Chickenpox
Your health expert: Dr Lewis Caplin, Lead Physician, Bupa
Content editor review by Liz Woolfe, May 2023
Next review due May 2026
Chickenpox is a highly infectious disease caused by a virus. It spreads easily, usually by direct contact or via droplets in the air and is most common in children. It causes an itchy rash with small blisters and can make you feel unwell.
About chickenpox
Chickenpox is a common infection caused by the varicella zoster virus. Children under 10 years are most likely to catch chickenpox. But if you haven’t had it before, you can get it at any age.
The chickenpox virus is very contagious. It spreads easily through the air when you cough or sneeze. Or you can catch it if you touch infected surfaces or blisters. When someone gets it, it’s very likely that anyone in the same household who hasn’t had it before will catch it too. You can catch chickenpox at any time of the year, but it’s most common in the spring.
For most people, chickenpox isn’t serious. You’ll probably feel better after a week or so. The infection can be more serious in particular situations. See our Complications section for more information.
If you’ve had chickenpox, the varicella zoster virus will stay in your body for the rest of your life. This doesn’t cause any symptoms or do you any harm. But in around one in three people, the virus reactivates (wakes up) later in life. This can trigger shingles, causing a rash and nerve pain.
You can’t catch shingles – you have to already have the virus in your body. But if you’ve never had chickenpox, you can catch it from someone with shingles.
Symptoms of chickenpox
Chickenpox symptoms generally begin 10 to 21 days after you’re infected. Some people start to feel unwell before the rash begins. This is more likely in teenagers and adults, with symptoms, such as aching muscles, headache, sore throat, feeling sick and loss of appetite.
The main chickenpox symptoms are an itchy rash and a raised temperature for two or three days. The rash has flat or slightly raised red spots, which rapidly progress to fluid-filled blisters. You’ll probably notice them on your (or your child’s) face, scalp and chest first.
The spots appear in patches or ‘crops’ and may spread to your arms and legs. You may also get them in your mouth, nose and genitals. The blisters can be extremely itchy and will usually crust over within a few days, forming scabs. They can take up to two weeks to heal completely.
Chickenpox symptoms vary from person to person. Some children may have only a few blistered spots, but others will have spots all over their body. Adults are more likely to have worse symptoms than children. They’re also more likely to develop complications.
When to seek help for chickenpox
If a young child has chickenpox, you’ll usually be able to manage the symptoms at home, without seeking medical help. You’ll probably be able to tell it’s chickenpox because it causes such a distinctive rash. If you know your child has recently been in contact with someone who has chickenpox, this makes it even more certain.
If you’re not sure whether the symptoms could be due to something else though, contact your GP. You should also contact your GP if you (or your child) are feeling particularly unwell.
There are certain other circumstances with chickenpox when you should also contact your GP, even if you just think you’ve been exposed to it. These include if you're pregnant, have a newborn baby, or you have a weakened immune system. There are treatments you may be able to take that can help to make your symptoms less severe. See the Treatment section for more information.
If you do need to see a doctor, let your GP surgery know that you may have chickenpox when you contact them. If you need to be seen, they may want to keep you away from other patients. For instance, they may ask you to wait in a different room to their usual waiting room. This is to make sure you don’t pass the infection on to anyone who has a higher risk of complications.
Under 18 GP Appointments
We now offer GP appointments for children aged between 1 and 18 via our remote video service (UK wide) and face to face appointments at selected centres. Please note that these appointments cannot be booked online so please call 0330 822 3072 for more information or to book. Lines are open Monday to Friday 8am to 8pm, Saturday and Sunday 9am to 5pm. We may record and monitor our calls. Available from £49.
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Stopping the spread of chickenpox
Chickenpox is highly contagious. You’re most infectious one to two days before your rash appears, so you can spread it to other people before you even realise you have it. You remain infectious until all your spots crust over (usually about five days after the rash appears).
If you think you have chickenpox, keep away from young babies, pregnant women and anyone with a weakened immune system. This might include people having cancer treatment or taking steroids. It’s best to stay away from public places, including your GP surgery, and work if possible. If your child has chickenpox, keep them off school or nursery for at least five days from when the rash first appears, and until the spots have all crusted over.
Self-help for chickenpox
If you or your child is generally fit and healthy, you’ll usually recover from chickenpox without any specific treatment. There are some simple things you can do at home though to ease your symptoms. These include the following.
- Make sure you’re drinking enough fluids to prevent dehydration.
- Make sure you’re not too hot or too cold. Wear layers so you can take clothes off (or put them on) if you need to.
- Wear smooth, cotton fabrics that are less likely to irritate your rash.
- Keep your nails short to stop you damaging your skin if you scratch it.
- Try not to scratch your spots as much as possible, as this can make them infected or lead to scarring. You might want to put mittens on young children overnight to reduce scratching.
- You should bathe/wash regularly to stop your spots getting infected.
Relieving itchy skin
If your skin is very itchy, try using cool or wet compresses to ease it. Some people find that an oatmeal or cornflour bath helps. Calamine lotion can help to soothe itching at first, but stops working once the lotion dries on your skin. It can also dry out your skin, making you want to scratch more. You may find that moisturising skin creams and ointments can ease the itching too.
If you’re very itchy, you can also try taking the antihistamine chlorphenamine (eg Piriton®).You can buy this over the counter from a pharmacy. Some antihistamines can cause drowsiness, so are best taken at bedtime. They’re not suitable for babies under one year.
Reducing fever
You can take paracetamol if you have any pain or a fever that’s bothering you. Children and babies older than two months can have junior paracetamol (such as Calpol).
