Diseases and Conditions › Alternative Medicine › Chickenpox

Chickenpox

Aakansha

First Author
M R Lokeshwar
Consultant Pediatrician, Hinduja Hospital, Mumbai, India
First Created: 02/04/2002 Last Updated: 10/25/2025

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Chickenpox is a viral infection caused by the varicella-zoster virus. It leads to fever and an itchy, blister-like rash. After the infection, the virus stays “dormant” in the body and may reactivate later in life as shingles.

How does chickenpox spread?

The virus commonly spreads from person-to-person by airborne droplets. This spread occurs when an infected person coughs or sneezes and causes dispersion of droplets of respiratory secretions in the surrounding air. It can also spread by direct contact with the chickenpox or herpes lesions as these contain infectious fluid.

When is chickenpox contagious?

A person with chickenpox is contagious:

2 days before the rash appears

Until all the blisters have scabbed over (usually about 5–7 days after the rash begins)

This means a child can spread chickenpox even before you know they have it.However, the transmission is most likely within the first two days before the appearance of the rash.

Can chickenpox be prevented?

Chickenpox is a highly contagious disease. Following a case of chickenpox, up to 90% of susceptible children and adults who come in close contact with the case can develop an infection. Therefore, when one child develops chickenpox, many susceptible children in the school and persons in the child's house develop the disease.

Isolating the infected child and avoiding contact with him can prevent the spread of infection. However, chickenpox is most infectious before the rash develops when there is no reason to suspect that he has chickenpox. Such a child, during this period, may continue to attend school, play with his playmates, and therefore spread the disease.

Once a child has come in contact with a case of chickenpox, he can be immunized with antibodies (varicella-zoster immunoglobulin) against the virus. However, for the immunization to be effective, it has to be given within 3-4 days of exposure. It is costly and offers protection only for a few weeks. Vaccination against chickenpox is now available and offers long-term protection against the disease.

Is chickenpox only a childhood disease?

Chickenpox mostly affects children, but teens and adults who haven't had it or the vaccine can still catch it. And it’s usually more serious in older people.

What are the symptoms of chickenpox?

Common symptoms include: Fever, tiredness, loss of appetite,An itchy rash that starts as red spots, turns into blisters, and then forms scabs,The rash usually appears on the face, chest, and back, then spreads.Blisters appear in batches, so different types may be seen at onceThe lesions then form a crust after 4-5 days of appearance. The crusts fall off after a week or two.

The rash is itchy and a young infant may get irritated due to the constant itch. Other common symptoms include fever, nausea, and anorexia, body ache, vomiting, listlessness, etc.

Is chickenpox a totally harmless disease in children?

In the vast majority of children, chickenpox is not associated with any complications. Secondary bacterial infection affecting the skin lesions is the commonest complication that one encounters. In a minority of children, the virus could prove more aggressive and cause infection in the lungs leading to pneumonia and may affect the brain leading to swelling and infection of the brain (encephalitis). Such a child may develop unconsciousness and convulsions. These could prove fatal. Occasionally, viruses may affect the small brain (cerebellum) resulting in difficulty in walking. Many other complications are described. But these usually have a self-limited course. Most children get away with only a few scars that remain to the skin once the crusts fall off. At times, the scarring may be unsightly, which may cause cosmetic concerns later in life.

What happens if an adolescent or adult contracts chickenpox?

Chickenpox is more severe in adolescents and adults than in children. The fever is higher and continues for much longer. The rash is much heavier. The likelihood of complications is greater, too. They are more likely to suffer from pneumonia. The risk of complications and death tend to be higher when chickenpox is contracted later in life.

Who are more likely to suffer from chickenpox?

Anyone who has never had chickenpox or the vaccine can get it.

People at higher risk include:

Infants after 12 months (maternal immunity fades)

Teachers, daycare workers, and healthcare staff around children

Immunocompromised individuals, like those with cancer or HIV

Is the course of chickenpox unusually severe in some children?

The disease is self-limited in most children as their immune system is well developed. If, however, a child whose immunity is low develops chickenpox, he is more likely to suffer from a severe course. Hence, children suffering from leukemia (blood cancer) or HIV infection or those on anti-cancer drugs may develop a severe variety of chickenpox. Adolescents may have an unusually severe course of chickenpox. Fever and constitutional symptoms are severe. The rash is heavier and confluent, complication rate higher, and chances of fatality greater in them.

