Table of ContentsView AllTable of ContentsFrequentLess CommonComplicationsWhen to See a Healthcare ProviderFrequently Asked QuestionsNext in Chickenpox GuideHow Chickenpox Is Diagnosed
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Frequent
Less Common
Complications
When to See a Healthcare Provider
Frequently Asked Questions
Next in Chickenpox Guide
Symptoms ofchickenpoxinclude rash, fever, swollen lymph nodes, abdominal pain, and others. The classic chickenpox rash is red and itchy. It occurs suddenly on the face, scalp, chest, back, and, to a lesser extent, arms and legs. Spots quickly fill with fluid, break open, and turn crusty.
Theincubation period—meaning the time between exposure and the appearance of chickenpox symptoms—is between 10 to 21 days, with an average of 14 days.
This article describes the frequent and rare symptoms of chickenpox, including potentially serious complications affecting the brain, nerves, skin, or lungs.
© Verywell, 2018
Frequent Symptoms of Chickenpox
Healthy people who become sick after being exposed to the varicella-zoster virus will develop a cluster of symptoms typical of any viral infection in addition to the telltale chickenpox rash.
In some people, particularly adults, the non-rash symptoms will appear before the rash does. In kids, the rash is often the first sign of chickenpox.
Non-Rash Symptoms
Most non-rash symptoms last for a day or two, then disappear as the rash develops. These are often non-specific and easily mistaken for things like flu.
Common non-rash symptoms include:
A person infected with VZV can be contagious during the first couple of days preceding the outbreak of the chickenpox rash.
Stay at HomeIf you come down with chickenpox, you’ll need to stay home from school, work, and other activities to avoid spreading the virus. This is true even if you’re feeling fine otherwise.
Stay at Home
If you come down with chickenpox, you’ll need to stay home from school, work, and other activities to avoid spreading the virus. This is true even if you’re feeling fine otherwise.
Chickenpox Rash
The chickenpox rash usually appears first on the torso, scalp, and face, and then spreads to the arms and legs.
The rash is extremely itchy, but it’s important not to scratch. Scratching can lead to infection and leave behind an unsightly scar.
The number of spots a person with chickenpox gets can vary. The typical range is between 100 and 300. Adults and older kids usually develop more than younger children.
Each one starts as a 2- to 4-millimeter red bump (papule) with an irregular border. Within a short period of time, the papule fills with highly-contagious fluid and develops a characteristic “dewdrop” appearance.
Alex Tihonovs / EyeEm / Getty Images
After eight to 12 hours, the fluid becomes cloudy and the tiny blister-like bumps (vesicles) erupt, leaving behind a crusty deposit that usually falls off after seven days.
Crusting and ContagiousnessOnce crusting has occurred, the chickenpox rash is no longer contagious.However, as old lesions crust over and fall away, new ones continue to form. Because of this, you are considered contagious until all lesions have healed and no new ones have appeared.
Crusting and Contagiousness
Once crusting has occurred, the chickenpox rash is no longer contagious.However, as old lesions crust over and fall away, new ones continue to form. Because of this, you are considered contagious until all lesions have healed and no new ones have appeared.
Less Common Symptoms of Chickenpox
Less commonly, the chickenpox rash can cause lesions onmucous membranesin the eyes, mouth, and vagina.
On rare occasions, children who have been partially vaccinated or even fully vaccinated can come down with chickenpox anyway. This is referred to asbreakthrough chickenpox.
The symptoms of breakthrough chickenpox tend to be milder and can easily be mistaken for bug bites or other commonrashes.
The symptoms of breakthrough chickenpox include:
Can You Get Chickenpox Twice?
Complications of Chickenpox
For people who are in good health, chickenpox is unlikely to lead to any serious issues. However, around 14,000 people are hospitalized in the United States each year as a result of chickenpox complications. For around 100 of them, chickenpox can be fatal.
Chickenpox complications can include bacterial infections that enter the skin due to scratching, neurological disorders, pneumonia, and shingles.
As many as a third of adults who get chickenpox are at risk of serious complications, especially people 65 and over and those withcompromised immune systems.
