Chicken pox
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CDC chickenpox varicella symptoms treatment when to seek care
Chickenpox (varicella) is a highly contagious infection caused by the varicella-zoster virus.
Typical symptoms
- Fever, tiredness, headache, reduced appetite
- An intensely itchy rash that becomes fluid-filled blisters, then crusts/scabs
- Rash often starts on the chest, back, or face and spreads, sometimes to the mouth or genital area. Illness usually lasts about 4-7 days. CDC overview
Spread
It spreads through close contact and airborne droplets. A person is contagious from about 1-2 days before the rash until every blister has crusted over. Stay home from school, childcare, and work during that period. CDC symptoms guidance
Home care
- Fluids, rest, loose clothing, cool baths, calamine or other anti-itch measures.
- Paracetamol/acetaminophen can help fever or discomfort.
- Do not give aspirin to children or teenagers with chickenpox because of the risk of Reye syndrome.
- Keep nails short and discourage scratching to reduce skin infection.
Seek medical advice promptly if the person is an adult, pregnant, immunocompromised, a newborn, or has chronic lung/skin disease. Antiviral treatment may be appropriate for people at higher risk, particularly when started early.
Urgent assessment is needed for breathing difficulty, severe headache, confusion, repeated vomiting, dehydration, high or persistent fever, a rash that becomes very red/warm/painful or drains pus, or trouble walking.
Vaccination is the best prevention. Chickenpox is usually mild in children but can cause serious complications, especially in adults and high-risk groups.
Treatment
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CDC chickenpox treatment acyclovir aspirin warning
Treatment of chickenpox
For a healthy child with uncomplicated chickenpox, treatment is mainly to relieve symptoms:
- Rest and fluids
- Paracetamol (acetaminophen) for fever or pain, using the age- and weight-appropriate label or clinician-directed dose
- Cool baths, loose cotton clothing, calamine lotion, and keeping fingernails short to reduce itching and skin damage
- Ask a pharmacist or clinician about an appropriate antihistamine if itching prevents sleep
Avoid
- Aspirin or salicylate-containing medicines in children or teenagers because of the risk of potentially fatal Reye syndrome.
- Ibuprofen is best avoided if possible in chickenpox, since it has been associated with severe bacterial skin/soft-tissue infections. CDC treatment advice
Antiviral medication
Acyclovir or valacyclovir may be prescribed for people more likely to have moderate or severe illness, including:
- Adults and adolescents
- Pregnant people
- People with weakened immunity
- People with chronic lung or skin disease
- People taking long-term steroids
- Severe or complicated infection
It works best when started within 24 hours of the rash appearing. Typical uncomplicated chickenpox in an otherwise healthy child usually does not need antiviral medication. Serious disease, such as chickenpox pneumonia or encephalitis, needs urgent hospital assessment and often intravenous acyclovir. CDC high-risk guidance
Seek urgent medical care if there is
- Difficulty breathing, chest pain, severe cough
- Severe headache, confusion, unusual drowsiness, seizures, repeated vomiting, or stiff neck
- Signs of dehydration
- Skin becoming very red, hot, swollen, painful, or producing pus
- Persistent high fever or fever that returns after improving
- Chickenpox in a newborn, pregnancy, or someone immunocompromised
Keep the person isolated until all lesions have crusted over, usually about a week after rash onset.
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