Chickenpox
Understanding chickenpox
Chickenpox (varicella) is a common illness caused by the varicella-zoster virus. It’s most commonly caught by children under the age of 10, often in winter and spring, but you can get it at any age and it can be more severe in adults. It’s possible to catch chickenpox more than once, but this is unusual.
Chickenpox causes a rash of red, itchy spots which turn into fluid-filled blisters that crust over to form scabs which eventually drop off. You can spread chickenpox to other people from 2 days before your spots appear until they have all formed scabs – usually 5 days after your spots appeared.
THE BOOTS CHICKENPOX VACCINATION SERVICE
The Boots Chickenpox Vaccination Service is a non-NHS service for adults and children aged between one and 65 years13. A full course consists of two vaccinations given a minimum of six weeks apart. If you, or your child, have had a first dose of a chickenpox vaccination from somewhere other than Boots, you can still have your second dose at Boots, providing you meet the eligibility criteria.
This service isn’t suitable for anyone who:
- is pregnant or breastfeeding
- has a weakened immune system
- has received the MMR vaccine in the previous 4 weeks
This isn’t a complete list and suitability will be checked before the vaccination is given.
The chickenpox vaccine is not typically provided by the NHS, but it is available if there is a risk of transmitting the virus to someone with a weakened immune system. Our private vaccination service is suitable for adults and children aged between one and 65 years. It’s available in selected Boots pharmacies13.
Price per dose: £75 Full course (2 doses): £150
Step 1
Book an appointment at a participating Boots Pharmacy1
Step 2
Receive the first dose of the vaccination (if suitable) after a pharmacist consultation
Step 3
Return for a second dose of the vaccination at least six weeks later
CHICKENPOX & HOW TO TREAT IT
Although considered a mild illness in children, chickenpox can cause unpleasant symptoms. However, in newborn babies, adults, pregnant individuals, and those with weakened immune systems, chickenpox can be more severe and carry a risk of complications. Learn more about chickenpox symptoms, treatment, and related conditions, and how to manage this in babies, children, and adults.
The most common symptom of chickenpox is an itchy rash of spots that turns into itchy blisters before forming a scab and falling off. These spots more often show up in clusters:
• behind the ears
• on the face
• across the scalp
• on the chest and tummy
• on the legs and arms
Chickenpox spots can appear anywhere on the body. It’s even possible to experience chickenpox in the mouth, ears, palms of hands, soles of feet, the genital area and in the nappy area on babies.
The spots can be red, pink, the same colour as the surrounding skin or darker, depending on your skin tone.
Alongside spots, it’s possible to experience mild flu-like symptoms before or after the rash appears that can make you feel unwell, including:
• having a high temperature (fever) of 38C (100.4F) or over
• experiencing painful and aching muscles
• feeling sick
• experiencing a loss of appetite
• having a headache
• generally feeling unwell
These symptoms are more common in adults with chickenpox, especially the high temperature. We explain more about chickenpox in the chickenpox in adults section.
In rare cases, more severe symptoms can occur. Contact your GP or get advice from 111 if you’re unsure it’s chickenpox, you’re concerned about your child or yourself, or your child experiences any of the following:
• the skin surrounding the blisters becomes red and painful
• pain in the chest or difficulty breathing
• signs of dehydration, such as cold hands and feet, drowsiness, and fewer wet nappies (in babies and children)
• chickenpox symptoms suddenly become worse
After you’ve come into contact with the chickenpox virus, it normally takes between 7 and 21 days (most often 14 to 16 days) for the spots to show. This is known as an incubation period.
Chickenpox happens in three stages, but new spots can appear in waves for three to five days after the rash begins, while others become blisters or form a scab.
Stage 1: Small spots appear
Chickenpox spots form in clusters and can be in a small area or spread across any area of the body. They’re usually itchy and can be painful.
Stage 2: The spots become blisters
After around 12 to 14 hours, the spots develop into fluid-filled blisters which are intensely itchy and may burst.
Stage 3: The blisters become scabs
After around one to two days, the fluid in the blisters becomes cloudy and they begin to dry out and crust over into a scab. Some scabs are flaky whilst others may leak fluid. The crusting skin falls off naturally after one to two weeks.