Bacterial Infection
With chickenpox, this can lead to secondary infections such as:
These infections are mostly superficial and easily treated with antibiotics. However, there is a risk that the bacteria can spread into the bloodstream, leading to a severe condition calledbacteremia.
People with bacteremia are at risk ofbacterial pneumonia, as well as other potentially serious infections likemeningitisandsepsis.
Neurologic Complications
The second most common set of complications of chickenpox involves the nervous system. One of the more serious neurological disorders is a childhood condition calledacute cerebellar ataxia.
Symptoms include fever, irritability, difficulty walking, and speech impairment, which can persist for days or even weeks. Fortunately, they usually resolve on their own without treatment.
Varicella meningoencephalitisis another potential neurological complication. This is the inflammation of the membranes that surround the brain and spinal cord.
Symptoms can include a headache, sensitivity to light, neck stiffness and pain, delirium, and seizures. People with compromised immune systems are most at risk, including those with advanced HIV.
Pneumonia
Varicella pneumonia is the leading cause of VZV-related illness and death in adults. It develops when the virus travels to the lungs via the bloodstream, where it causes infection.
Risk factors include:
Approximately one in every 400 adults who get chickenpox will be hospitalized as a result of this varicella pneumonia.
Shingles
After a person is infected with chickenpox, VZV is not completely eliminated from the body. Instead, it embeds itself in clusters of nerve cells calledganglia, where it remains dormant (inactive).
Certain triggers can cause VZV to suddenly reactivate, often decades after the initial infection. The consequence is a painful, blister-like eruption known asshingles(herpes zoster).
Shingles most commonly affect adults over 50.Vaccination against shinglescan help prevent this complication.
Chickenpox is an easily identifiable illness that a healthcare provider can often diagnose over the phone or a virtual visit. And, like most viral infections, it usually gets better on its own.
However, if you have signs of a secondary infection or other complications, call a healthcare provider immediately.
Symptoms of concern include:
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Unfortunately, no. Usually, chickenpox must be allowed to simply run its course. Skin-soothinghome remediescan help relieve itching, while over-the-counter pain medications can reduce discomfort. A prescription antiviral medication may be recommended for certain individuals.
It’s unlikely. The virus spreads very easily, and without vaccination, the immune system has no defense against it. According to the CDC, about 90% of unvaccinated people in close contact with a contagious person will contract the virus themselves.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Chickenpox (varicella).Institute for Quality and Efficiency in Health Care.Chickenpox: overview.Blair RJ.Varicella zoster virus.Pediatr Rev. 2019;40(7):375-7.Leung J, Broder KR, Marin M.Severe varicella in persons vaccinated with varicella vaccine (breakthrough varicella): a systematic literature review.Expert Rev Vaccines. 2017;16(4):391-400.National Vaccine Information Center.Chickenpox (varicella) disease & vaccine information.Bhatt DD, Kharkwal N, Yadav DK.Staphylococcal endocarditis after chicken pox in a child with structurally normal heart.Ann Pediatr Cardiol. 2017;10(3):312–313. doi:10.4103/apc.APC_17_17Lee KG, Cheng MO.Varicella-zoster infection with secondary bacteremia and extensive facial abscesses.Med J Malaysia. 2012;67(5):529.Desai J, Mitchell WG.Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.J Child Neurol. 2012 Nov;27(11):1482-8. doi:10.1177/0883073812450318Corti M, Villafañe MF, Vittar N, et al.Meningoencephalitis due to varicella zoster virus in AIDS patients. Reports of eleven cases and review of the literature.Rev Inst Med Trop Sao Paulo. 2015;57(6):505–8. doi:10.1590/S0036-46652015000600007Spernovasilis N, Milioni A, Gialamas I, Kokorakis E, Fanti G.Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: a case report and literature review.IDCases. 