Get answers to your questions about chickenpox in adults, including high risk groups like pregnant women. We cover everything from how to treat your symptoms to who can get the chickenpox vaccination & the link to shingles
Chickenpox is a common viral infection that causes an itchy red rash which turns to blisters then scabs.
Most people get chickenpox when they’re children because the virus spreads easily when you’re in close contact with an infected person.
It normally clears by itself but in adults it can be more severe and lead to complications.
Certain groups like pregnant women and those with a weakened immune system are more at risk of serious illness.
Read on to find out more about chickenpox in adults, including possible complications, how to get relief from your symptoms and when to see a GP.
Symptoms of chickenpox in adults
Chickenpox typically starts as small itchy red spots which turn to blisters after about 12 hours. The fluid in the blisters tends to turn cloudy after a day or two then dry out and form scabs. The crusty skin from the scabs then falls off gradually over the next one to two weeks.
You may notice new spots appearing for up to five days after you first get the rash. Adults may get more spots than children and may be more prone to scarring.
The spots normally develop in clusters and can appear anywhere on the body but are most common on the:
• Face
• Scalp
• Behind the ears
• Chest and stomach
• Legs and arms
Before the rash appears, adults with chickenpox can develop mild flu-like symptoms such as:
• A high temperature (38C or above)
• Loss of appetite
• Headache
How does chickenpox spread?
Chickenpox spreads easily, so it’s advisable not to go to work or public places until all the spots have formed scabs. This is when the infection stops being contagious. This usually happens after around five days from when the rash first appears. However, chickenpox is contagious from about one to two days before the spots appear.
The chickenpox virus, known as varicella-zoster, spreads through contact with fluid from chickenpox blisters. This means you can get it if you touch the same surface as someone with blisters. It can also be passed on by being in the same room as someone with it.
Spots tend to appear one to three weeks after you’ve contracted the virus.
If you have chickenpox, avoid contact with the following people as they may be at a higher risk:
• Pregnant women
• People with a newborn baby
• Breastfeeding mothers
• People with a weakened immune system like those having chemotherapy
If you’re due to fly when you get chickenpox, let your airline know and they will advise you on their policy. You’re likely to have to wait until you develop scabs so you’re no longer contagious when you fly.
Complications in adults
Chickenpox in adults can clear itself but in severe cases it may need hospitalisation.
The virus puts adults, particularly older ones, at risk of:
• Lung conditions like pneumonia — especially if you’re a smoker
• Hepatitis which causes inflammation of the liver
• Encephalitis (swelling of the brain) which often starts off with flu-like symptoms. This rare condition needs to be treated in hospital and the earlier it's treated the more chance of success
You should speak to your GP, or call 111, if you develop any of the following symptoms:
• Hot, red and painful skin around the blisters — this may be harder to see on darker skin
• Difficulty breathing or chest pain
• Signs of dehydration such as drowsiness, or cold hands and feet
You should also speak to your GP if any of your chickenpox symptoms become suddenly worse or you’re concerned about any of your symptoms.
High risk groups
The following groups of adults have a higher risk of developing complications from chickenpox:
• Pregnant women
• People with a weakened immune system — due to chemotherapy or HIV for example.
High risk people should speak to their GP if they’ve come into contact with someone with chickenpox or shingles (as it’s caused by the same virus).
If you’re unsure if you’ve previously had chickenpox, your GP may be able to check your records. It’s very rare to get chickenpox twice.
Chickenpox in pregnancy
Around three in every 1,000 pregnant women get chickenpox. If you’re pregnant and you haven’t had chickenpox before then it’s best to avoid contact with anyone who has chickenpox or shingles.
If you’ve been in contact with someone with the virus, let your GP know urgently and they may arrange for you to have a blood test to check if you’re immune to the virus. If you aren’t immune, they may give you medication to help reduce the risk of infection.
Getting chickenpox when you’re pregnant can put you at risk of lung conditions like pneumonia. Around one in 10 pregnant women with chickenpox also develop pneumonia, which tends to be more severe further into pregnancy and worse if you smoke too.
There’s also a risk of passing on chickenpox to your unborn baby.
