Chickenpox — just hearing the name can bring a wave of itchy memories for adults who had it as kids. Though often considered a childhood rite of passage, chickenpox is far more than a harmless annoyance. It’s a contagious viral infection that can lead to complications, particularly in infants, teens, and immunocompromised individuals.
Today, with widespread vaccination, chickenpox is far less common — but it hasn’t vanished. Here’s what every parent needs to know about the virus, its symptoms, and how to manage it.
Table of contents:
- What is chickenpox?
- How it spreads
- Symptoms and stages
- What does chickenpox feel like?
- Complications to watch out for
- When to call a doctor
- Treatment and care at home
- What about antiviral medication?
- Prevention: The chickenpox vaccine
- Chickenpox and school attendance
- Chickenpox in adults and teens
- Can you get chickenpox twice?
- Final thoughts
What is chickenpox?
Chickenpox, or varicella, is a highly contagious disease caused by the varicella-zoster virus (VZV) — the same virus that later causes shingles. Once incredibly common, chickenpox saw a sharp decline in developed countries after introducing the varicella vaccine in the 1990s. Despite this progress, outbreaks still occur, especially in communities with lower vaccination rates.
How it spreads
Chickenpox is famously easy to catch. It spreads through:
- Airborne droplets when an infected person coughs or sneezes.
- Direct contact with the fluid from the characteristic blisters.
- Contaminated surfaces or clothing, although this is less common.
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A person with chickenpox is contagious from 1–2 days before the rash appears until all blisters have crusted over, which typically takes 5 to 7 days.
Symptoms and stages
Chickenpox symptoms usually appear 10 to 21 days after exposure to the virus. The classic progression includes:
- Early Symptoms (1–2 Days Before the Rash)
- Fever
- Fatigue or general malaise
- Loss of appetite
- Headache.
- The Rash (3 Key Stages)
- Red Spots: Small, red, itchy spots start on the face, chest, or back.
- Blisters: These quickly turn into fluid-filled blisters.
- Crusting: After a day or two, the blisters burst and scab over.
New spots can continue appearing for several days, often in waves. It’s common to see all three stages at once on a child’s body.
What does chickenpox feel like?
For most children, chickenpox is unpleasant but manageable. The main complaint is intense itching, which can lead to scratching, broken skin, and potential infection. Fevers and general discomfort often accompany the rash, especially in the early stages.
Sometimes, the illness is very mild — especially in vaccinated children. Others may experience a more severe form with widespread rash and high fever.
Complications to watch out for
Although often mild, chickenpox can cause serious complications, especially in certain groups. These include:
- Bacterial skin infections (from excessive scratching)
- Pneumonia
- Encephalitis (inflammation of the brain)
- Dehydration
- Sepsis
Children with weakened immune systems, newborns, and pregnant women are at higher risk of complications and should be monitored closely.
When to call a doctor
Seek medical attention if your child:
- Has a high fever that lasts more than 4 days
- Develops a cough, difficulty breathing, or chest pain
- Shows signs of infection in the blisters (redness, swelling, pus)
- Becomes extremely lethargic or confused
- Has persistent vomiting or signs of dehydration
For most children, a call to the pediatrician for guidance is sufficient. They may advise you to manage symptoms at home unless complications arise.
Treatment and care at home
There is no cure for chickenpox, but symptoms can be managed to keep your child comfortable. Key approaches include:
- Rest and fluids: Encourage hydration and rest throughout.
- Itch relief:
- Use calamine lotion or colloidal oatmeal baths.
- Keep fingernails short to reduce scratching and prevent infection.
- For intense itching, antihistamines (e.g., diphenhydramine) may be recommended by a doctor.
- Fever control:
- Use acetaminophen (paracetamol) to lower fever.
- Avoid ibuprofen unless prescribed, as it may increase the risk of skin complications.
- Never use aspirin, which can lead to Reye’s syndrome — a rare but serious condition.
- Comfort clothing: Dress your child in loose, soft cotton to avoid irritating the rash.
What about antiviral medication?
In severe cases or for high-risk individuals, doctors may prescribe antiviral medications like acyclovir. These are most effective if started early, ideally within 24 hours of the rash appearing. For healthy children with mild symptoms, antivirals are usually not necessary.
Prevention: The chickenpox vaccine
The varicella vaccine is the most effective way to prevent chickenpox. It’s typically given in two doses:
- First dose: 12–15 months
- Second dose: 4–6 years
Vaccinated children either won’t get chickenpox or will have a very mild form, with fewer spots, lower fever, and a shorter duration.
The vaccine is over 90% effective at preventing the disease and nearly 100% effective at preventing severe forms. It also contributes to herd immunity, protecting those who cannot be vaccinated.
Chickenpox and school attendance
Children with chickenpox should stay home until all blisters have crusted over. This usually takes about a week. Keep them away from:
- School and daycare
- Public places (playgrounds, shops, etc.)
- Pregnant women, newborns, and immunocompromised people
Once the rash has fully scabbed, they are no longer contagious and can safely return to normal activities.
Chickenpox in adults and teens
Though often mild in kids, chickenpox tends to be more severe in teens and adults. These groups may experience a more extensive rash, higher fever, and increased risk of complications like pneumonia.
For this reason, unvaccinated teens and adults who haven’t had chickenpox are encouraged to get vaccinated — especially if they work in healthcare, education, or child care.
Can you get chickenpox twice?
It’s rare but possible. Most people gain lifelong immunity after one infection, but occasional cases of a second, milder bout occur.
However, the varicella-zoster virus never fully leaves the body. Later in life, it can reactivate as shingles — a painful rash that usually affects adults over 50. The shingles vaccine is recommended for older adults to prevent this.
Final thoughts
While chickenpox isn’t the terror it once was — thanks to vaccines and modern care — it still poses a risk, especially to vulnerable groups. If your child catches it, rest assured that most cases resolve without complications. With proper care, a bit of calamine lotion, and lots of TLC, your little one will soon return to their usual energetic self.
And if you’re reading this while applying anti-itch cream to a very spotty toddler: solidarity, snacks, and clean sheets. You’ve got this.
This article is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider for any health-related concerns.
