Chickenpox

  • Chickenpox is an infection caused by the varicella virus. It cannot be treated with antibiotics. Treatment is usually to relieve the symptoms, which are commonly fever and a rash.

    Chickenpox is easily spread by direct contact with a person who has chickenpox, or by fluid droplets in the air when they cough or sneeze. A person with chickenpox is infectious to others from one to two days before the rash first appears until the last blisters have dried up.

    In rare cases, children can develop serious complications as a result of chickenpox. A chickenpox vaccination is given to children aged 18 months as part of their normal schedule of vaccinations. It is very effective, has few side effects and is free in Australia.

    A second dose of the chickenpox vaccine (booster) can be given to further increase protection. This needs to be given at least one month after the initial vaccine.

    Signs and symptoms of chickenpox

    If your child has chickenpox, they may:

    • have a mild fever
    • feel tired and irritable
    • be itchy
    • have a rash.

    The rash usually appears 10 to 21 days after first being exposed to someone who has chickenpox. The time between exposure and getting the rash is called the incubation period. The rash usually first appears on the chest, back or face.  It can then move to other areas of the body, including inside the mouth. At first, the rash looks like small pimples. These later become blisters full of fluid. Most children with chickenpox are unwell for about five to seven days. 

    Care at home

    Children with chickenpox can usually be cared for at home and do not need to see a doctor.

    Because chickenpox is a virus, it cannot be treated with antibiotics. Treatment is about controlling the itching from the rash and other symptoms related to the viral illness. There are many medications and creams that you can buy from your local pharmacy to help with the itching.

    It can be difficult to make sure children drink enough when they are unwell. To prevent dehydration, give your child sips of drinks (water is best), jelly, icy poles, soup and other fluids often.

    Children with chickenpox may have a fever and can feel tired and irritable. Taking paracetamol can help, but do not give your child aspirin or ibuprofen. See our fact sheets Pain relief for children and Fever in children.

    When to see a doctor

    You should take your child to see a GP if:

    • they get large, sore, red areas around the rash, which may indicate a secondary bacterial infection
    • they become increasingly unwell, are very drowsy, have a high fever or are not drinking
    • you are concerned for any reason.

    If your child has a skin problem like eczema, you may need to speak to a health professional for advice on which creams you can use on your child’s rash.

    Children with a very severe infection or with underlying serious medical conditions may be given anti-viral medication if they have been exposed to chickenpox.

    If your child is unwell with a fever and a skin rash (small bright red spots or purple spots or unexplained bruises) that does not turn to skin-colour (blanch) when you press on it, this may be a sign of meningococcal infection (see our fact sheet Meningococcal infection).

    How is chickenpox spread?

    Children and adults can get chickenpox, but it is more common in children. Chickenpox is highly contagious, which means it is very easy to catch. It can be spread by having direct contact with the person who has chickenpox, especially by touching the liquid from the blisters. Chickenpox is also spread by the fluids that are coughed or sneezed into the air.

    If your child has chickenpox, they are infectious to others from one to two days before the rash first appears up until the last blisters have dried up. Some members of the family may need to stay away from the child during this infectious stage. Anyone taking long-term oral steroids or who is immunocompromised (has a weakened immune system e.g. due to chemotherapy), pregnant women or babies under three months should see a GP if they could have been exposed to chickenpox, as they may need treatment to prevent the virus.

    Children with chickenpox should not go to child care, kindergarten or school until the last blister has dried. A dry blister scab is not infectious. You should tell the school if your child gets chickenpox, as there may be other children who need to be immunised or treated.

    Key points to remember

    • Chickenpox is very easy to catch, and is infectious for one to two days before the rash starts up until the last blister has dried.
    • The rash usually starts between 10 to 21 days after the first exposure to chickenpox. 
    • Antibiotics will not cure chickenpox. 
    • A chickenpox vaccination is given to children aged 18 months as part of their normal schedule of vaccinations.

    For more information

    Common questions our doctors are asked

    Will my child’s chickenpox blisters scar? 

    Chickenpox sometimes causes pockmark scars on the skin. Regular chicken pox blisters do not scar, but if they are scratched or become infected, they are more likely to leave permanent marks on the skin.

    How can I stop my child scratching her rash?

    There are many medications and creams that you can buy from your local pharmacy to help with the itching – ask your pharmacist for advice. Young children and babies might need to wear mittens to help prevent them from scratching. 

    What can I do about the blisters inside my child’s mouth? 

    Unfortunately, there isn’t much you can do to help the blisters. Try giving your child paracetamol to relieve the pain. If your child is in so much pain from mouth blisters that they are not drinking, they will need to be admitted to hospital to prevent dehydration.

    My child has had the MMRV vaccination but he got chickenpox. Why? 

    Being immunised against varicella (chickenpox) will greatly reduce the chances that your child will catch chickenpox, but sometimes your child may be infected with the virus. Children who have been immunised and still catch chickenpox will get a milder form of the virus, with a less severe rash, a lower fever and they will recover more quickly. Having two doses of the chickenpox vaccine provides children with increased protection against the virus. The Australian government funds one free dose of chickenpox vaccine, and parents can purchase a second dose four to six weeks later if they choose. 

    What are the serious complications of chickenpox?

    One in 5000 people who catch chickenpox will develop a brain inflammation called encephalitis, and three in 100,000 will die. These complications are very rare and most children make a full recovery.


    Developed by The Royal Children's Hospital Emergency and Infection Control departments. We acknowledge the input of RCH consumers and carers.

    Reviewed July 2021. 

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.