What are the consequences for a pregnant woman who comes in contact with a case of chickenpox?

If a pregnant woman has previously suffered from chickenpox and has immunity against it, she is at no risk of developing chickenpox. If not, she may contract the infection which may have a severe course with a higher likelihood of complications like pneumonia, and may even succumb to the disease. There could be effects on her unborn fetus too.

What are the effects on fetus, if a pregnant woman develops chickenpox?

The effects depend on the timing of the infection. If a mother develops an infection during early pregnancy (e.g. first three months of pregnancy), the growth of various fetal organs may get affected and the baby may be born with skin scarring, abnormalities of limb development, and cataract. These babies may be mentally retarded, and may develop heart defects too. There is a possibility that abortion may occur in a pregnant woman. If the infection occurs later in pregnancy but not too close to delivery, the baby will be normally born but there is a possibility that she will develop herpes zoster (shingles) during infancy.

If the mother develops chickenpox within 5 days prior to the delivery or in 2 days after the delivery, the baby receives the virus but not the ready-made maternal antibodies. Given her immature immune system, such a baby is in a weaker position to combat varicella infection and may develop severe manifestation of the disease. Newborn babies are more likely to develop serious complications like pneumonia and are at an enhanced risk of death from infection.

How is shingles related to chickenpox?

Both these conditions are caused by the varicella-zoster virus. First exposure to the varicella-zoster virus results in chickenpox, which is followed by immunity against the infection, which usually lasts life-long. The virus, however, hides in certain nerve roots and remains dormant. The virus may get reactivated many years later leading to shingles (Herpes Zoster).

How does shingles present?

Shingles usually afflict adults, especially old people. The rash, in shingles, is vesicular and is limited to one or two segments on one side of the body. However, the rash is extremely painful. This pain is notorious for not getting easily controlled by routinely used analgesics or painkillers. If the rash affects the eye, it is a potentially sight-threatening complication.

Shingle may be followed by neuralgia and pain may persist for several months and years. Immunocompromised individuals like those suffering from leukemia/cancer or AIDS or patients on immunosuppressive therapy like steroids, anti-cancer therapy, or radiation, may develop shingles which may involve many segments of the body and can have complications which are potentially fatal.

Does childhood chickenpox have a social impact?

Yes. The full impact of childhood chickenpox on patients and their families is often not appreciated. Physically, varicella is very uncomfortable for patients because they have to endure discomfort from symptoms such as the rash and the associated itching, fever anorexia, and other constitutional symptoms. Patients often need to be isolated and kept at home. Thus, a school-going child may miss her school for a few days up to a month (which is ideally not needed). The child may develop chickenpox during the examination period, which is usually held during March-April, which is also the peak period for developing chickenpox (in winter). The rash may leave behind a permanent scar, which, for cosmetic reasons, may cause concern during adolescence or adulthood.

What are economic costs for a family when a child suffers from chickenpox?

The economic costs can be divided into direct costs and indirect costs. The cost of medications to control fever, relieve itching can be considered as direct costs. Occasionally, the child may have to be hospitalized or rarely suffer a severe complication. These add to direct costs. In addition, there are indirect expenses that the family has to incur. E.g. when a child has chickenpox, he cannot attend school and cannot be cared for in a day-care center, for the fear of spreading infection. This compels one of the adult household members, usually a parent to abstain from work and be at home to take care of the sick child. This may mean missing important appointments, rescheduling assignments, or even loss of wages.

How does one treat chickenpox?

As stated earlier, chickenpox presents with fever, other constitutional symptoms, and rash. In most children, it has a self-limited course. Paracetamol can be given to control fever. The use of aspirin should be avoided, as it is feared to give rise to certain complications. Itching can be controlled by the application of calamine lotion or oral antihistaminic drugs after consulting your doctor. The fingernails should bathe daily (contrary to general belief) so as to decrease the possibility of secondary infection.

Anti-viral drugs effective against varicella are known but are usually not required for otherwise healthy children and for uncomplicated cases of chickenpox. They may, however, be required when complications such as varicella pneumonia occur or when an immunocompromised child suffers from chickenpox.