Chickenpox can spread easily and can be caught by:
• being in the same room as someone who has the virus
• touching objects or surfaces contaminated with fluid from the blisters or droplets from the mouth or nose of an infected person when they cough or sneeze
You can spread chickenpox from two days before a rash forms until all the spots have crusted over into a scab, which is usually five to six days after your spots first appeared.
If you or your child have chickenpox, you should stay away from work, school or nursery until all the blisters have formed scabs which is when you’re no longer infectious. During this time, you should avoid contact with the following people who may be more at risk from chickenpox:
• newborn babies
• people who are pregnant
• people who have a weakened immune system (such as people undergoing chemotherapy or taking immunosuppressant medication like steroids)
If you’re in a household with someone with chickenpox, you can help stop the virus spreading by regularly disinfecting surfaces and washing clothing or bedding that could have been contaminated with the virus.
Besides chickenpox, there are many common rashes in babies and children that can be caused by things such as hives (an allergic reaction), ringworm (a fungal infection) and nappy rash (irritation from nappies).
The NHS has more information about common rashes in babies and children including imagery, guidance on how to treat them and information on when to see a GP.
You should call 999 or go to A&E urgently if your child has a rash along with any of these symptoms:
• a stiff neck
• they’re bothered by light
• they seem confused
• a high temperature
• they’re having difficulty breathing (they may be making grunting noises or their tummy is being sucked under their ribs), they’re breathless, or they're breathing very fast
• they have a rash that looks like small bruises or bleeding under the skin which doesn’t fade when you press a glass against it
• their skin, lips or tongue look pale, blue, grey or blotchy
On brown and black skin, you may find it easier to see the rash or colour changes on the soles of the feet, palms, lips, tongue and inside the eyelids.
It’s important to trust your instinct and speak to your GP urgently if you’re concerned about your child or if they have a rash and you’re not sure what to do.
Although chickenpox is usually caught in childhood, sometimes this isn’t the case and adults can catch it too. This can cause complications for those who are pregnant, which we cover in more detail in the chickenpox & pregnancy section.
For most children, chickenpox is a mild illness that gets better on its own, but chickenpox tends to be more severe in adults.
In adults, chickenpox spots usually look the same as they do on children, but adults can get more spots and may have a higher temperature for longer.
Adults with chickenpox are at a higher risk of developing complications, for example around one in 10 develop lung problems like pneumonia, which is made worse if you smoke. Here are some tips to help stop smoking.
Adults are also more likely to be admitted to hospital, but in most cases, adults make a full recovery from chickenpox. You should see a GP if you’re not sure it’s chickenpox or if the blisters become infected. You can find out more in our article on chickenpox in adults.
If you catch chickenpox whilst you’re pregnant, it can occasionally cause complications such as increasing your risk of developing pneumonia. This risk increases the further you are into your pregnancy and is made worse if you smoke. It’s best to quit smoking if you’re pregnant to avoid harming your unborn baby.
Having chickenpox when you’re pregnant also creates a small but significant risk of your unborn baby developing a condition called foetal varicella syndrome (FVS).
The syndrome is rare but there’s a risk of it occurring during the first 28 weeks of your pregnancy:
Weeks 1-12 – the risk is less than 1%
Weeks 13-20 – the risk is 2%
Weeks 20-28 – the risk is less than 2%
FSV can cause serious complications to your unborn baby including:
• brain damage
• eye defects, such as cataracts
• shortened limbs
• scarring
There are other risks from catching chickenpox after 20 weeks of pregnancy, for example your baby could be born prematurely (before 37 weeks).
If you catch chickenpox seven days before or after giving birth, there is a risk that your newborn baby could develop a more serious type of chickenpox, which in severe cases can be fatal.
Contact your GP, 111 or midwife urgently if:
• you are pregnant and have not had chickenpox before, or you're not sure, and you have been near someone with chickenpox
• you have been in contact with someone who has chickenpox or have chickenpox symptoms
• you are pregnant or have given birth in the last seven days
• your baby is less than four weeks old
• you are breast-feeding
Shingles (herpes zoster) are caused by the varicella-zoster virus, which also causes chickenpox.
