Chickenpox
Overview
What is chickenpox?
Chickenpox is an infection that causes a skin rash. The disease is caused by a germ called varicella-zoster virus. (Chickenpox itself is also called varicella-zoster.) Most people will get the virus when they’re young if they haven’t had a chickenpox vaccine.
A child with chickenpox can easily give the virus to other children. Chickenpox today is much less common because most children are vaccinated when they are young. Before the first vaccine against chickenpox was approved in the U.S. in 1995, almost everyone got chickenpox. Very few had complications.
Once you’ve had chickenpox, you won’t catch it again from another person. If you’re not vaccinated, you can get chickenpox at any age. Adults who get chickenpox may become very sick, so it's better to have chickenpox when you're a child, or prevent getting it by being vaccinated.
How is chickenpox spread?
Children can get chickenpox at any age. After being exposed to chickenpox, your child may appear to be fine for one to three weeks before feeling sick. Children can spread the virus from one day before they show signs of illness to about five days after a skin rash appears.
The virus is spread by:
- Coming in contact with someone who has chickenpox.
- Breathing air from an infected person who sneezes or coughs.
- Coming in contact with fluids from an infected child's eyes, nose or mouth.
What is the difference between smallpox and chickenpox?
Chickenpox and smallpox are both diseases that produce rashes on the skin, but they are different. For one thing, smallpox is a much more serious disease, causing severe illness and death. They are caused by different viruses.
While the two diseases both produce rashes, the rashes themselves develop at different times and the rashes look different. Smallpox pustules look the same as each other, while the chickenpox rash develops in waves. The individual spots don’t look the same and some form scabs while others are still blistering.
There’s another important difference. A massive global vaccination program has eradicated (wiped out) smallpox.
Symptoms and Causes
What are the signs and symptoms of chickenpox?
Signs of chickenpox are easy to see. Healthcare providers often can look at a child's skin and know if he or she has chickenpox. Signs of chickenpox usually happen in the following order:
- Fever.
- Feeling tired.
- Headache.
- A stomachache that lasts for one or two days.
- A skin rash that is very itchy and looks like many small blisters.
- Bumps filled with a liquid that looks like milky water.
- Scabs after the blisters break.
- Skin that looks blotchy.
- Spots that fade away.
Diagnosis and Tests
How is chickenpox diagnosed?
Signs of chickenpox are easy to see. Healthcare providers often can look at a child's skin and know if they have chickenpox.
Management and Treatment
How can I help my child with chickenpox?
Make sure your child gets plenty of rest and fluids. Chickenpox will go away on its own in a week or two. To help your child feel less itchy, you can:
- Press a cool, moist rag on the rash.
- Keep your child cool.
- Encourage your child not to scratch. Trim their fingernails so they can't scratch.
- Put a lotion with antihistamines on the rash. These lotions are available at the drugstore. If you don't know what to buy, ask the pharmacist for help.
- Give your child an over-the-counter (OTC) form of antihistamine. Diphenhydramine (Benadryl®) and cetirizine (Zyrtec®) are two examples of OTC antihistamines.
- Give your child a cool bath or shower every day. You can also give your child an oatmeal bath. When you’re drying them off, don’t rub with the towel. Pat your child dry.
Don't give your child aspirin. Aspirin can harm children who have fevers. If your child needs a pain reliever, use acetaminophen (such as Tylenol®). If you’re not sure what product to use, ask your healthcare provider or pharmacist.
To prevent dehydration, give your child fluids. Cold fluids and a soft bland diet will help if they have mouth sores.
What if my baby gets chickenpox?
If your newborn baby (up to age 3 months) gets chickenpox, let your healthcare provider know right away. Chickenpox is more dangerous to newborns than to other healthy people.
What complications are possible with chickenpox?
Complications from chickenpox are unlikely, but possible. They may include:
- Bacterial infections of the skin, blood, and soft tissues.
- Encephalitis.
- Pneumonia.
- Becoming dehydrated.
- Blood clotting or healing issues.
- Liver problems.
Who is more likely to have complications from chickenpox?
