Chickenpox: symptoms, care, and warning signs

It is often mild in otherwise healthy children, but adults, pregnant people, babies, and people with weakened immunity can become more unwell. Contact a clinician early if someone in one of these groups is exposed or develops symptoms.

Chickenpox often presents with an itchy rash whose spots progress to fluid-filled blisters and then crusts. New spots can appear while older ones are crusting, so several stages may be visible together. Fever, tiredness, headache, or reduced appetite may accompany the rash.

The varicella-zoster virus spreads through respiratory contact and contact with blister fluid. A person can pass it on before the rash is obvious and remains contagious until every blister has crusted. After recovery, the virus stays inactive in nerves and can later reactivate as shingles.

Encourage fluids, use cool baths or a soothing lotion for itch, keep nails short, and choose loose clothing. A pharmacist or clinician can advise on an age-appropriate antihistamine or fever medicine. Do not give aspirin to a child or teenager with chickenpox because of the risk of a serious reaction.

Keep the affected person away from school, nursery, work, and anyone who is pregnant, immunocompromised, or a newborn until all spots have crusted. Call ahead before attending a clinic so staff can limit exposure to other patients. Antiviral medicine may be considered early for people at greater risk of complications.

Get urgent medical help for difficulty breathing, unusual sleepiness or confusion, a stiff neck, trouble walking, repeated vomiting, severe abdominal pain, or a rash that bleeds or bruises. A blistered area that becomes increasingly red, hot, swollen, painful, or releases pus may have a bacterial infection.

Seek same-day advice when fever is persistent or worsening, the person cannot drink enough, urine output drops, or spots affect the eyes. Early contact is also needed for pregnancy, infancy, adulthood, significant lung or skin disease, or immunity weakened by illness or medicine.

Ask whether the rash pattern fits chickenpox, whether testing is needed, and which itch or fever treatments are suitable for the person's age and health. Also clarify whether antiviral treatment is appropriate, when isolation can end, and how vaccination applies to susceptible household contacts.