Chickenpox in children: signs, symptoms and how to treat it

When the rash does appear it tends to appear in stages.

• The spots initially are pink/red, or brown/darker than your skin tone. They can occur anywhere on the body and tend to come up in crops of spots.
• The spots then turn into small blisters, becoming filled with fluid. It is at this point that they often are very itchy!
• The final stage of the rash is that the blisters scab before falling off.

You can have new spots developing even as others are scabbing over.

• What's that spot? Picture guide to common childhood spots and rashes

How does chickenpox spread and what’s the incubation period?

Chickenpox is infectious and spreads via droplets in the air, spending time in the same room or having a conversation with someone infected can lead to infection.

The incubation period for chickenpox is relatively long, this is the length of time between being exposed to the virus and developing the rash. For chickenpox the incubation period is one to three weeks, commonly around 10-14 days before the rash appears.

How do I look after a child with chickenpox?

Let’s start with the practical – cut fingernails short to try and limit scratching! Treatment of chickenpox is generally around trying to help ease symptoms such as itching, so a soothing cream such as calamine or aloe vera might be helpful, as might oat based bath products, or even filling the foot of a pair of tights with porridge oats and squeezing under the running bath water and bathing in the water can help. If itching and scratching at night is a particular problem then you can try a dose of an over the counter sedating antihistamine such as a chlorphenamine (for over 1 year olds).

As always, treat the child and not the number on the thermometer, if your child has a fever but is running around happily, eating and drinking as normal there is no need to treat the fever. Give plenty to drink and don’t dress them in too many layers. But if your child is miserable with a temperature then paracetamol can be given to help ease symptoms. Ibuprofen should NOT be given with chickenpox as there is a potential association with skin reactions in this instance.

If your child is particularly at risk of complications due to chickenpox then they may be offered an antiviral medication – aciclovir. This tends to be used in babies under one month old and children with a suppressed immune system. If you aren’t sure or are concerned please seek medical advice.

Should you keep your child at home if they have chicken pox?

Yes, please keep your child off school or nursery if they have chickenpox. They are infectious from around two days before the rash appears until all the spots have crusted over, which is about a week after the spots appear. They should also avoid seeing people at risk of serious illness at this time, for example people receiving chemotherapy.

Do you need to take your child to the doctor if they have chickenpox?

Most children with chickenpox will recover on their own so there’s no need to take them to the doctor. However, if you are concerned about your child please seek medical advice.

What time of year is chickenpox most common?

Chickenpox is an infection which tends to occur in the Winter and Spring months and often has a peak at around March/April/May time each year.

Why isn’t the chickenpox vaccine offered on the NHS?

There is a chickenpox vaccine against varicella zoster virus, but it is not currently part of the routine immunisation schedule in the UK, though it is in other countries such as America.

However the JCVI – Joint Committee on Vaccinations and Immunisations – recommended that the chickenpox vaccine be added to the routine schedule in the UK in November 2023. These recommendations are then put to the Department of Health and Social Care.

Currently the vaccine is offered to particular groups, for example if you work in healthcare and aren’t immune to chickenpox, or if you are in close contact with people with a suppressed immune system, for example if a member of your household is having chemotherapy.

There are various reasons given as to why the chickenpox vaccine is not available on the NHS, from it not being cost effective, to chickenpox generally being a mild illness in children, though complications can and do happen. However now the JCVI have recommended the vaccine is added to the routine schedule watch this space!

Is it worth paying to have a child vaccinated against chickenpox and if so, what age is best?

The chickenpox vaccine is available privately after a consultation. This is a personal decision about what you feel is best for you and your family, the vaccine is not given to children under 9 months of age and pregnant women.

Is it best to get chickenpox when you’re young? And, is it ok to purposefully expose your child to another child with chickenpox?

There are various ideas around actively trying to encourage a child to develop chickenpox, including the idea that chickenpox is generally milder in children than in adults and that as immunity is generally life long (though occasionally people can get it more than once) it is worth getting infected as a child.

However, chickenpox can and does have complications, which can be serious. In addition children are infectious in the day or so before the rash develops and therefore can unknowingly put other people at risk, such as pregnant women, or those with a suppressed immune system. I wouldn’t recommend a chickenpox party!

Can chickenpox be serious for some children? Is it ever fatal?

Chickenpox can have complications, and these are more likely for babies, children with a suppressed immune system or severe heart or lung conditions. Complications can include secondary bacterial skin infections, pneumonia and encephalitis, where the brain becomes inflamed, though this is uncommon. It can be fatal, though thankfully this is extremely rare. As always, if you are concerned about your child please seek medical advice.

What’s the difference between shingles and chickenpox?

Shingles and chickenpox are often confused but they aren’t quite the same! If you have ever had chickenpox you may develop shingles, the virus remains dormant in your body, and shingles occurs if it becomes reactivated. The virus affects the skin supplied by a nerve, so is localised to one part of the body, commonly a band around your torso, but it can develop in other places. The rash starts as spots, then blisters and then scabs over and can be painful. If started within 72 hours of the rash developing antiviral medication can be given, this is available over the counter after discussion with a pharmacist for adults under the Pharmacy First scheme.

Importantly, you can’t catch shingles from someone with shingles, however you can catch chickenpox from someone with shingles if you haven’t previously had chickenpox.

Can you catch chicken pox again if you’ve already had it?

Most people have had chickenpox at some point in their lives and their immune system will have produced antibodies to help fight the infection. The antibodies remain in your body and generally mean that you have lifelong immunity to chickenpox, meaning that you aren’t likely to have more than one episode of chickenpox in your life – but uncommonly, it does happen!

Read more:

• Children's spots and rashes in pictures
• Should my child have the chickenpox jab?
• Chickenpox in pregnancy