Chickenpox
Also known as Varicella
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is chickenpox?
Chickenpox is a highly contagious infection causing an itchy rash that develops into blisters and then scabs. In healthy children it is usually mild and self limiting. It is more serious in adults, pregnant women, newborns and anyone with weakened immunity, who should seek advice promptly rather than managing it at home.
Causes
- Varicella zoster virus
- Spread by coughs, sneezes and contact with blister fluid
- Highly contagious from two days before the rash until all spots crust
- Reactivation later in life causes shingles
Symptoms
- Itchy spots that blister then crust over
- Spots appearing in crops over several days
- Fever, often before the rash
- Tiredness and loss of appetite
- Aches and headache
- Spots anywhere including the scalp and mouth
Risk factors
- Not having had chickenpox or the vaccine
- Age under 10 for typical infection
- Contact with an infected person or someone with shingles
- Weakened immune system for severe disease
- Pregnancy
Diagnosis
- Clinical diagnosis from the characteristic rash
- PCR of blister fluid where confirmation matters
- Blood test for immunity in pregnancy or before immunosuppression
- Assessment for bacterial superinfection of the skin
Treatment
- Rest, fluids and paracetamol for fever
- Cooling gels, calamine lotion and antihistamines for itch
- Antiviral treatment for adults, pregnancy and immunosuppression
- Antibiotics if the skin becomes bacterially infected
- Varicella vaccine, offered routinely in many countries
- Immunoglobulin for vulnerable contacts
Self care
- Keep nails short and consider mittens for young children
- Use cooling creams or a lukewarm bath with oat products
- Dress in loose smooth cotton clothing
- Give paracetamol rather than ibuprofen, which is linked to skin complications
- Keep fluids up, especially if there are mouth spots
- Stay off school or work until all spots have crusted over
- Avoid pregnant women, newborns and anyone immunosuppressed
When to see a doctor
Book an appointment if:
- Chickenpox in an adult or teenager
- Chickenpox during pregnancy
- A newborn baby with chickenpox
- Weakened immune system or on steroids
- Spots becoming red, hot, swollen or leaking pus
- Symptoms worsening after the first few days
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Varicella vaccination where offered
- Avoid contact with infected people if not immune
- Vulnerable contacts may be offered immunoglobulin or antivirals
- Check immunity before pregnancy or immunosuppressive treatment
- Keep infected children away from others until spots crust
Outlook
Healthy children usually recover within one to two weeks with no lasting effects, though scarring can follow scratching or skin infection. Adults tend to be more unwell and have a higher risk of pneumonia. The virus stays dormant in nerve roots afterwards and can reactivate decades later as shingles.
Common questions
Why should ibuprofen be avoided?
Anti inflammatory painkillers have been associated with severe skin and soft tissue infections during chickenpox. Paracetamol is recommended instead for fever and discomfort.
Can you catch chickenpox from someone with shingles?
Yes, if you have never had chickenpox or the vaccine. Contact with shingles blister fluid can cause chickenpox, though not shingles itself. Shingles is less contagious than chickenpox and requires direct contact.
Why is chickenpox in pregnancy taken seriously?
It can cause severe pneumonia in the mother and, depending on timing, harm the baby. Anyone pregnant who is exposed and not known to be immune should seek advice urgently, as treatment is time sensitive.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.