Illness & Symptoms
Chickenpox
Is this your child's symptom?
- A rash all over the body caused by the chickenpox virus.
 - The chickenpox rash starts as small red bumps. The bumps change to blisters or pimples. The bumps change to open sores, and finally they scab over.
 - A doctor has told you that your child has chickenpox.
 - Or your child had close contact with another person who has it (or shingles). The contact should be 10-21 days earlier.
 
- If NOT, try one of these: 
 - Rash or Redness - Localized
 - Rash or Redness - Widespread
 
Symptoms of Chickenpox
- Chickenpox starts with some small water blisters or pimples on the head and trunk.
 - Chickenpox progress within 24 hours through the next 5 stages: 
- Small red bumps
 - Thin-walled water blisters
 - Cloudy blisters
 - Open sores, and finally
 - Dry brown crusts.
 
 - Rash is all over the body. Most often, starts on the head and back.
 - Repeated crops of new chickenpox keep appearing for 4 to 5 days. Therefore, all 5 stages are present at same time.
 - Sores (ulcers) can also occur in the mouth, on eyelids, and on genitals.
 - Fever is most often present. The more the rash, the higher the fever.
 - Known contact to a child with chickenpox or shingles 10 - 21 days earlier
 - Main related problems: skin infections from scratching.
 
Cause of Chickenpox
- Chickenpox is caused by a virus. It is called Varicella.
 - Chickenpox can be prevented by getting this vaccine against this virus.
 
When to Call for Chickenpox
 Call 911 Now
 Call Doctor or Seek Care Now
  |  
  Contact Doctor Within 24 Hours
 Contact Doctor During Office Hours
  |  
  Self Care at Home
  |  
Call 911 Now
- Not moving or too weak to stand
 - You think your child has a life-threatening emergency
 
Call Doctor or Seek Care Now
- Bright red skin or red streak
 - Very painful swelling or very swollen face
 - New red rash in addition to chickenpox rash
 - Walking is not steady
 - Trouble Breathing
 - Bleeding into the chickenpox
 - Fever higher than 104° F (40° C)
 - Age less than 1 month old
 - Vomits 3 or more times
 - Eye pain or constant blinking
 - Took a steroid medicine within past 2 weeks
 - Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
 - Chronic skin disease (such as eczema)
 - Chronic lung disease (such as cystic fibrosis)
 - Your child looks or acts very sick
 - You think your child needs to be seen, and the problem is urgent
 
Contact Doctor Within 24 Hours
- Age less than 1 year old
 - Teen 13 years or older has chickenpox
 - Been near to person with chickenpox or shingles in last 5 days. Also, healthy person who never had a chickenpox vaccine.
 - One lymph node gets larger and more tender
 - Fever lasts more than 4 days
 - Fever returns after being gone more than 24 hours
 - Scab or sore drains yellow pus
 - One sore gets much larger in size than the others
 - Gets new chickenpox after day 6
 - You think your child needs to be seen, but the problem is not urgent
 
Contact Doctor During Office Hours
- You have other questions or concerns
 
Self Care at Home
- Chickenpox with no other problems
 
Care Advice for Chickenpox
What You Should Know About Chickenpox:
- Chickenpox is caused by the varicella virus.
 - It's now uncommon because of the chickenpox vaccine.
 - Your job is to keep your child comfortable and to limit the itching.
 - Here is some care advice that should help.
 
Cool Baths for Itching:
- For itching, give cool or lukewarm baths for 10 minutes as often as needed.
 - Caution: avoid any chill.
 - Can add baking soda 2 ounces (60 mL) per tub.
 - Baths don't spread the chickenpox.
 - Do not use soaps. Reason: soaps cause dry skin and make the itch worse.
 
Calamine Lotion for Itching:
- Put calamine lotion on the chickenpox that itch the most.
 - You can also use an ice cube on the itchy spots for 10 minutes.
 - Don't use any lotion containing Benadryl in it. Reason: it can be absorbed across the skin. This can cause side effects in kids.
 
Allergy Medicine for Itching:
- If itching becomes severe, give a dose of Benadryl.
 - No prescription is needed. Age limit: 1 and older.
 
Try Not to Scratch:
- Try not to let your child pick and scratch at the sores. This can lead to infected sores.
 - Trim fingernails.
 - Wash hands often with soap.
 
Fever Medicine:
- Give acetaminophen (such as Tylenol) for fever higher than 102° F (39° C).
 - Never use aspirin. Reason: risk of Reye syndrome.
 - Also, don't use ibuprofen products (such as Advil). Reason: may increase risk of bad strep skin infections.
 
Fluids and Soft Diet:
- The mouth and throat ulcers are painful. Try to get your child to drink adequate fluids.
 - Goal: keep your child well hydrated.
 - Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
 - Solids. Offer a soft diet. Also, avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: fluid intake is more important than eating any solids.
 - For babies, you may need to stop the bottle. Give fluids by cup, spoon or syringe instead. Reason: the nipple can increase the pain.
 
Liquid Antacid for Mouth Pain (Age 1 Year and Older):
- For mouth pain, use a liquid antacid (such as Mylanta or the store brand). Give 4 times per day as needed. After meals often is a good time.
 - Age 1 to 6 years. Put a few drops in the mouth. Can also put it on with a cotton swab.
 - Age over 6 years. Use 1 teaspoon (5 mL) as a mouth wash. Keep it on the ulcers as long as possible. Then can spit it out or swallow it.
 - Caution: do not use regular mouth washes, because they sting.
 
Ointment For Pain With Passing Urine:
- For girls with painful genital ulcers, use petroleum jelly (such as Vaseline).
 - Put on the sores as needed.
 - For males with painful pox on the tip of the penis, this also works.
 
Return to School:
- Your child can go back to school after all the sores have crusted over.
 - Most often, this is day 6 or 7 of the rash.
 
What to Expect:
- Expect new chickenpox every day for 4 or 5 days.
 - Most children get 400 to 500 chickenpox.
 - They get less pox if they've had the vaccine.
 
Prevent the Spread of Chickenpox in the Office:
- If your child needs to be seen, call first to the office.
 - Try to bring another adult. Have one adult enter the office first for instructions.
 - For nonurgent problems, the doctor may do an exam in the car.
 
Call Your Doctor If:
- Chickenpox look infected (draining pus, scabs become larger)
 - Gets any new chickenpox after day 6
 - You think your child needs to be seen
 - Your child becomes worse
 
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.
Reviewed: 5/6/2025 Updated: 1/25/2025