If you get chickenpox in the first 28 weeks of pregnancy your baby could develop a rare condition called foetal varicella syndrome (FVS). This can cause serious complications such as:
• Eye defects such as cataracts
• Brain damage resulting in learning difficulties
• Shortened limbs
• Scarring
The risk of FVS during pregnancy is estimated to be less than 1% in weeks one to 12 and around 2% in weeks 13 to 20. A small but significant number of cases have been reported between 20 and 28 weeks but the risk is thought to be lower than during the first 20 weeks of pregnancy.
If you get chickenpox after 20 weeks of pregnancy your baby may be born prematurely (before 37 weeks).
Unfortunately, if you get chickenpox seven days before or seven days after your baby is born they’re also at risk of severe chickenpox. Contact 111 or speak to your GP if you’ve been in contact with someone who has chickenpox or you have chickenpox symptoms and:
• You’re pregnant or have given birth in the last seven days
• Your baby is less than four weeks old
• You’re breastfeeding
Treatments for chickenpox in adults
There's no cure for chickenpox, but it usually clears itself. There are some common treatments, which are available to buy at your local pharmacy, to help manage your symptoms, including:
• Paracetamol to help relieve the pain. Don’t take ibuprofen (unless advised by your doctor), as it can cause a serious skin reaction
• Calamine cream or lotion to help relieve discomfort in irritated skin, but make sure to read the patient information leaflet
Your GP may also recommend an oral antiviral medication. This may make symptoms less severe and helps reduce the risk of complication but it’s usually best taken within 24 hours of the rash starting.
If blisters become infected from scratching you may be given antibiotics.
High risk people who have been exposed to the virus may also be given a Human Varicella-Zoster Immunoglobulin injection which contains antibodies to the chickenpox virus.
Tips to help relieve chickenpox symptoms
• Wear loose fitting cool clothes
• Avoid scratching as this can also lead to scarring
• Use a fan to cool down. Cordless fans are a good portable option
• Bathe in cold water
• Drink plenty of fluids to avoid dehydration
Tips to help with chickenpox scars
Unfortunately, in some cases you might develop scars from chickenpox. To minimise the chances of this happening, try to avoid scratching.
Chickenpox scars often have a sunken appearance. Although this never goes away, it does improve with time. Protecting your skin with a sunscreen of at least SPF30 can help with scars that may be more sensitive to the sun. You can also try massaging a moisturiser into the scar to keep it hydrated, but speak to a pharmacist if you’re unsure which products to use.
Chickenpox vaccinations
A vaccination to help protect against chickenpox is available on the NHS for people who are likely to come into contact with those at risk of complications. Children who haven’t had chickenpox can get the vaccination to help protect others. The vaccination isn’t part of the routine childhood vaccination schedule. The vaccine is also given to those whose job puts them at risk, for example healthcare workers who are in contact with patients. Alternatively, you may be able to get the vaccination privately. Take a look at our Chickenpox Vaccination Service*.
The vaccination isn’t suitable for pregnant women or people with a weakened immune system as it contains a live virus.
The vaccination is given as two separate injections, usually four to eight weeks apart. It is more effective in young children than adults and teenagers. The recommended two doses is estimated to offer 98% protection from chickenpox in children, and 75% protection in teenagers and adults. Having two doses is recommended as this produces a better immune response.
Shingles
After you’ve had chickenpox, the varicella-zoster virus remains dormant but can cause shingles later if it becomes reactivated. The virus can be reactivated by:
• Stress
• Chemotherapy
• Other illnesses or infections
Shingles is an infection which affects the nerves and the skin around it. It causes a painful rash and itchy blisters on one side of the body where the affected nerve is.
You may also feel unwell or get a headache and experience numbness and tingling a few days before the rash. While you can’t get shingles from another person, those with shingles can give people chickenpox if they’ve not had it before.
People aged 70 to 79 can get the shingles vaccine on the NHS. The vaccine isn’t available on the NHS to anyone aged 80 or over as it doesn’t seem to be as effective.
People aged 50 and over may be able to get the Shingles Vaccination Service* at selected Boots stores, if suitable for them.* Please note, this is not an NHS service.
* Selected UK Boots pharmacies, subject to availability. Eligibility criteria apply. Charges apply.
