You probably know chicken pox for the classic itchy, raised rash that comes with it. While bumps, blisters, and scabs are certainly a hallmark of the virus, there’s more to it than that. Chicken pox can also cause flu-like symptoms typical of viral illnesses, like a fever, and a general feeling of malaise. These generalized symptoms often occur before the chicken pox rash appears on the skin.
Chicken pox can lead to other complications, especially in certain at-risk individuals. Luckily, when chicken pox occurs in otherwise healthy children it’s mild and self-limiting, which means it goes away on its own within a week or two. Chicken pox in adults can cause a more severe illness, but will also generally resolve by itself. In any case, it’s important to be cautious and seek medical care with your doctor or your child’s pediatrician —or chat with a doctor on K—if you have any concerns about your or your child’s health.
What Is Chicken Pox?
Chicken pox, known primarily for its raised, itchy bumps and blisters, is a highly contagious illness caused by the varicella-zoster virus. Since the chicken pox vaccine became available in 1995, the virus has become less common, but both adults and children still contract it.
If someone has had chicken pox, it’s uncommon (but not impossible) to contract it again. That’s because when children first become infected, their bodies make antibodies to fight the virus. These antibodies remain in the body throughout adulthood, which then fight off any subsequent encounters with the virus and reduce the risk of infection later on in life.
What Are the Causes of Chicken Pox?
Chicken pox is caused by the varicella-zoster virus, which also causes herpes zoster, or better known as shingles. The virus is highly contagious and spreads through close contact between people with chicken pox to others who have never had the virus and aren’t vaccinated. The varicella virus can also spread by breathing air where an infected person sneezes or coughs, or coming into contact with fluids from an infected person’s eyes, nose, or mouth.
Since shingles is caused by the same virus, a child without the varicella vaccine or has never had chicken pox can get chicken pox from someone who has shingles.
If your child has chicken pox, try your best to keep him or her away from anyone (including babies, children, and adults) who hasn’t had the chicken pox vaccine and anyone who hasn’t had chicken pox before.
Chicken Pox Symptoms
Out of all childhood illnesses, chicken pox is probably one of the most memorable, thanks to the extremely itchy, blister-like rash and the following days of crusty scabs. However, the chicken pox rash is unfortunately only one part of chicken pox symptoms.
More general viral symptoms are usually the first to surface after chicken pox exposure. Children with chicken pox often experience the following a day or two before the rash appears:
- Fever (usually between 101-102° F)
- Fatigue or sleepiness
- Lack of appetite
- General malaise
- Sore throat
- Stomach ache
The chicken pox rash also has a distinct appearance:
- Extremely itchy bumps that look like pimples or small blisters
- Bumps filled with milky-looking liquid
- Scabs that appear after the blisters break and leak
- Blotchy skin
Keep in mind that chicken pox is contagious for up to two full days before the onset of the rash, and it can continue to spread until all of the blisters have crusted over with scabs.
Chicken pox symptoms usually subside within a week or two. You can expect your child to miss about five days of school or childcare while recovering from the chicken pox virus.
Chicken Pox Stages
Chicken pox occurs in several phases. Because chicken pox is a viral illness, early stage chicken pox usually begins with typical viral symptoms, which can emerge anywhere from 10-21 days after exposure.
One or two days after the initial onset of the viral symptoms, children usually develop an itchy, raised red or pink rash on their face, abdomen, and back. The rash then typically spreads to other areas of the child’s body, like the mouth, arms, legs, scalp, and genital area.
Next, the bumps turn into blisters filled with fluid. This happens in about a day, during which the blisters burst open and leak.
After about a week, the blisters gradually turn into scabs, which can take several days to completely heal.
Since new bumps can emerge throughout the course of the illness, a child may have all three phases of the rash at once, and this is considered to be a classic finding in chicken pox.
Diagnosing Chicken Pox
Usually, chicken pox is a fairly simple diagnosis. If you suspect your child has the virus, your child’s pediatrician will examine the rash and consider the viral symptoms. To confirm the diagnosis, your child might also undergo lab tests, like a blood test or a culture of the skin lesions.
When you visit your doctor, keep in mind that since the chicken pox spreads easily and certain populations (such as young babies and pregnant women) are at greater risk, it’s important to be careful and keep your distance in your health care provider’s waiting room.
Chicken Pox Treatments
Chicken pox is a virus, so doctors don’t treat it with antibiotics unless the sores become infected with bacteria. Often, the illness resolves on its own over time. If your child’s doctor has reason for concern about your child’s health—for example, if your child is immunocompromised, has asthma or a skin condition called eczema—he or she might prescribe an anti-viral medication to lessen the severity or decrease the duration of the illness. However, these medications are only effective when initiated within 24 hours of the onset of illness.
