Chickenpox: itchy spots, and why adults suffer more

What it is, in plain words

Chickenpox is the first infection with the varicella zoster virus. It spreads by droplets and by contact with the fluid in the blisters. After recovery the virus hides in nerve roots for life and can reactivate decades later as shingles.

Signs to look out for

• Mild fever and tiredness a day or two before the rash
• Very itchy spots appearing in crops: red macules, then blisters, then crusts, all stages present at once
• Spots on the scalp and inside the mouth, which helps distinguish it
• Contagious from two days before the rash until every lesion has crusted
• In adults and pregnancy: higher fever, more spots, and a real risk of pneumonia

Why it happens

Most cases occur in children under ten. Adults, pregnant women, newborns and immunosuppressed people are at much greater risk of severe disease.

How doctors confirm it

Diagnosis is clinical in typical cases. PCR of blister fluid confirms uncertain cases. In pregnancy, immunity testing after exposure guides urgent preventive treatment.

Treatments and solutions

• Symptom relief: paracetamol for fever, oral antihistamines at night, cool baths and calamine, short nails and cotton clothing
• Avoiding ibuprofen, which has been linked with severe skin infection during chickenpox
• Aciclovir within 24 hours of the rash for adolescents, adults, pregnant women and immunosuppressed patients
• Antibiotics if a spot becomes hot, spreading and painful, indicating bacterial superinfection
• Vaccination, which prevents the disease and is given after exposure in some situations

Living with it day to day

Keep away from pregnant women who have never had it, newborns and immunosuppressed people until all lesions have crusted, usually five to seven days.

When to seek medical help

Seek urgent care for a spot with spreading redness and severe pain, breathlessness or cough, drowsiness, unsteadiness, stiff neck, or chickenpox during pregnancy.

This article explains general health information in simple language. It does not replace advice from your own doctor.