Everyday illness is a normal part of childhood and it’s absolutely natural for your little one to pick up some kind of stomach bug or virus; this also includes chickenpox.
Medically known as varicella, chickenpox can easily spreads to others, but in terms of an illness, it's classed as a mild one and improves on its own.
Health and medical writer, Dr Deborah Lee says: "The majority of children catch it before they are five, but almost always before they are 10. The most common time to have chickenpox is in winter or spring - particularly between March and May."
What is chickenpox?
Chickenpox is a common childhood illness that causes an itchy, red rash with red spots that turn into fluid filled blisters. Eventually the spots shrink, form scabs and drop off. Some children have just a few spots, while others are covered all over including in their mouth, on their head and in their genitals. It is commonly spread in nurseries and schools.
"Chickenpox is highly contagious – meaning it spreads very easily. When an infected person coughs or sneezes, VZV-infected mucous droplets are propelled into the air, which another person then easily inhales into their lungs. The virus can also be directly transmitted by touching mucous, saliva or blister fluid from an infected person." Explains Dr Deborah Lee.
Although chickenpox is common, it can leave your little one feeling uncomfortable and very irritable with its itchy red spots. They usually clear up in a week or so, but it can be dangerous for some people, including pregnant women, newborn babies and those with a weakened immune system. 90 per cent of adults are immune to chickenpox because they’ve already had it as a child but if you do have it as an adult, the symptoms can be more severe.
What are the symptoms of chickenpox?
While an itchy, spotty rash is the obvious sign, the NHS explains the chickenpox stages:
• Small spots will start to appear - this can be anywhere on the body
• The spots then become blisters - the spots can become itchy, they fill with a fluid and may even burst.
• They spots turn into scabs - the spot will turn into a scab and may leak fluid or become flaky.
Before the spots appear, many children may have mild flu-like symptoms including:
• a headache
• a temperature (in the 38.3° to 38.8° region)
• generally feeling unwell
• aching muscles
The spots are at their itchiest 12-14 hours after they appear. They generally clear up within a week or two of scabbing over. It's worth noting, your little one is contagious until all the blisters have scabbed over, which is normally five to six days after the rash first appeared. During this time, it's advisable to keep them indoors and not send them to school or nursery.
In the majority of cases, chickenpox clears up by itself, but in a handful of rare cases, there can be some complications including:
• secondary bacterial infections causing sepsis – including Streptococcus A
• pneumonia
• encephalitis (swelling of the brain)
• bleeding issues or haemorrhage
What does a chickenpox rash look like?
The rash will appear as small red bumps on the skin that look like insect bites or little spots. These red bumps will usually appear on the skin over 2-4 days before developing into small blisters filled with fluid. The blisters will then turn into scabs that are usually red or brown in colour.
What causes chickenpox?
Chickenpox is caused by a virus called varicella-zoster. If your baby hasn’t already had chickenpox, there’s a 90% chance of them being affected if they come into contact with the infection.
This contagious bug is sneezed and breathed around, just like the common cold. It can take seven to 21 days for the symptoms of chickenpox to show up after your baby has come into contact with the virus.
You can also catch chickenpox from:
• touching a contaminated surface
• touching contaminated bedding or toys (which explains why all your children may suffer at the same time
• touching the chickenpox or shingles rash
• face-to-face contact with an infected person
• being in the same room as someone with chickenpox for more than 15 minutes
What can you do if your child has chickenpox?
Call your GP so the infection can be noted in your child’s medical records, but don’t take them to the surgery; The virus is highly infectious, so unless your child is severely unwell, your GP will probably ask you to treat them at home. Your child will be infectious from around 1-2 days before the rash appears. When it comes to treating and helping your baby feel more comfortable, try the following:
• Dab calamine lotion/cooling gels to soothe the itching and dress your child in loose cotton clothing.
• Pat the skin rather than scratching it - try and discourage your toddler from scratching as this can spread the virus to surfaces, toys and other people.
• Stay hydrated.
• Use paracetomol to relieve fever, muscle pain and discomfort. The NHS urges parents NOT to use medication containing ibuprofen as it can make things much worse. • Encourage your toddler to cover their mouth if they cough/sneeze to prevent the virus spreading.
• If your toddler has blisters in their mouth, sugar-free ice-lollies are soothing.
• Take a cool bath. You can add a tablespoon of salt to the bath water, or a handful of oats tied in a muslin which can also alleviate the itching.
• Antihistamines - seek advice from a pharmacist as they can make children sleepy.
In the majority of cases, antiviral drugs are not required to treat chickenpox as it is considered a mild illness that disappears after a few weeks. Antivirals are reserved for the most severe cases, such as seriously ill adults, very young babies or those with a weakened immune system.
Worried about chickenpox? When you should phone your GP
Complications are rare in healthy children, but it's still good to know when to contact your GP. According to the NHS, you should phone your GP if:
• You're not sure if a rash is chickenpox. If in doubt, check as chickenpox can be highly contagious and dangerous to pregnant women and elderly people.
• Your baby is less than four weeks old and you are worried she might have chickenpox.
• Your baby's symptoms haven't improved in six days.
• You're an adult and you've got chickenpox.
• If the area surrounding a blister becomes red, sore or hot - this could be a sign of infection.
• If your toddler is dehydrated.
• It is rare, but chickenpox can lead to complications such as meningitis or encephalitis (swelling of the brain). Signs can include drowsiness, vomiting, headache, a stiff neck, seizures and behavioural changes. If you notice any of these, contact your GP immediately.
Is chickenpox dangerous when pregnant, and why?