It’s an infection of a nerve and the skin around it which causes a painful rash that turns into blisters that ooze fluid. It’s most common on your chest and tummy but can appear on any part of one side of your body and usually doesn’t cross over the midline.
In most cases, when you have chickenpox, you become immune to catching it again because your body develops antibodies to the varicella-zoster virus. However, the virus remains inactive (dormant) in your body and can be reactivated later and cause shingles. This can happen when your body’s immune system is lower such as:
• during old age
• during times of stress
• if you have certain conditions like HIV
• after certain types of surgery
• during certain types of treatment, such as chemotherapy
You can’t catch shingles from someone else who has shingles or chickenpox. However, it’s possible to catch chickenpox from someone with shingles if you’ve not already had chickenpox. For this reason, you should stay at home if you have shingles and if your rash is oozing fluid and cannot be covered until the rash has dried out.
You should avoid the following groups of people who may be more at risk of complications from catching chickenpox:
• those who are pregnant and haven’t had chickenpox before
• people with a weakened immune system – such as those having chemotherapy
• newborn babies less than one month old
The NHS offers a shingles vaccine to those aged between 70 and 79 to help protect against shingles. Alternatively, we offer a private Shingles Vaccination Service13
In healthy children, complications from chickenpox are rare. Sometimes, chickenpox blisters can become infected with bacteria. In these cases, the surrounding skin will become red and sore. If this happens to your child, you should contact your GP, as antibiotics may be needed.
In some cases, chickenpox in children can cause more serious complications, including:
• Encephalitis – inflammation of the brain
• Pneumonia
• Appendicitis
You should seek medical help immediately if your child develops any of the following symptoms after having chickenpox:
• problems with their breathing
• weakness, such as becoming wobbly on their feet
• drowsiness
• fits (convulsions)
• pain or a headache that becomes worse even after taking paracetamol
• being unable to consume fluids because of a severe rash in the mouth
• a severe rash or a rash that bruises and bleeds into the skin (haemorrhagic rash)
• generally becoming more and more unwell
Other groups of people who are at risk of developing complications from chickenpox include:
• adults – chickenpox symptoms can be more severe and adults are at risk of developing lung-related conditions such as pneumonia
• pregnant people – are more at risk of developing pneumonia and chickenpox complications in unborn babies such as foetal varicella syndrome (FVS) or premature birth
• newborn babies – are at risk of a serious type of chickenpox which can be fatal if their mother was infected with chickenpox seven days before or after giving birth
• people with a weakened immune system (such as those undergoing chemotherapy or taking immunosuppressive medication like steroids) – are more at risk of developing complications such as pneumonia and encephalitis (inflammation of the brain).
You can help reduce the chance of getting chickenpox scars by avoiding scratching the spots and blisters whilst you are infected. Scratching a chickenpox spot or blister can cause damage to your skin which can lead to chickenpox scars. This is because when a wound is damaged, the tissues in the area can break causing collagen to be released, which builds up and forms a scar. Chickenpox scars usually have a sunken appearance like a pit.
Most scars will fade over time as the collagen breaks down at the site of the wound and the skin becomes smoother, although they never completely disappear.
If you have chickenpox scars that are bothering you, a pharmacist may be able to recommend products that may help the appearance of scars. Massaging a moisturiser into the area can help keep it hydrated, and you should wear a broad-spectrum sunscreen of minimum SPF30, as scars may be more sensitive to the sun.
If chickenpox scars are painful or affecting your mental health, speak to your GP who may be able to refer you to a dermatologist (skin specialist) or plastic surgeon for further treatment. Some of these treatments may only be available privately.
In certain cases, some people may be given oral antiviral medicine. This can’t cure chickenpox, but may make the symptoms, such as fever, less severe and help prevent complications if taken within 24 hours of the rash starting.
This is not suitable for everyone and is only prescribed in certain cases if the person is diagnosed early enough - usually within 24 hours of the rash appearing.