At Home Chicken Pox Treatments
The greatest complaints about chicken pox are the discomfort caused by the rash and viral syndrome, and there are some treatments that you can try at home to make your child more comfortable as you wait for the illness to run its course.
Most importantly, just as you would for any viral illness, focus on ensuring your child gets ample rest and drinks plenty of fluids to stay hydrated. You can also treat their fever, if they have one, with acetaminophen (Tylenol).
While it’s only natural for your child to scratch his or her itchy bumps and blisters, try to discourage excessive scratching as much as possible. Too much scratching can slow the healing process and increase the risk of a bacterial infection. You can reduce the scratching by putting gloves or mittens on your child’s hands (especially during sleep) or simply trimming his or her fingernails and keeping them clean. You can also try giving your child an antihistamine like Benadryl, which is an effective medication to reduce itching.
Treating itchiness with home remedies
A cool bath with baking soda, uncooked oatmeal, or colloidal oatmeal (a finely ground oatmeal made specifically for soaking) can soothe itching. You can also try dabbing calamine lotion on chicken pox spots for itch relief. A cold compress such as an ice pack wrapped in a towel can also be effective in reducing the severity of the itchiness.
At times, a chicken pox rash can occur in a child’s mouth. To prevent further irritation of these painful sores, encourage a soft, bland diet and avoid acidic or salty foods. Instead, offer foods like yogurt, bananas, apple sauce, soup, oatmeal, or smoothies. Ice pops and ice cream can also help to cool the inside of your child’s mouth and lessen their discomfort.
Treating fever and other chicken pox discomforts at home
For your child’s fever and other symptoms of discomfort, you can try children’s ibuprofen or acetaminophen. It’s important to avoid giving children aspirin, which has been shown to increase the risk of a serious condition called Reye’s Syndrome, particularly when they have chicken pox. In general, it’s always a good idea to talk to your child’s doctor before administering medication for an illness.
The Chicken Pox Vaccine
The best way to prevent chicken pox is with the chicken pox vaccine, also known as the “varicella” vaccine. This vaccine became available in the United States in 1995. Since then, the number of cases of chicken pox seen in the U.S. has declined drastically.
Just two doses of the chicken pox vaccine has been proven 90% effective in preventing chicken pox. It’s still possible, however, for vaccinated individuals to get the chicken pox virus. Usually, however, these cases are much more mild, involving a lower fever and often no or minimal blisters after the initial rash.
For babies, doctors usually offer the chicken pox vaccine around age one and again between ages four and six. For children 13 and older who haven’t been previously vaccinated, experts recommend two doses at least 28 days apart.
Risk Factors and Related Conditions
For otherwise healthy children, chicken pox is usually uncomplicated and rarely results in any serious side effects. In some cases, it can lead to other illnesses or complications, including:
- Bacterial infections of the skin, soft tissues, bones, joints, or bloodstream
- Inflammation of the brain (encephalitis)
- Toxic shock syndrome
- Liver problems
Some children may also be more prone to chicken pox complications:
- Newborn babies and infants whose mothers don’t have a chicken pox vaccine
- Adolescents (ages 10-18)
- Children with suppressed immune systems due to medications like chemotherapy or conditions like HIV
- Children on steroid medications for any condition
- Children with leukemia
- Anyone who is pregnant
Chicken pox in adults
Chicken pox is most commonly acquired by children, but adults can get it too. People who didn’t get the chicken pox vaccine or haven’t had chicken pox in the past are susceptible to the virus. In general, adults who contract chicken pox are more likely to develop complications, but certain populations are considered to be at especially higher risk:
- People who smoke
- Pregnant women
- Anyone with a compromised immune system
- Adults with with leukemia
- People who have had transplants
If your child has chicken pox and you either haven’t had it before or are not vaccinated, talk to your doctor about your options for staying healthy.
When to See a Doctor
Chicken pox in babies younger than six months usually requires medical attention. If your child is younger than six months of age or has another condition that makes chicken pox complications more likely, it’s important to see a doctor. In addition, if your child’s fever exceeds 102° F (38.9° C) or lasts longer than three days, talk to a medical professional. It’s also important to alert your doctor if your child has any of the following symptoms, which can indicate a more serious illness:
- A rash in one or both eyes
- A rash that becomes very red, warm, or tender, which could indicate a bacterial skin infection
- Dizziness, disorientation, rapid heartbeat, shortness of breath, tremors, loss of muscle coordination, a severe and worsening cough, vomiting, stiff neck, or a fever higher than 102° F (38.9° C)
How K Health Can Help
Are you concerned that your child’s symptoms might be chicken pox? Wondering if treatment is needed and want some peace of mind about a developing illness? Download K and chat with a doctor, who can diagnose and treat your little one’s chicken pox or help you determine if you should visit a physician in person.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.