Chickenpox is an itchy, spotty rash caused by the varicella-zoster virus, and in most healthy children it gets better on its own within one to two weeks. Home care is about easing the itch and fever safely: paracetamol is fine, aspirin is not, and ibuprofen should only be used if a doctor says so.
Most families get through it at home, but newborns, pregnant women, adults and people with weak immunity can get seriously ill. This guide covers how chickenpox looks day by day, how long it’s catching, what actually helps, and the signs that mean you need a doctor.
Chickenpox symptoms and stages
Before the rash, or alongside it, you may notice a high temperature, aches, loss of appetite and generally feeling unwell. Then the spots follow a set pattern, as described by the NHS:
- Spots. Small red or pink spots appear, anywhere on the body, including inside the mouth and around the genitals. They’re harder to see on brown skin.
- Blisters. The spots fill with fluid and turn into very itchy blisters, which may burst.
- Scabs. The blisters crust over. Some scabs are flaky and some leak a little fluid.
The CDC says the rash often starts on the chest, back and face before spreading, a person can have up to 500 blisters, and it takes about a week for all of them to scab.
How long is chickenpox contagious?
Chickenpox spreads easily. According to the NHS:
- Spots appear about 1 to 3 weeks after catching the virus.
- You can pass it on from 2 days before the spots appear until every spot has scabbed over, usually about 5 days after the first spots.
- Children should stay home from school or daycare, and adults from work, until all spots have crusted.
While you’re contagious, keep away from newborn babies, pregnant women and anyone with a weakened immune system, because chickenpox can be dangerous for them.
Safe home care for chickenpox
There’s no home remedy that kills the virus. The aim is to keep your child comfortable, drinking well and not scratching.
| Do | Don’t |
|---|---|
| Give paracetamol for fever or pain, at the dose on the pack for your child’s age | Don’t give aspirin to anyone under 16 |
| Offer plenty of fluids; ice lollies help if a child won’t drink | Don’t use ibuprofen unless a doctor advises it |
| Dress them in loose cotton clothes | Don’t let them scratch the spots |
| Trim fingernails and put socks over hands at night | Don’t send them to school before all spots have scabbed |
Why no aspirin?
The NHS links aspirin in children and young people under 16 to Reye’s syndrome, a rare condition that can cause serious brain problems. It usually appears after a viral illness such as flu or chickenpox. Check that cold and pain medicines you have at home don’t contain aspirin.
Why be careful with ibuprofen?
The NHS says ibuprofen may cause serious skin infections in chickenpox, and the CDC notes that the American Academy of Pediatrics advises avoiding it where possible. Stick to paracetamol unless your doctor tells you otherwise.
How to relieve the itch
- Calamine lotion. The CDC suggests calamine lotion for itching. Dab it on the spots with cotton wool.
- Cool baths. The CDC suggests a cool bath with added baking soda, uncooked oatmeal or colloidal oatmeal. The NHS advises bathing in cool water and patting the skin dry rather than rubbing.
- Cooling creams or gels. Recommended by the NHS.
- Antihistamines. Ask a pharmacist or doctor which one suits your child’s age, since some cause drowsiness.
- Short nails. Scratching can cause scars and lets bacteria into the skin.
Children with eczema need extra care, as broken skin is easier to infect. Our guide to eczema symptoms explains the condition.
What about neem leaves in bathwater?
Putting neem leaves in the bath or on the bed is a long-standing tradition in many Indian homes during chickenpox. Some laboratory studies have looked at neem extracts against the virus, but there are no trials showing that a neem bath treats or shortens chickenpox in people. If your family wants to keep the custom, use washed leaves in cool, clean water. Treat it as comfort, not treatment, and keep using paracetamol and the itch measures above.
Who is at higher risk of serious chickenpox?
The CDC says complications aren’t common in healthy people, but the risk is higher for:
- Babies, especially newborns
- Teenagers and adults
- Pregnant women (the virus can pass to the baby)
- People with weakened immunity, for example from cancer treatment, HIV or steroid medicines
Possible complications include bacterial skin infections, pneumonia, brain infection or swelling, bleeding problems, bloodstream infections and dehydration (CDC).
Antiviral medicine can help some people, but it works best when started within 24 hours of the rash appearing. MedlinePlus says it isn’t often prescribed for healthy children with mild illness, but teenagers and adults, and people with eczema, lung conditions such as asthma, or recent steroid use, may benefit. If you’re in one of these groups, see a doctor on day one.
Chickenpox vaccine in India
A vaccine is the best way to prevent chickenpox, and the CDC says two doses prevent almost all severe illness. The Indian Academy of Pediatrics’ 2014 schedule places the first dose at 15 months, noting that breakthrough chickenpox is less likely when it’s given from 15 months onwards. In its 2020-21 update, IAP says the second dose should preferably be given 3 to 6 months after the first.
The CDC advises two doses for anyone who has never had chickenpox or the vaccine, so if your child missed it, or you’re an adult who never had chickenpox, ask your doctor about catching up. Our article on flu season covers another vaccine worth adding to the family list.
The link between chickenpox and shingles
After chickenpox heals, the virus doesn’t leave. It stays dormant in the nerves, and years later it can wake up and cause shingles (MedlinePlus). Someone who has never had chickenpox can catch chickenpox from a person with shingles, but you can’t catch shingles from someone with chickenpox (NHS).
When to see a doctor
Contact a doctor promptly if:
- You’re not sure the rash is chickenpox
- A newborn baby has chickenpox or has been near someone with it
- You’re pregnant or have a weakened immune system and have been near someone with chickenpox
- A teenager or adult gets chickenpox (early antivirals may help)
- Fever lasts longer than 4 days or rises above 102°F (38.9°C)
Go to hospital or call 112 if there’s:
- Difficulty breathing, or more breathlessness than usual
- Skin around the blisters that becomes very red, hot, painful or starts leaking pus (harder to see on brown skin)
- Confusion, unusual drowsiness or difficulty waking up
- A stiff neck
- A rash with bleeding or bruising
- Signs of dehydration, such as far fewer wet nappies or a child who won’t drink
For more on spotting dehydration in children, see our guide to diarrhoea and dehydration signs.
Frequently asked questions
Can I bathe a child with chickenpox?
Yes. Cool baths are recommended by both the NHS and CDC to ease itching. Pat the skin dry gently afterwards.
Can a vaccinated child still get chickenpox?
Yes, but the CDC says vaccinated people who catch it usually have milder symptoms, and two doses prevent almost all severe illness.
When can my child go back to school?
Once every spot has crusted over, usually about 5 days after the spots first appeared.
Is chickenpox contagious before the rash appears?
Yes. The NHS says it can spread from about 2 days before the first spots, which is why it moves so quickly through schools and families.
Is chickenpox dangerous in pregnancy?
It can be, for both mother and baby. If you’re pregnant and have been near someone with chickenpox, call your doctor the same day, even if you feel well.
This article is for general information and is not a substitute for advice from a doctor. If you have symptoms or a health condition, please consult a qualified healthcare professional.
