Chickenpox is one of those diseases that we don’t think about as much as we used to. It’s for good reason: The chickenpox vaccine, which was introduced in 1995, prevents 70% to 90% of infections and 95% of severe cases. In addition, it is included in the childhood vaccination schedule recommended by the Centers for Disease Control and Prevention (CDC).
Of course, those numbers don’t mean you’re guaranteed to avoid it. If you or your child experiences an itchy rash, you will need to know the symptoms of chickenpox so you know when you may need to talk to a doctor. Here’s what you should know about chickenpox, from its cause and symptoms to treatments and risk factors.
Chickenpox is a viral skin rash loaded with blisters.
Chickenpox is a highly contagious viral infection. It is mainly known for its main symptom, which is an itchy skin rash with small, pimple-like blisters. It is most common in children under 10 years old, but anyone can get it. A first case of chickenpox in adults and adolescents tends to be more severe than in children, possibly due to changes in the immune system as the body matures.
The cause of chickenpox and how it is transmitted.
Chickenpox is caused by the varicella-zoster virus, which is also responsible for shingles in adults. The virus can be transmitted through saliva, mucus, or fluid from blisters. This means you can be exposed to chickenpox through coughing, sneezing, direct contact with other people, and contaminated objects. It is rare to get chickenpox after having had it once or having received a vaccine against it, but in the rare case that you do, the symptoms tend to be milder.
The relationship between chickenpox and shingles
Later in adulthood, people who have had chickenpox may develop shingles, a painful, blistering rash that usually appears on one side of the body. The varicella-zoster virus remains in the body after a chickenpox infection, and shingles occurs when the virus reactivates during a period of weakened immune system. The immune system can be weakened by factors such as other infections, stress, lack of sleep, alcohol consumption and smoking.
Someone with shingles can spread the varicella-zoster virus to others while the rash is present, but an infection will cause chickenpox, not shingles.
As with chickenpox, there is a vaccine available for shingles. It’s called Shingrix, and the CDC recommends it for people age 50 and older, as well as people age 19 and older who have weakened immune systems. Talk to your doctor if you have questions about the Shingrix vaccine.
How to recognize chickenpox symptoms: early signs, normal characteristics and differences from other rashes
Chickenpox can usually be distinguished from other conditions that cause a rash by the specific characteristics of its rash and the other symptoms that often appear with it. Again, if your immune system is already familiar with chickenpox due to a vaccination or previous infection, symptoms will likely be milder and some may even be absent.
The first symptoms of chickenpox
A couple of days before the chickenpox rash appears, you or your child may develop cold- or flu-like symptoms. These may include:
- Fever
- Reduced appetite
- Headache
- Fatigue
- Cough
- Sore throat
What the chickenpox rash looks like
The chickenpox rash is characterized by raised, itchy bumps that may look like pimples or insect bites. It usually starts on the face, scalp, chest, or back before spreading throughout the body. The bumps gradually turn into blisters, which eventually burst and form scabs. Chickenpox generally does not leave scars unless the rash is scratched, which can also cause a bacterial infection.
Other causes of skin rashes and how they differ from chickenpox
- Hand, foot, and mouth disease (HFMD) – Flu-like symptoms and a skin rash are the main symptoms of HFMD, but as the name implies, the rash tends to appear primarily on the palms of the hands and soles of the feet. However, it can also spread to other parts of the body, including the face and buttocks.
- Impetigo – The most common type of impetigo, nonbullous impetigo, is another condition characterized by a skin rash with small red blisters. The difference between impetigo and chickenpox is that impetigo usually forms first around the mouth and nose, and the scabs left by the blisters have a distinctive honey-like color.
- Scabies – Scabies can cause a rash with small blisters that appear visually similar to chickenpox. However, scabies rashes usually come with raised lines on the skin where scabies mites hide, and scabies does not cause flu-like symptoms.
- Contact dermatitis – Sometimes the skin can react to direct contact with an allergen or irritant, such as poison ivy. Symptoms of a reaction depend on the cause, but may include an itchy rash or blisters. However, these types of reactions are usually limited to the area that came into contact with the allergen or irritant.
When to seek immediate treatment for chickenpox
In healthy children and people with existing immunity to chickenpox, many cases of chickenpox resolve on their own. However, since it can be more serious in teenagers and adults, it is important to talk to a doctor if you or a child over 12 years old develops symptoms of chickenpox. It is also important to talk to a doctor about possible exposure to chickenpox if:
- Your child is less than 1 year old.
- You or your child have a weakened immune system.
- you are pregnant
As for symptoms, you should talk to a doctor if you or your child experience:
- severe itching
- Severe cough or abdominal pain.
- Vomiting
- Difficulty breathing, walking, or waking up.
- Confusion
- A rash that lasts more than two weeks.
- Pronounced redness, warmth, or tenderness in the areas affected by the rash
- A rash that appears with bruising, bleeding, or leakage of pus (the pus is thicker and less clear than the fluid in the blisters)
- A rash on an eyeball
How long does chickenpox last?
After exposure, chickenpox has an incubation period of about 10 to 21 days before symptoms appear. Chickenpox becomes contagious about 48 hours before symptoms appear and remains contagious as long as there are blisters without scabs.
Chickenpox blisters will appear continuously for a few days to a week, and it takes about a week for a new blister to scab over. Once all the blisters have healed, you will no longer be considered contagious.
How chickenpox is diagnosed
A doctor or doctor can usually determine if you have chickenpox based on the rash. However, it is standard procedure to collect a blister or blood sample to confirm the diagnosis.
What are the treatment options for chickenpox?
Since most cases of chickenpox resolve on their own, treatment usually focuses on controlling fever and itching. However, a doctor may prescribe antiviral medications for people who are at higher risk for serious symptoms or complications from chickenpox. Antivirals are more effective the sooner they are taken and should ideally begin within 24 hours of the chickenpox rash appearing.
Home remedies for chickenpox
There are several things you can do at home to relieve the uncomfortable symptoms caused by chickenpox. Home treatments to control itching and fever caused by chickenpox include:
- Cold baths with baking soda or oatmeal added to the water.
- Calamine lotion or cold compresses.
- Keep nails trimmed to help prevent infections from scratching
- Oral antihistamines (talk to a doctor before giving antihistamines to your child)
- Ibuprofen or acetaminophen (do not give your child aspirin)
As with any infection involving a rash, it is important to change your clothes and bedding daily, avoid sharing objects, and wash your hands thoroughly with soap and water before and after touching the rash.
Getting vaccinated is the most effective way to prevent chickenpox
If you have never had chickenpox, getting vaccinated is the best way to prevent it. The chickenpox vaccine prevents the vast majority of infections and significantly reduces the risk of having a severe case if you get it. According to the CDC, cases of chickenpox have decreased by more than 97% since the introduction of the vaccine.
If you think you may have chickenpox, talk to a doctor.
Chickenpox may be much less common than it used to be, but it’s still important to take it seriously. If you suspect that you or your child has chickenpox, make an appointment with a primary care provider. They can make a diagnosis, provide treatment, and give recommendations to relieve symptoms.