Remember – don’t take non-steroidal anti-inflammatory drugs (such as ibuprofen). These medicines can cause a serious skin infection in children and adults with chickenpox.
Always read the patient information leaflet that comes with any medicine. If you have any questions, ask your pharmacist for advice. If your symptoms seem to be getting worse, or you start feeling very unwell, contact your GP.
Treatment of chickenpox for people at risk
In certain circumstances, your doctor may be able to offer you treatment if you have chickenpox, or think you’ve been exposed to the virus. This includes if:
- you're pregnant
- have a newborn baby
- have a weakened immune system.
There are two main types of treatment your doctor may give you.
Anti-viral medicines
If you’re over 14 years, your GP may offer you an anti-viral drug called aciclovir (Zovirax). This is most likely if your chickenpox is severe or you’re at risk of getting complications. For aciclovir to work, it has to be less than 24 hours since your spots first appeared. Starting it this soon may help to reduce your symptoms and mean you recover more quickly.
Antibody treatment
If you know you’ve been exposed to the virus, you may be able to have antibody treatment before you develop symptoms, to help fight it off. Your doctor is only likely to offer this if you are at significant risk of a severe infection or complications (for example, you are pregnant or have a weakened immune system).
Your doctor will ask you to have a test for antibodies to chickenpox first, to check whether you’re immune. You may have to go to hospital to have this done, as it can be quicker to get the results. If the test is negative (you’re not immune), you may have an antibody injection. This is called a varicella zoster immunoglobulin (VZIG) injection.
Antibodies are proteins that help your immune system to fight bacteria and viruses. For the VZIG injection to work, you’ll need to have it within 10 days of coming into contact with someone who has chickenpox. The antibodies may not stop you having chickenpox, but they may make your symptoms milder.
Complications of chickenpox
Complications of chickenpox are rare. If you're generally healthy, it’s usually a mild infection and serious problems are unlikely. Chicken pox in adults is more likely to be serious than in children. Chickenpox can also be more serious for:
- pregnant women
- older people
- newborn babies
- people with a weakened immune system
Sometimes the chickenpox spots get infected with bacteria – probably from scratching. Chickenpox spots can sometimes leave scars, especially if they become infected. Signs of a bacterial infection include a high temperature (fever) and redness and pain around the chickenpox spots. Seek urgent medical help if you or your child develop these symptoms.
Young children can also be at risk of becoming dehydrated. Signs of dehydration include peeing less, feeling very tired and cold fingers and toes. Your child’s skin may also be less elastic, which means it won’t bounce back if you pull it slightly. If your child shows these signs, call a doctor straightaway. Rarer complications of chickenpox can include:
- lung infection (pneumonia) – this is more likely if you smoke, or are pregnant
- inflammation of your liver (hepatitis)
- infection of the brain (encephalitis)
Chickenpox and pregnancy
If you’re not immune to chickenpox and catch it during the first 28 weeks of your pregnancy, there’s a small risk it could affect your baby. If you get chickenpox in the last few weeks of your pregnancy, before you give birth, your baby could get chickenpox too. Women who are pregnant are also more likely to get complications from chickenpox, such as pneumonia.
If you’re pregnant and come into contact with chickenpox, you don’t need to worry if you’ve ever had chickenpox before, or you’ve had a chickenpox vaccine. You should already be immune.
If you’ve never had chickenpox or aren’t sure, see your midwife or GP as soon as possible. Your GP may give you treatments that can reduce the severity of the infection if you do get it. See Treatment section above for more information. If you develop chickenpox, your GP may want to monitor you closely in case of complications, or refer you to a specialist.
Contact your GP or seek urgent medical advice from your midwife or health visitor if you get chickenpox within a week of giving birth. Your baby can be given injections of antibodies to help protect them against the infection.
Common childhood viruses [podcast]
Why children pick up so many viruses | Podcast | Listen in 18:31 minutes
In this podcast, Bupa GP, Dr Samantha Wild, to discuss common childhood viruses. Find out why children pick up so many viruses and illnesses during childhood, how to manage them and when to seek medical advice. They also discuss how the pandemic has affected general immunity, and whether the vaccination programme will extend to children.
Chickenpox is a common infection caused by the varicella zoster virus. The rash you get with chickenpox has flat or slightly raised red spots, which rapidly progress to fluid-filled blisters. You might also have a raised temperature (fever), headache, sore throat and loss of appetite.
Chickenpox is most infectious one to two days before your rash appears. So, you can spread it to other people before you even realise you have it. You remain infectious until all your spots crust over – usually about five days after the rash appears. See the section on stopping the spread of chickenpox.
Some people feel ill for a day or two before they develop a rash. The rash starts with spots that blister and then crust over about five days after the rash started. After that, you’re no longer infectious. Once you’ve had chickenpox, the virus stays in your body for life, but usually causes no problems.
You shouldn’t use any form of public transport until you’re no longer infectious. This is when all your spots have crusted over – usually around five days after the chickenpox rash appears. If you’re flying and your spots are still visible, you may need a doctor’s letter to confirm that you’re no longer contagious. Contact your airline for advice.
There is a chickenpox vaccine, but in the UK it’s only recommended for certain groups (and if they’re not immune already). This includes healthcare workers and anyone in regular close contact with someone who has a weakened immune system.
Once you’ve had chickenpox, you’re usually immune for life. So, you’re unlikely to catch it again and won’t spread it to others. Sometimes the virus can flare up in later life causing shingles. But it’s very unusual to get chickenpox more than once. There is more information in our section about chickenpox.
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