The following types of people who may be considered for this treatment include:
-Newborn babies
-Pregnant women
-People who have a weakened immune system
-Adults and teenagers over the age of 12
-People with severe infection at any age
In other cases, a treatment called Human Varicella-Zoster Immunoglobulin may be given by injection to help protect people exposed to the virus who are at a higher risk of developing a severe chickenpox infection, including:
-Newborn babies whose mothers develop chickenpox within seven days before or seven days after their baby’s birth or whose mothers have never had chickenpox or aren’t immune
-Premature babies born before 28 weeks of pregnancy, or newborns with a low birth weight
-People who are pregnant and aren’t immune to chickenpox especially up to about 30 weeks of pregnancy
-Adults and children who’ve never had chickenpox and/or aren’t immune and their ability to fight infection is reduced by certain medicines such as steroids, anti-cancer drugs or by certain treatments such as radiotherapy
-Adults and children who have a weakened immune system which makes them more likely to catch infections such as chickenpox, unless they’re receiving other types of regular antibody (immunoglobulin) treatment
This treatment is a solution of antibodies to the chickenpox virus that’s taken from healthy donors. This may only be prescribed where necessary in high-risk cases, as supply is limited.
If you or your child has chickenpox, you should stay away from work, school or nursery until all of the spots have formed a scab, which is usually five to six days after the spots first appeared. This is a signal that you’re no longer contagious.
Although there’s no cure for chickenpox, there are some ways to help soothe and ease symptoms until the infection clears up by itself.
Tips for relieving chickenpox in adults
• stay hydrated by drinking plenty of non-caffeinated drinks such as water
• take paracetamol (if suitable for you) to help relieve pain – avoid ibuprofen, unless advised by a doctor, which may cause a serious reaction of the skin in people with chickenpox
• avoid scratching the spots and blisters as this can lead to scarring
• use cooling creams, gels or a calamine lotion such as Boots Calamine & Glycerin Cream (always read the label) to help relieve discomfort
• speak to a pharmacist about using antihistamines to help relieve itching (these are not suitable for everyone)
• bathe in cool water and gently pat skin dry rather than rubbing
• dress in loose clothes to avoid irritating your rash further
Tips for relieving chickenpox in babies and children
Many of the tips for adults also apply to babies and children, but here are some more specific tips on relieving their chickenpox symptoms, including appropriate types of pain relief:
Hydration
Babies and children also need to stay hydrated when they have chickenpox. If your child isn’t drinking, you could try giving them sugar-free ice lollies (if they’re old enough) which are a good way of getting fluids into children.
Pain relief
If your child is in pain or has a high temperature (fever) you could consider giving them paracetamol such as Boots Paracetamol 120 mg/5 ml Oral Suspension 2 Months Plus (contains paracetamol, always read the label). Paracetamol is the recommended pain relief for helping to relieve pain and fever in chickenpox cases.
You should avoid giving them ibuprofen unless advised to by a doctor, as it may cause a skin reaction during chickenpox. You should also avoid giving children under 16 aspirin.
You should always check with your GP before giving any pain relief to babies under two months old.
Stop the scratching
Chickenpox spots can be very itchy, so it can be helpful to cut babies’ and children’s fingernails short and put socks or mitts over their hands at night to help stop them from scratching in their sleep.
For very itchy and sore skin, you could use calamine lotion such as Boots Calamine & Glycerin Cream (always read the label) to help relieve discomfort in irritated skin. Alternatively, you could use a cooling gel such as ViraSoothe Chickenpox Relief Cooling Gel or a mousse such as PoxClin CoolMousse to help provide soothing relief from chickenpox.
Cool their skin
You can help to keep babies and children’s skin feeling cool by dressing them in loose, cotton clothing, you could also use a fan.
Bathe them in cool water and pat their skin dry.
There’s a chickenpox vaccination available on the NHS, which is recommended for people who aren’t immune to chickenpox but are in close contact with people at risk of becoming seriously ill if they catch it. An example of this could be children who aren’t immune and whose parents are undergoing chemotherapy. If the child caught chickenpox, they could spread it to their parent who has a weakened immune system during chemotherapy.