If you've already had it, you will be immune to it. If you do contract chickenpox when pregnant you're likely to make a full recovery. If you know you are not immune to chickenpox, avoid contact with anyone who has it while you are pregnant.
If you are infected with chickenpox during the first 28 weeks of your pregnancy there is a tiny risk that your unborn baby could develop a condition known as foetal varicella syndrome. This condition can cause scarring, eye defects, shortened limbs and brain damage. Similarly, if a pregnant woman gets chickenpox in the last 3 weeks of pregnancy, the baby may develop a serious infection and can be fatal.
If you do come into contact with the virus during pregnancy i.e from your own children, contact your midwife or GP right away. You can be tested to check your immunity and given the antibody to mount a defence against the virus if necessary.
What is the chickenpox vaccine?
The chickenpox vaccine protects against the varicella zoster virus that causes chickenpox. It is available on the NHS, but it's not part of the routine childhood vaccination schedule. It is only offered to those in close contact with someone who is vulnerable to chickenpox for example those who:
• take long-term steroid tablets
• are having chemotherapy
• have had their spleen removed
• have had an organ transplant and are using immunosuppressant medicines
• have been diagnosed with HIV or AIDS
The NHS also recommended the vaccination for:
• brothers and sisters of a child who has leukaemia
• a child whose parent is having chemotherapy
What is the difference between chickenpox and shingles?
"The VZ virus also causes herpes zoster – shingles. But the nature of the infection is different. Shingles are due to the reactivation of a previous chickenpox infection and usually affect only one dermatome – one nerve supplying a specific area of skin," says Dr Deborah.
She continues: "A person can catch chickenpox from shingles, but you can’t catch shingles from chickenpox. Or putting it another way - you have to have had chickenpox to get shingles. You can’t have shingles if you haven’t had chickenpox."
According to the NHS, it is estimated one in four adults will suffer from shingles during their lifetime. It is not known why some people catch shingles, but in most cases it is thought to be because of a weakened immune system.
Further chickenpox questions
Can my child get the chickenpox vaccination?
At present in the UK, babies are not routinely immunised against chickenpox, but the situation is up for debate. If you think you or your family are vulnerable and should have the chickenpox vaccine, speak to your GP. Not all GP surgeries offer it, so you may need to pay for it privately.
"Note that the chickenpox vaccine is a live vaccine and should not be given to anyone with a weakened immune system, including babies under 9 months of age, pregnant women and those receiving chemotherapy.", Dr. Deborah Lee explains.
The NHS only vaccinates high-risk groups against chickenpox, such as those who come into contact with others who have a weakened immune system. The VZV vaccine is given in the arm. Two doses are needed, four to eight weeks apart.
How long does chickenpox last?
Chicken pox usually lasts 1-2 weeks. The first symptoms occur 10-21 days after being exposed to the VZV virus. The spots continue to appear for 3-5 days. It takes 5-7 days for the spots to crust over, scab and for the scab to fall off. The person remains infectious until the last crop of spots is dry.
Can you get chickenpox twice?
This is very unlikely. If this does happen, it could indicate you had chickenpox before you were 6 months old, you had a very mild illness or you have a weakened immune system.
What is the chickenpox incubation period?
The incubation period is 10-21 days after being in contact with the VZ virus. The infected person is believed to be contagious from 1-2 days before the rash first appears until all the spots have crusted over and become dry. This usually is around 1-2 weeks depending on the severity and number of spots.
Can you fly if you have chickenpox?
It’s not sensible to fly if you have chickenpox as the virus can be transmitted through the air by coughing and sneezing. It can also be spread by direct contact with an infected person's blisters, saliva, or mucus, or by touching contaminated items.
If you or your child is infected before you are due to fly on holiday, you'll have to cancel your trip and stay home. Some airlines have regulations that prohibit travelling with chickenpox. For example, TUI state a person cannot fly until 7 days after their last crop of spots has disappeared, and you may need a GP letter to support this. Airlines also have the right to refuse travel to anyone who they suspect may be contagious
How long does chickenpox live on surfaces?
The VZ virus does not live for long outside the body on other surfaces. It is inactivated by cleaning with usual household bleach and by washing with standard detergents at 60°C.
Can you use Sudocrem on chickenpox?
Sudocrem can be used for chickenpox. It contains zinc oxide which can help soothe itching as it prevents the release of histamine from mast cells. Histamine is a cell-signalling molecule that is released in allergic and inflammatory reactions. Use a cotton bud to dab a little onto each spot.
How long for chickenpox to scab?
It takes around 5 days for a chickenpox spot to blister, dry out and scab. Because new spots keep appearing for 5 days or more, a person will have spots at all different stages of development at the same time. On average it takes 10 -14 days for all the spots to appear, heal, scab and disappear.
Is chickenpox dangerous for babies, and why?
Young babies are at risk from chickenpox as they have a relatively weak immune system. The antibodies they obtained from their mother, through the placenta and early breast milk, have mostly disappeared by 3 months of age, leaving them susceptible to a wide range of infections including VZV.
Meet the expert:
Dr Deborah Lee has worked for many years in the NHS, mostly as lead clinician within an integrated Community Sexual Health Service. She now works as a health and medical writer, with an emphasis on women's health. She has also published several books and remains passionate about all aspects of medicine and sexual health.
Adejumoke Ilori is commercial content writer for Mother&Baby and mummy to a little girl. With a BA hon in Creative Writing, she has worked for digital platforms, where she has empowered women from the inside and out, by sharing real life stories based on relationships, loving yourself and mummyhood.