Healthy people who get chickenpox don’t usually have complications. However, having a severe case of chickenpox could be more dangerous for very young babies, teenagers, pregnant people and people with immunity issues, such as transplant patients. This group also includes people with cancer or HIV or people being treated with chemotherapy or steroids.
Can chickenpox be fatal?
It’s very unlikely that you will die from chickenpox. Most people recover without complications. However, people have died from chickenpox. In the U.S., that number has dropped to about 20 people per year after mass vaccinations from some 100 deaths per year before vaccines were available. Hospitalizations decreased 84% from over 10,000 per year.
Prevention
Can my child get a shot to prevent chickenpox?
Yes, there’s a vaccine for chickenpox. It’s recommended, so ask your healthcare provider about the vaccine.
What should I know about the chickenpox vaccine?
Two doses are recommended. When your child is under the age of 13, they should get one dose between the ages of 12 and15 months, and the second between the ages of four and six years.
If you’re 13 or older and never got the vaccine, you should get two doses at least 28 days apart.
There is a vaccine that’s only for chickenpox called Varivax®. There is another called ProQuad® that protects against measles, mumps, rubella and varicella (MMRV).
Vaccination is over 90% effective at preventing chickenpox.
Who shouldn’t get the chickenpox vaccine?
There are people who shouldn’t get the chickenpox vaccine. You shouldn't get the chickenpox vaccine if you:
- Are allergic to the vaccine or to any part of the vaccine.
- Are pregnant or think you might be pregnant.
- Have problems with your immune system.
- Have tuberculosis.
- Aren’t feeling well. (Get the vaccine when you feel better.)
- Recently had a blood transfusion or any other live vaccines.
Talk with your healthcare provider about whether or not you should be vaccinated.
Outlook / Prognosis
Can adults get chickenpox?
When children get chickenpox, their bodies fight the illness by making a substance called antibodies. The antibodies fight the virus and help the body get well. These antibodies stay in your body throughout your life. If an adult comes in contact with the virus, the antibodies are there to fight the germ.
What are shingles?
In adults, the chickenpox virus (varicella zoster) can become active again. When that happens, it causes an illness caused shingles. People "catch" shingles from their own chickenpox virus. People who have shingles can spread chickenpox to people who haven’t had chickenpox. However, you can’t get shingles unless you’ve had chickenpox.
Shingles is also called herpes zoster, but it’s not the same as genital herpes. Like chickenpox, it looks like a rash made up of small bumps. Shingles can be painful and can take a while to heal. It will usually go away on its own in a week or two. There are vaccines to prevent shingles. Talk to your healthcare provider to see which one is right for you.
Living With
When should you call your healthcare provider if your child has chickenpox?
Call your healthcare provider if your child:
- Is acting ill and has a severe headache.
- Has sores in their eyes.
- Has sores that get bigger or have pus in them.
- Has difficulty breathing or is breathing very fast.
When can my child go back to school?
Your child can go back to school about seven to 10 days after the rash appears. You don’t need to wait for the scabs to heal, but you do need to wait until all the blisters have scabbed over. You’re contagious while the blisters have fluid.
Frequently Asked Questions
What are the three stages of chickenpox?
The three stages of chickenpox usually refer to the way the rash looks. Stage one is a red and bumpy rash. Stage two is the fluid-filled blistered rash. Stage three is when the blisters break and scab over.
Where does chickenpox usually start?
You usually start getting chickenpox on your face and trunk (your chest and your back). From there, it spreads to the rest of your body.
Can I get chicken pox twice?
It’s rare for anyone to get chickenpox twice, but it can happen.
How many days does it take to recover from chickenpox?
Chickenpox usually goes away after 10 to 14 days.
A note from Cleveland Clinic
Before the vaccine for chickenpox was developed, the infection caused deaths and hospitalizations. The available vaccine is over 90% effective at preventing this once-common childhood illness. If you don’t get chickenpox, you won’t get shingles, a painful condition that happens because the virus that causes chickenpox stays in your body long after the rash is gone. While there are home remedies to deal with chickenpox and shingles symptoms, vaccination makes that unnecessary.
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