgently if:

• If you or your child have a weakened immune system and have been exposed to chickenpox
• If symptoms are severe, such as high fever, confusion, or difficulty breathing
• If the rash spreads to the eyes or becomes infected

Book a routine appointment if:

• If you think you or your child might have chickenpox and need advice on managing symptoms
• If you are pregnant and have been in close contact with someone with chickenpox

Diagnosis

Doctors usually diagnose chickenpox by looking at the rash and asking about symptoms and exposure history. It is often obvious from the appearance of the spots.

Tests that may be done

• In most cases, no tests are needed.
• A swab of the blister fluid can confirm the virus if the diagnosis is unclear.
• Blood tests can check for immunity or the virus in certain situations.

What to expect at your appointment

During a consultation, the doctor will examine the rash, check temperature, and ask about other symptoms. They will then advise on home care and whether you need to isolate to avoid spreading the virus. Most people are advised to stay away from work, school, or public places until the blisters have crusted over, which usually takes about 5 to 7 days.

Treatment

Chickenpox usually gets better on its own within 1 to 2 weeks. Treatment focuses on relieving symptoms and preventing complications, especially in high-risk individuals.

Self-care at home

• Get plenty of rest and stay hydrated by drinking water or clear fluids.
• Take cool baths with baking soda or oatmeal to soothe itching.
• Wear loose, soft clothing to avoid irritating the rash.
• Keep fingernails short and clean to reduce scratching; you can also use antihistamine creams or tablets (ask a pharmacist or doctor).
• Use paracetamol (acetaminophen, e.g., Panadol) for fever and discomfort. Do not use aspirin for children as it can cause a serious condition called Reye's syndrome.

Medical treatments

For people at high risk of complications, such as pregnant women or those with weakened immune systems, a doctor may prescribe antiviral medication (taken by mouth or through a vein) to reduce the severity and duration. These medications are most effective when started within 24 hours of the rash appearing. In some cases, an injection of antibodies (immunoglobulin) may be given to prevent or reduce the illness after exposure. Always speak to your healthcare provider about the best options for your situation.

When is surgery considered?

Surgery is not used to treat chickenpox.

Living with this condition

During chickenpox, you or your child will need to stay home from school, work, and public places until the blisters have all crusted over (usually 5 to 7 days). It is important to avoid spreading the virus to others, especially pregnant women, newborn babies, and people with weak immune systems.

Lifestyle tips

• Take cool baths or showers daily to help relieve itchiness and keep the skin clean.
• Apply calamine lotion or a moisturiser to soothe the rash.
• Avoid scratching as much as possible to prevent scarring and infection.
• Rest as needed and take time off from routine activities until you feel better.

Diet and exercise

There is no special diet for chickenpox, but eating light, easy-to-digest foods can help if you or your child have a sore mouth from spots inside the mouth. Stay hydrated. Gentle activity like walking is fine once you feel up to it, but avoid strenuous exercise until symptoms have fully resolved.

Mental health and emotional wellbeing

Chickenpox can be uncomfortable and frustrating due to itching and feeling unwell. It is normal to feel irritable or anxious, especially for children. Reassure them that the illness is temporary. If you are an adult, the isolation and discomfort can be stressful. Talk to friends or family, and contact a healthcare provider if you feel overwhelmed.

Prevention

Yes, chickenpox can be prevented with a vaccine. The varicella vaccine is safe and effective. It is part of routine childhood vaccinations in some countries, but not all. In the UK, it is offered to healthcare workers and people at high risk of complications, but not universally to children.

Vaccines

The varicella vaccine is usually given as two doses – the first around 12–15 months of age and the second between 4 and 6 years old. It can also be given to older children and adults who have not had chickenpox. Ask your doctor if the vaccine is recommended for you or your family.

Screening programmes

There is no routine screening for chickenpox. If you are at high risk (e.g., pregnant or immunocompromised) and have been exposed, a blood test can check your immunity. If you are not immune, a vaccine or treatment may be offered.

Complications

If left untreated

• Bacterial infection of the skin (cellulitis) from scratching
• Pneumonia (lung infection), especially in adults and smokers
• Encephalitis (brain inflammation), which can cause confusion, seizures, or coma
• Reye's syndrome if aspirin is used in children
• Birth defects or serious infection in the newborn if a pregnant woman gets chickenpox

Long-term outlook

For most healthy children, chickenpox is a mild illness that goes away without problems. After recovery, the virus stays dormant and can cause shingles later in life, but this is usually a different condition. With proper care and, if needed, antiviral treatment for high-risk groups, the outlook is excellent. Vaccination can prevent chickenpox entirely.

Find support

International organisations

• World Health Organization (WHO) – Chickenpox ↗
• Centers for Disease Control and Prevention (CDC) – Varicella ↗

Local organisations

• NHS – Chickenpox ↗ · United Kingdom
• Healthline – Chickenpox ↗ · International

Helplines

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