What should you know about start of chickenpox?

Chickenpox is caused by varicella-zoster virus. Most people with chickenpox develop an itchy rash that appears in crops: new spots can arrive while older ones become blisters, then crust. The rash may begin on the chest, back, or face and spread, but its pattern varies. Fever, tiredness, headache, or reduced appetite can occur around the beginning.

A clinician may consider other blistering illnesses. Shingles is related to the same virus but usually follows a different pattern, often affecting a more limited strip of skin. Do not scratch or burst the blisters, because broken skin can become infected and may leave marks.

Avoid close contact with pregnant people who are not immune, newborn babies, and people with weakened immune systems until a clinician says the contagious period has ended. Wash hands, keep fingernails short, use loose clothing, and ask a pharmacist about suitable itch relief. Do not give aspirin to a child with a suspected viral illness.

Arrange a GP consultation if the diagnosis is uncertain, the patient is an adult, pregnant, very young, immunocompromised, or has a significant chronic condition. Antiviral treatment may be considered for some people when started early; a clinician decides whether it fits.

Seek urgent care for breathing difficulty, severe headache, confusion, repeated vomiting, dehydration, a rapidly worsening rash, severe skin pain, or blisters near the eyes. Also seek advice promptly if the skin around blisters becomes increasingly red, hot, swollen, or painful, which can suggest a secondary infection.

Ask whether the rash fits chickenpox, when the patient can return to school or work, which itch or fever measures are suitable, and whether antiviral treatment is indicated. Ask about vaccination for household members who may not be protected and what symptoms should prompt reassessment.