Chickenpox

What is chickenpox?

Chickenpox is an infection that causes an itchy, blister-like skin rash. A virus called varicella-zoster causes it. Chickenpox is highly contagious. But it’s much less common today because there’s a vaccine that protects you from it. Children are the most susceptible to getting chickenpox, although you can get it as an adult, too.

Before the availability of the first vaccine against chickenpox in 1995, almost everyone got chickenpox as a toddler or young child. But since the late 1990s, the rate of chickenpox has declined by nearly 90%. Today, most children receive a vaccine against chickenpox as part of their routine immunization schedule.

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 receiving the vaccine.

What are the three stages of chickenpox?

The three stages of chickenpox usually refer to the way the rash looks:

• Stage 1 is a red and bumpy rash. This can last a few days.
• Stage 2 is a fluid-filled blistered rash. The blisters break open after about one to two days.
• Stage 3 is when the blisters scab over. This stage also lasts a few days.

Even though the rash goes through three stages, you could have all types of bumps at the same time. This means some bumps can be forming while others are already breaking open. The entire rash can last up to about 10 days.

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 all the way to your fingers and toes.

What age will you get chickenpox?

Now that there’s a vaccine to prevent chickenpox, most children in the U.S. don’t get chickenpox. But in those who aren’t vaccinated, it’s more common to get it between the ages of 3 and 6.

Why is chickenpox rare now?

Chickenpox isn’t as common as it once was because the chickenpox vaccine has greatly reduced the number of cases.

What are the symptoms of chickenpox?

Chickenpox symptoms are easy to see. Healthcare providers often can look at your child’s skin and know if they have chickenpox. Symptoms of chickenpox usually happen in the following order:

• Low-grade fever.
• Feeling tired.
• Headache.
• A stomachache that makes you not want to eat.
• A skin rash that’s 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.
• Crusty spots that fade away.

Children who’ve been vaccinated against chickenpox are usually protected against getting chicken pox. But the vaccine isn’t 100% effective, and some children will have a “breakthrough” infection despite being vaccinated. The good news is that these “breakthrough” infections are usually very mild.

What causes chickenpox?

A virus causes chickenpox. Viruses spread when a person with the virus gives it to another person either through bodily fluid (coughing, sneezing, etc.) or bodily contact (touching the rash).

How does chickenpox spread?

Children can get chickenpox at any age. After exposure to chickenpox, your child may appear to be fine for one to three weeks before feeling sick. Children can spread the virus from one to two days before they show any signs of illness until all the blisters have crusted over or scabbed.

Chickenpox spreads 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.

Who is at risk for chickenpox?

You’re at risk for getting chickenpox if you didn’t receive the vaccine and haven’t ever had it. Your risk is even higher if you’re around children or work in a school or daycare facility.

What complications are possible with chickenpox?

Complications from chickenpox are unlikely but possible. They may include:

• Bacterial infections of your skin, blood and soft tissues.
• Encephalitis or Reye’s syndrome.
• Pneumonia.
• Dehydration.
• Issues with how your blood clots.
• Liver problems.

Even when chickenpox was prevalent, healthy children generally had mild cases of chickenpox. But chickenpox can cause more serious symptoms in adults over 18.

Who is more likely to have complications from chickenpox?

Healthy children who get chickenpox don’t usually have serious complications. However, having a severe case of chickenpox could be more dangerous for:

• Babies whose birth parent didn’t have chickenpox or the vaccine.
• Pregnant people who didn’t have chickenpox.
• Anyone over 18.
• People with immune system disorders.
• People with cancer or HIV.
• People undergoing chemotherapy.
• People who had an organ transplant.

Can chickenpox be fatal?

It’s very unlikely that you’ll die from chickenpox. Most people recover without complications. Of those who die from chickenpox, most people are adults. In 2022, there were fewer than 30 deaths from chickenpox in the U.S. and fewer than 1,400 hospitalizations.

How is chickenpox diagnosed?

Signs of chickenpox are easy to see. Healthcare providers often can look at your child’s skin and know if they have chickenpox.

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 them with the towel. Instead, pat your child dry.
• Give your child plenty of water and fluids to prevent dehydration. A soft, bland diet can help if they have blisters in their mouth.

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 child’s healthcare provider.

What if my baby gets chickenpox?

If your baby (up to age 3 months) gets chickenpox, let your child’s healthcare provider know right away. Chickenpox is more dangerous to newborns than to other healthy people.

What is the treatment for adults with chickenpox?

The treatment for adults is the same as for children. But your healthcare provider may recommend an antiviral medication. Adults who are at risk for severe symptoms or who have certain medical conditions may benefit from antiviral drugs.

How long is chickenpox contagious?

Chickenpox is contagious until all bumps on your body are scabs. If you have any fluid-filled blisters that haven’t broken or scabbed over, you’re still able to spread the virus.

How many days does it take to recover from chickenpox?

Chickenpox usually goes away after 10 to 14 days.

Can my child get a shot to prevent chickenpox?

Yes, there’s a vaccine for chickenpox. Your child’s pediatrician will give it in two doses.

When your child is under the age of 13, they should get one dose between ages 12 months and 15 months. The second dose happens between the ages of 4 and 6. Most children receive the chickenpox vaccine as a combination vaccine that also protects against measles, mumps and rubella (called MMRV). It can also be a standalone vaccine.

Adults who haven’t had chickenpox should also get the vaccine. If you’re 13 or older and never got the vaccine, you should get two doses at least 28 days apart.

Vaccination is over 90% effective at preventing chickenpox. Since 1995, the vaccine has prevented at least 91 million cases of 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-attenuated vaccines.

Can adults get chickenpox if they had it as a child?

When children get chickenpox, their bodies fight the illness by making a substance called antibodies. The antibodies fight the virus and help their body get well. These antibodies stay in your body throughout your life. So, if you come in contact with the virus as an adult, the antibodies are there to fight the virus off.

Can you get chicken pox twice?

It’s rare for anyone to get chickenpox twice, but it can happen.

What is the oldest you can be to get chickenpox?

There really isn’t an age limit to when you can still get chickenpox. Adults who didn’t have chickenpox as a child and who haven’t had a vaccine can still get chickenpox in their 80s or 90s.

When can my child go back to school after chickenpox?

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 go away completely, but you do need to wait until all the blisters have scabbed over. You’re contagious while the blisters have fluid.

When should you call your healthcare provider if your child has chickenpox?

Call your healthcare provider if your child has any of the following symptoms:

• Severe headache or fever that doesn’t go away.
• Sores in their eyes.
• Sores that get bigger or have yellow pus in them.
• Difficulty breathing or breathing very fast.
• Stiff neck or muscle/joint stiffness.
• Has trouble waking up.

When should adults with chickenpox seek medical care?

Chickenpox can be more serious in adults. You should contact a healthcare provider right away if you believe you have chickenpox, especially if you or someone in your house is pregnant or if you live with someone who has a suppressed immune system.

How are shingles and chickenpox related?

In adults, the chickenpox virus can become active again. When that happens, it causes an illness caused by 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.