Chickenpox: Symptoms, the Itchy Phase and When It Is Serious
Chickenpox is a common, highly contagious infection caused by the varicella virus. It produces an itchy rash of small red spots that turn into fluid filled blisters and then crust over. It usually causes a mild fever and tiredness, is most common in young children, and most cases clear up on their own.
Since a funded vaccine was introduced, chickenpox has become far less common in Australia, and many children now have only a mild illness or avoid it altogether. Even so, the virus still circulates, and most parents will meet it at some point. For healthy children it is usually more of a nuisance than a danger, but it can be more serious for newborn babies, pregnant women and people with weakened immune systems, which is why knowing the warning signs matters.
This guide walks through the spots and how they change, how chickenpox spreads, how to ease the itch safely at home, when your child can return to school, and the signs that mean you should speak to a doctor.
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The chickenpox rash has a pattern that helps parents recognise it. Spots usually appear first on the chest, back, tummy or face, then spread outwards, and they often come in crops over three to five days. This means you can see spots at different stages at the same time: new red bumps, fluid filled blisters, and older ones that have dried and crusted over. The blisters are intensely itchy, which is the part most children find hardest to cope with.
A day or two of mild fever, tiredness, headache or loss of appetite often comes before or alongside the first spots. Because several childhood illnesses cause spots or blisters, it can be confusing to tell them apart. Our guide to hand, foot and mouth disease describes a different rash that also produces blisters, but in a different pattern and in different places on the body. With chickenpox, the telltale clue is the mix of spots at all stages at once, spread widely across the skin, together with the strong itch that comes with them.
Chickenpox is caused by the varicella virus and is one of the most contagious of all childhood infections. It spreads through the air when an infected person coughs or sneezes, and through contact with the fluid in the blisters. A child is infectious from a day or two before the rash appears until every blister has crusted over, which is why it moves so easily through families, childcare and schools before anyone realises it is there.
The reassuring news is that the chickenpox vaccine is on the National Immunisation Program, with one funded dose given at around 18 months of age, so many children today are protected or have only a very mild illness. A mild fever often arrives a day before the spots, and our guide to when a child's fever is worth worrying about can help you judge whether a fever needs attention. If your unvaccinated child has been in close contact with chickenpox, it is worth speaking to a doctor about what to do next.
The itch is the main challenge with chickenpox, and a few gentle measures make a real difference. Cool or lukewarm baths can soothe the skin, and patting rather than rubbing dry helps avoid breaking the blisters. Keep your child's fingernails short and clean, and consider light cotton mittens for babies, because scratching can lead to infection and scarring. Loose, soft clothing reduces irritation against the spots.
Dab, rather than rub, any soothing lotions your pharmacist or doctor suggests. If the itch is severe and disturbing sleep, a doctor may advise antihistamines suitable for your child's age. This is a class of medicine, and the decision is one for your doctor. Children who already have sensitive or broken skin can find chickenpox especially uncomfortable, and our guide to eczema in children has more on caring for itchy skin. Offer plenty of fluids, keep your child cool, and use quiet activities and cuddles to distract them from the itch, which often feels worse when they are bored or tired.
Children with chickenpox need to stay home from school or daycare until all the blisters have dried and crusted over, which is usually at least five days after the rash first appears. Exclusion rules vary between states and territories, so always check your own state's guidance or ask your child's school. The same applies to other contagious illnesses such as scarlet fever.
For fever and discomfort, use pain and fever relief suitable for children, following the dosing instructions for their age and weight. There is one very important safety rule: do not give aspirin-containing medicines to children with chickenpox, because this combination is linked to a rare but serious illness that affects the brain and liver. It is also best to avoid anti-inflammatory pain relievers during chickenpox unless a doctor specifically advises them, as they may increase the risk of a skin infection. If you are ever unsure what is safe to give your child, a doctor or pharmacist can guide you before you reach for anything.
See the same doctor each time
Most children recover from chickenpox without any trouble, but some signs need prompt medical attention. Contact a doctor straight away if your child becomes very unwell, is drowsy or difficult to wake, seems confused, has trouble breathing, has a stiff neck, or is not drinking. Watch the skin closely too. If any spots become very red, hot, swollen and painful, or start weeping pus, they may have become infected, and our guide to impetigo, or school sores explains how a skin infection can take hold in broken skin.
Some people are at higher risk and should seek advice quickly if they are exposed to chickenpox, including newborn babies, pregnant women, and anyone with a weakened immune system, for example from certain illnesses or treatments. If your own child is seriously unwell, struggling to breathe, or you feel something is badly wrong, do not wait to see how things go. Trust your instincts and seek urgent help.
Abby Health is an online-first clinic, so you can talk to an Australian GP about your child's chickenpox from home, seven days a week, without bringing a contagious child into a waiting room. Over video, a doctor can help confirm whether the rash is chickenpox, advise on easing the itch and managing fever safely, and talk through which treatment options are suitable for your child. If you are wondering what can and cannot be handled online, our help centre explains what Abby can and cannot prescribe safely.
You can choose to see the same doctor each time, so your child's history is understood. If your child needs to stay home until the blisters crust over, we can help with a carer's medical certificate for your workplace. Book through our everyday family clinic when it suits you. Bulk billed for eligible patients with a valid Medicare card. Strict eligibility criteria apply. This is general information only and not a substitute for personal medical advice. If your child is drowsy and hard to wake, struggling to breathe, or seriously unwell, call 000 immediately.
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