2018;12:104–6. doi:10.1016/j.idcr.2018.04.008Denny JT, Rocke ZM, McRae VA, et al.Varicella pneumonia: case report and review of a potentially lethal complication of a common disease.J Investig Med High Impact Case Rep. 2018;6:2324709618770230. doi:10.1177/2324709618770230Singh A, Parkash S, Gupta SK, Soni RK.Severe varicella pneumonia in adults: seven years' single-center experience from India.Indian J Crit Care Med. 2018;22(3):162–167. doi:10.4103/ijccm.IJCCM_495_17Institute for Quality and Efficiency in Health Care.Shingles: overview.Additional ReadingAbro, AH, et.al.Hepatic dysfunction is frequent in varicella infection. Rawal Med Jour. 33(2).American Academy of Dermatology.Shingles: diagnosis and treatment.Centers for Disease Control and Prevention.Clinical overview of chickenpox (varicella).Mayo Clinic.Reye’s syndrome.Michigan Medicine, University of Michigan.Chickenpox (varicella): when to call a doctor.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Chickenpox (varicella).Institute for Quality and Efficiency in Health Care.Chickenpox: overview.Blair RJ.Varicella zoster virus.Pediatr Rev. 2019;40(7):375-7.Leung J, Broder KR, Marin M.Severe varicella in persons vaccinated with varicella vaccine (breakthrough varicella): a systematic literature review.Expert Rev Vaccines. 2017;16(4):391-400.National Vaccine Information Center.Chickenpox (varicella) disease & vaccine information.Bhatt DD, Kharkwal N, Yadav DK.Staphylococcal endocarditis after chicken pox in a child with structurally normal heart.Ann Pediatr Cardiol. 2017;10(3):312–313. doi:10.4103/apc.APC_17_17Lee KG, Cheng MO.Varicella-zoster infection with secondary bacteremia and extensive facial abscesses.Med J Malaysia. 2012;67(5):529.Desai J, Mitchell WG.Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.J Child Neurol. 2012 Nov;27(11):1482-8. doi:10.1177/0883073812450318Corti M, Villafañe MF, Vittar N, et al.Meningoencephalitis due to varicella zoster virus in AIDS patients. Reports of eleven cases and review of the literature.Rev Inst Med Trop Sao Paulo. 2015;57(6):505–8. doi:10.1590/S0036-46652015000600007Spernovasilis N, Milioni A, Gialamas I, Kokorakis E, Fanti G.Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: a case report and literature review.IDCases. 2018;12:104–6. doi:10.1016/j.idcr.2018.04.008Denny JT, Rocke ZM, McRae VA, et al.Varicella pneumonia: case report and review of a potentially lethal complication of a common disease.J Investig Med High Impact Case Rep. 2018;6:2324709618770230. doi:10.1177/2324709618770230Singh A, Parkash S, Gupta SK, Soni RK.Severe varicella pneumonia in adults: seven years' single-center experience from India.Indian J Crit Care Med. 2018;22(3):162–167. doi:10.4103/ijccm.IJCCM_495_17Institute for Quality and Efficiency in Health Care.Shingles: overview.Additional ReadingAbro, AH, et.al.Hepatic dysfunction is frequent in varicella infection. Rawal Med Jour. 33(2).American Academy of Dermatology.Shingles: diagnosis and treatment.Centers for Disease Control and Prevention.Clinical overview of chickenpox (varicella).Mayo Clinic.Reye’s syndrome.Michigan Medicine, University of Michigan.Chickenpox (varicella): when to call a doctor.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Chickenpox (varicella).Institute for Quality and Efficiency in Health Care.Chickenpox: overview.Blair RJ.Varicella zoster virus.Pediatr Rev. 2019;40(7):375-7.Leung J, Broder KR, Marin M.Severe varicella in persons vaccinated with varicella vaccine (breakthrough varicella): a systematic literature review.Expert Rev Vaccines. 2017;16(4):391-400.National Vaccine Information Center.Chickenpox (varicella) disease & vaccine information.Bhatt DD, Kharkwal N, Yadav DK.Staphylococcal endocarditis after chicken pox in a child with structurally normal heart.Ann Pediatr Cardiol. 2017;10(3):312–313. doi:10.4103/apc.APC_17_17Lee KG, Cheng MO.Varicella-zoster infection with secondary bacteremia and extensive facial abscesses.Med J Malaysia. 2012;67(5):529.Desai J, Mitchell WG.Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.J Child Neurol. 2012 Nov;27(11):1482-8. doi:10.1177/0883073812450318Corti M, Villafañe MF, Vittar N, et al.Meningoencephalitis due to varicella zoster virus in AIDS patients. Reports of eleven cases and review of the literature.Rev Inst Med Trop Sao Paulo. 2015;57(6):505–8. doi:10.1590/S0036-46652015000600007Spernovasilis N, Milioni A, Gialamas I, Kokorakis E, Fanti G.Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: a case report and literature review.IDCases. 2018;12:104–6. doi:10.1016/j.idcr.2018.04.008Denny JT, Rocke ZM, McRae VA, et al.Varicella pneumonia: case report and review of a potentially lethal complication of a common disease.J Investig Med High Impact Case Rep. 2018;6:2324709618770230. doi:10.1177/2324709618770230Singh A, Parkash S, Gupta SK, Soni RK.Severe varicella pneumonia in adults: seven years' single-center experience from India.Indian J Crit Care Med. 2018;22(3):162–167. doi:10.4103/ijccm.IJCCM_495_17Institute for Quality and Efficiency in Health Care.Shingles: overview.