The vaccination is also given to people who aren’t immune to chickenpox and whose jobs put them at risk of catching it. This could include healthcare workers or laboratory staff who aren’t immune but could be exposed to chickenpox through their work or through contact with patients.
The vaccination isn’t recommended for people with a weakened immune system as it contains a small amount of the live virus that causes chickenpox which could make them ill.
Alternatively, Boots offer a private Chickenpox Vaccination Service1
As with any vaccination, it’s not 100 per cent effective. Nine out of 10 children who’ve had a single dose of the vaccination are shown to develop immunity against chickenpox. Two doses are recommended for an even better immune response. The vaccination is less effective after childhood and it’s estimated that 75 per cent of adults and teenagers who’ve had the vaccination will become immune to chickenpox.
People may wish to get a private vaccination to lessen the chance of having to stay off work or school with chickenpox or lessen the risk of catching it before a big event or holiday.
If you’re not sure if you or your child has chickenpox, or you’re concerned about your child in any way, speak to your GP, but make sure you tell the receptionist it could be chickenpox before going into the practice. You should speak to your GP or call 111 if any of the following apply to you or your child:
• The skin around the chickenpox blisters is hot, painful and red – redness may be harder to see on brown or black skin
• Your child has chickenpox and is dehydrated – signs of this include feeling thirsty, tired, dizzy or lightheaded, they are urinating less than usual or having fewer wet nappies, they have dark, strong-smelling urine, they have a dry mouth, lips and tongue and sunken eyes
• Chickenpox symptoms suddenly get worse
• You're pregnant and haven’t had chickenpox before, or you're not sure, and you've been near someone with chickenpox
• You have a weakened immune system, such as undergoing chemotherapy treatment or taking immunosuppressants like steroids and have been near someone with chickenpox
• You think your newborn baby has chickenpox
If you or your child has chickenpox, you should inform your airline as soon as the rash appears. You will usually be allowed to fly once the last spot has crusted over, but each airline will have its own policy on when they will allow you to fly, so it’s best to check with them.
You should also let your travel insurer know so you can make sure you’re covered if you have to delay, cancel or extend your holiday until you’re well enough to fly home.
In some cases, an airline may refuse entry to passengers who look unwell with an infectious condition like chickenpox, even if you’re no longer contagious. This could be if you’re still showing signs such as crusted spots following chickenpox. You should carry a fit to fly letter from a GP which confirms that you’re no longer contagious. Contact your GP directly if you need one of these ahead of travelling.
You can find more information on the NHS Fit for Travel page.
If you have a weakened immune system, you’re more at risk of catching chickenpox because your body is producing fewer antibodies to fight off infection.
Your immune system is what helps your body defend itself from bacteria, viruses and illness, you may have a weakened immune system if you have certain illnesses, you’re undergoing chemotherapy or you’re taking immunosuppressive medication such as steroids.
Having a weakened immune system can put you at more risk of developing complications from chickenpox such as:
• Pneumonia
• Encephalitis (inflammation of the brain)
You should see your GP urgently if you have a weakened immune system and you’ve got chickenpox or been in contact with someone with chickenpox.
How can Boots help?
The Boots Chickenpox Vaccination Service is available to those seeking protection from the chickenpox virus, including those who are eligible through the NHS but choose a private vaccination service.
If our Chickenpox Vaccination Service is suitable, you'll receive two vaccinations at a minimum of six weeks apart. If you, or your child, had a first dose of chickenpox vaccination at a different provider, you can still have your second dose at Boots, provided you meet all the eligibility criteria for the Boots service.
Who is the Boots Chickenpox Vaccination Service suitable for?
The service is suitable for both adults and children aged between one and 65 years inclusive at the time of the first vaccination.
The service isn't suitable for pregnant or breastfeeding women, anyone with a weakened immune system, or anyone who's had an allergic reaction to any previous vaccination. The service is also not suitable for anyone who's received the MMR vaccine in the previous four weeks. Your pharmacist will check suitability during the consultation.
