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Chickenpox


Expert reviewer, Dr Melanie Hill, Bupa Clinics GP
Next review due February 2024

Chickenpox is a highly contagious viral infection that spreads easily from person to person. It is most common in young children, and causes an itchy rash with small blisters and can make you feel unwell.

A father and son sitting on the couch having a cuddle

About chickenpox

Chickenpox is a common infection caused by the varicella zoster virus. Children under 10 years are most likely to catch chickenpox, but you can be affected at any age. The chickenpox virus is very contagious. It’s spread easily through the air when you cough or sneeze or if you touch infected surfaces or blisters. If you’ve not had chickenpox before and someone in your household gets it, it’s very likely you’ll catch it too. You can catch chickenpox at any time of the year, but the infection is most common in the spring months.

For most people, chickenpox isn’t serious. You’ll probably feel better after a week or so. The infection may be more serious if you’re very elderly, have a weakened immune system or if you're pregnant. Adults are also more likely to have a severe infection and develop complications, and it can be serious for newborn babies too. 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 sometimes the virus reactivates (wakes up), later in life. This can trigger shingles, which causes a rash and nerve pain. You can catch chickenpox from someone with shingles if you haven’t already had chickenpox, but not the other way round.

Symptoms of chickenpox

Symptoms of chickenpox begin 10 to 21 days after you’re infected. Some people start to feel unwell before the rash begins. You might have symptoms such as a raised temperature (fever), headache, sore throat and loss of appetite. This is more likely in teenagers and adults.

The rash you get with chickenpox 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.

Image showing boy with chickenpox
Chickenpox

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 around two weeks to heal completely.

Image showing chickenpox blisters
Chickenpox blisters

Chickenpox symptoms vary from person to person and tend to be worse in adults. Some children may have only a few blistered spots, but others will have spots all over their body. It’s possible to have very few symptoms, or to not even notice that you’ve had it in mild cases. 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 you’ve 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’re feeling particularly unwell.

There are certain other circumstances when you should also contact your GP, if you think you have chickenpox or may have 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 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’s at a higher-than-normal risk of complications from chickenpox.

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 in places, you can try using cool or wet compresses to ease the itch. Some people find that an oatmeal or cornflour bath helps. You may also find that calamine lotion soothes the itching, but be careful as it can dry out your skin. It also stops working once the lotion dries on your skin. You may find that moisturising emollient 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 medicine over the counter from a pharmacy. They’re not suitable for children under the age of one.

Reducing fever

You can take paracetamol if you have any pain or a fever that’s bothering you. Children older than two months can take junior paracetamol (such as Calpol). Don’t take non-steroidal anti-inflammatory drugs (such as ibuprofen) for chickenpox, as these medicines can cause a serious skin infection in children and adults with chickenpox. Always read the patient information leaflet that comes with your medicine, and 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, or have a weakened immune system. There are two main types of treatment your doctor may be able to give you.

Anti-viral medicines

Your GP may offer you an anti-viral drug called aciclovir (Zovirax) if you’re over 14 years and it’s been less than 24 hours since your chickenpox spots started appearing. They’re most likely to suggest you have it if your chickenpox is severe or you’re at risk of getting complications. Taking anti-virals within 24 hours of your rash first appearing may help to reduce your symptoms and mean you recover faster.

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 may ask you to have a test for antibodies to chickenpox first, to check whether you’re immune. If the test is negative (you’re not immune), you may be offered 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 are unlikely to stop you having chickenpox, but they may make your symptoms milder.

Complications of chickenpox

Complications of chickenpox are rare. If you're generally healthy, chickenpox is usually a mild infection and it’s unlikely you’ll have serious problems. Complications are more likely to affect adults than children. Chickenpox can also be more serious for pregnant women, older people, newborn babies or people with a weakened immune system.

Complications of chickenpox can include lung infection (pneumonia), inflammation of your liver (hepatitis) and infection of the brain (encephalitis). You’re more likely to get pneumonia if you smoke or are pregnant.

Sometimes the chickenpox spots get infected with bacteria – probably from scratching. This is more common in children. 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.

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 late in your pregnancy, especially around the time 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 previously had chickenpox yourself, or you’ve had a vaccine. You should already be immune. But 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.

Frequently asked questions about chickenpox

  • 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 symptoms, such as a raised temperature (fever), headache, sore throat and loss of appetite.

  • 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).

  • You’re no longer infectious when all your spots have crusted over. This is usually around five days after the chickenpox rash appears. But, if you’ve had chickenpox, the varicella zoster virus will stay in your body for the rest of your life.

  • You shouldn’t travel by plane until you’re no longer infectious, which is when all your spots have crusted over. This is usually around five days after the chickenpox rash appears. Airlines have a right to refuse you if you’re unwell, as it’s their duty to protect other passengers. This is because you could pass on the infection to other people. So, if you’ve already booked a flight, you may need to delay it for a few days.

    If your spots have crusted over but are still visible, you may need a letter from your doctor to confirm that you’re no longer contagious. Contact the airline you’re travelling with to find out.

  • There is a chickenpox vaccine, but in the UK it’s only recommended for certain people 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, it’s likely you’ll stay immune for life. This means you’re unlikely to catch the infection again and won’t spread it to others. It’s possible to get chickenpox again, usually if your first infection was very mild – but this is very rare.

    Once you’ve recovered from chickenpox, the virus stays hidden in your body. This doesn’t usually cause any symptoms. But at any time later in your life, the virus can be reactivated, causing shingles.



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Related information

    • Chickenpox. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2018
    • Infectious disease. Oxford handbook of general practice. Oxford Medicine Online. oxfordmedicine.com, published online June 2020
    • Acute varicella-zoster. BMJ Best Practice. bestpractice.bmj.com, last reviewed 30 October 2020
    • Varicella: the green book, chapter 34. Public Health England, last reviewed 26 June 2019. gov.uk
    • Pediatric chickenpox. Medscape. emedicine.medscape.com, updated 30 November 2018
    • Chickenpox. Patient. patient.info, last edited 7 November 2016
    • Shaw D. The hidden risks of the waiting room: confidentiality and cross-infection. Br J Gen Pract 2019; 69(683):299. doi:10.3399/bjgp19X703925
    • Health protection in schools and other childcare facilities. Public Health England, updated 27 March 2019. www.gov.uk
    • Chickenpox (varicella). MSD Manual. www.msdmanuals.com, last full review/revision October 2019
    • Passenger health FAQs: The aircraft cabin – your health and comfort. Infections. Civil Aviation Authority. www.caa.co.uk, accessed 3 December 2020
  • Reviewed by Pippa Coulter, Freelance Health Editor, February 2021
    Expert reviewer, Dr Melanie Hill, Bupa Clinics GP
    Next review due February 2024

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