Centers for Disease Control and Prevention.Chickenpox (varicella).
Institute for Quality and Efficiency in Health Care.Chickenpox: overview.
Blair RJ.Varicella zoster virus.Pediatr Rev. 2019;40(7):375-7.
Leung J, Broder KR, Marin M.Severe varicella in persons vaccinated with varicella vaccine (breakthrough varicella): a systematic literature review.Expert Rev Vaccines. 2017;16(4):391-400.
National Vaccine Information Center.Chickenpox (varicella) disease & vaccine information.
Bhatt DD, Kharkwal N, Yadav DK.Staphylococcal endocarditis after chicken pox in a child with structurally normal heart.Ann Pediatr Cardiol. 2017;10(3):312–313. doi:10.4103/apc.APC_17_17
Lee KG, Cheng MO.Varicella-zoster infection with secondary bacteremia and extensive facial abscesses.Med J Malaysia. 2012;67(5):529.
Desai J, Mitchell WG.Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.J Child Neurol. 2012 Nov;27(11):1482-8. doi:10.1177/0883073812450318
Corti M, Villafañe MF, Vittar N, et al.Meningoencephalitis due to varicella zoster virus in AIDS patients. Reports of eleven cases and review of the literature.Rev Inst Med Trop Sao Paulo. 2015;57(6):505–8. doi:10.1590/S0036-46652015000600007
Spernovasilis N, Milioni A, Gialamas I, Kokorakis E, Fanti G.Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: a case report and literature review.IDCases. 2018;12:104–6. doi:10.1016/j.idcr.2018.04.008
Denny JT, Rocke ZM, McRae VA, et al.Varicella pneumonia: case report and review of a potentially lethal complication of a common disease.J Investig Med High Impact Case Rep. 2018;6:2324709618770230. doi:10.1177/2324709618770230
Singh A, Parkash S, Gupta SK, Soni RK.Severe varicella pneumonia in adults: seven years' single-center experience from India.Indian J Crit Care Med. 2018;22(3):162–167. doi:10.4103/ijccm.IJCCM_495_17
Institute for Quality and Efficiency in Health Care.Shingles: overview.
Abro, AH, et.al.Hepatic dysfunction is frequent in varicella infection. Rawal Med Jour. 33(2).American Academy of Dermatology.Shingles: diagnosis and treatment.Centers for Disease Control and Prevention.Clinical overview of chickenpox (varicella).Mayo Clinic.Reye’s syndrome.Michigan Medicine, University of Michigan.Chickenpox (varicella): when to call a doctor.
Abro, AH, et.al.Hepatic dysfunction is frequent in varicella infection. Rawal Med Jour. 33(2).
American Academy of Dermatology.Shingles: diagnosis and treatment.
Centers for Disease Control and Prevention.Clinical overview of chickenpox (varicella).
Mayo Clinic.Reye’s syndrome.
Michigan Medicine, University of Michigan.Chickenpox (varicella): when to call a doctor.
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