Which Boots pharmacies offer the Chickenpox Vaccination Service
The Boots Chickenpox Vaccination Service is available in selected Boots pharmacies. Find your nearest pharmacy offering the service.
How long will the in-store consultation take?
The first in-store consultation and vaccination, if suitable, will take about 25 minutes. The second appointment and vaccination will take about 20 minutes.
What else do I need to know before the appointment?
Children under the age of two will typically be vaccinated in the thigh, and anyone over the age of two will usually be vaccinated in the arm. However, the pharmacist will use their judgement in each case to decide whether to vaccinate in the thigh or arm. Therefore, it’s helpful for you or your child to wear loose-fitting clothing and short sleeves that can be rolled up
If a child is being vaccinated, try to stay calm as young children can be nervous about vaccinations, and try to leave plenty of time before the appointment. You'll be asked to stay behind for five minutes after each injection to make sure there are no immediate reactions to the vaccination.
Price
The Chickenpox Vaccination Service costs £150 if you buy the full course of two vaccinations together at the first appointment or £75 per dose if purchased separately. Book your appointment today.
CHICKENPOX-RELATED PRODUCTS
LEARN MORE ABOUT CHICKENPOX
FREQUENTLY ASKED QUESTIONS
Whilst vaccinations shouldn’t cause too much discomfort, the injected area can become swollen and red.
You may also develop a fever (a temperature over 37.5°C), so it’s a good idea to check your, or your child’s, temperature regularly with a thermometer and use age-appropriate paracetamol if needed.
Following the vaccination, if you’re in any doubt about your health or your child’s, trust your instincts and get advice urgently by contacting your GP or calling the NHS on 111, or call an ambulance in the case of an emergency.
On rare occasions, people who have received the chickenpox vaccine can transmit the infection to others.
If you’re very likely to come into contact with pregnant women who haven’t had chickenpox, newborn babies of mothers who haven’t had chickenpox, those with a weakened immune system or who are at risk of serious illness if they have chickenpox, you should avoid any such contact during the period between vaccinations and for six weeks after the second dose.
This is particularly important if you develop a rash within six weeks of the first or second dose and, should this occur, contact must be avoided until the rash has completely disappeared.
This is because more vulnerable people can develop serious complications if they catch chickenpox.
Normally, you won’t require a GP to diagnose chickenpox because the symptoms are very distinctive (a rash of itchy spots that turn into blisters).
Usually, the spots are distinctive enough from other common rashes in babies and children, as outlined by the NHS.
If you’re not sure if you or your child has chickenpox or you’re concerned about your child, you should speak to your GP but let the receptionist know beforehand that it could be chickenpox before going to the GP practice.
If you have chickenpox and you’re breastfeeding, contact your GP who can advise on whether you should continue breastfeeding whilst you have the infection.
If you’re not sure if you’ve previously had chickenpox and you’re worried about catching it, for example, if you’re pregnant or you have a weakened immune system, you could first try asking family or friends if they remember you having it as a child.
You could check with your GP if chickenpox is on your medical records from childhood. However, not everyone who had chickenpox as a child will have this on their records, for example, if they didn’t need to see a doctor during the time they had the virus.
In certain cases, such as if you’re pregnant and you’ve come into contact with someone infected with chickenpox and you’re not sure if you’ve had it, your GP may be able to do a blood test to check if you’re immune to the virus.
Chickenpox usually stops being contagious after all your spots have formed a scab, which is usually five to six days after your spots appeared.
Chickenpox spots start appearing between one and three weeks after you caught chickenpox, and you can pass chickenpox on to other people up to two days before your rash first appears.
Chickenpox symptoms affect everyone differently, so there isn’t a day that’s considered worse for everyone. You may experience mild flu-like symptoms such as a high temperature before your rash appears, which tends to be worse in cases of adult chickenpox.
Chickenpox spots can be very itchy and they are usually at their itchiest after 12 to 14 hours when they turn into blisters, but the itchiness will affect everyone differently.
1 Subject to availability. Eligibility criteria may apply. Charges may apply.
13 Selected UK Boots pharmacies, subject to availability. Eligibility criteria apply. Please note this is not an NHS service.
