Chickenpox is a highly contagious infection that causes itchy rashes and fever. Many people get chickenpox as children, which generally results in a milder course of the disease than in teenagers and adults. People who have had chickenpox can get shingles later in life.
The cause of chickenpox
Chickenpox is caused by a virus called varicella zoster. Chickenpox is very easily transmitted by direct contact and via the air around the person who is ill. The incubation period for chickenpox varies between 10 and 21 days but is usually about two weeks. Because chickenpox is contagious before the first symptoms break out, it is difficult to stop the spread and many students in preschool groups and school classes can become ill at the same time.
If you have once had chickenpox or been vaccinated against the disease, you are then immune for the rest of your life. There are people who have had chickenpox twice, but it is very unusual. Varicella zoster belongs to a group of viruses (herpes virus) that are characterized by being dormant in the body after the infection has healed and can be activated again later in life. If varicella zoster flares up again, it can not cause chickenpox a second time, but another disease called shingles. You can unfortunately get shingles several times, you do not become immune.
Chickenpox – course and symptoms
The typical course of the disease in chickenpox is:
- Two to three weeks without symptoms (incubation period)
- Fever, fatigue, body aches, malaise for one to two days before the rash
Then comes itchy rash, which undergoes three phases:
- First, small raised dots appear. On light skin it is visible that the rash is red, on dark skin the redness is more difficult to see. It can start with occasional rashes, usually on the chest, abdomen or back, which then become more and more.
- After a few days, each dot has become an itchy fluid-filled blister with clear contents. They sit one by one and can vary in size. On light skin, red rashes can be seen under the blisters. On dark skin, the clearest feature is the blisters themselves, which are fluid-filled and slightly lighter than the skin underneath. Eventually the blisters burst and the fluid leaks out.
- After the blisters have ruptured, scabs form which take a few more days to heal.
For a few days, more and more new spots appear at the same time as others have turned into blisters. All three phases – dots, blisters and crusts – can occur simultaneously. After a few days, new spots stop appearing, and the disease begins to heal. It can take up to two weeks from the first symptoms until the last scabs have healed. In some children, the fever can come and go during recovery, and it is not uncommon to get secondary bacterial infections such as smallpox (impetigo).
Some children get a few spots while others get a rash all over their body. Sometimes blisters can form in the throat, eyes, mucous membranes of the abdomen and genitals.
Risk groups for more serious illness
Chickenpox is usually a mild illness, especially for children. Getting chickenpox as an adult can in some cases mean a more difficult course of the disease. This is especially true for:
- pregnant women who have not had chickenpox, and are not vaccinated
- smokers
- people with a weakened immune system
- people treated with cortisone
What can I do myself?
There is a lot you can do yourself to relieve chickenpox. It is primarily about relieving the itching and reducing the risk of infected wounds and other complications.
- Keep skin clean. Make sure the skin is clean to avoid the risk of infected wounds. Fever can make the skin sweaty, which increases itching. Wash with water and mild soap and wipe the skin dry gently with a clean towel.
- Check your nails. Reduce the risk of lacerations by making sure your nails are not sharp. Cut or file the nails.
- Try to calm the itching. Anything that can reduce the itching makes the disease easier. It makes it easier to sleep and reduces the risk of infection in torn wounds. There are many tricks, try what works best. Pharmacies have several over-the-counter alternatives that can relieve itching. There are also over-the-counter medications with antihistamines (same as for allergies) that can be used for itching. Ask the staff at the pharmacy for advice.
- Airy clothes. Wear airy clothing and leave small children without a diaper as much as possible to reduce the itching.
- Avoid cortisone and ibuprofen. These drugs can increase the risk of complications in various ways. Instead, use medications that contain paracetamol to lower the fever and other methods to relieve the itching.
Treatment for chickenpox
Chickenpox in most cases requires no special treatment in addition to self-care. There is no cure for chickenpox once the disease has broken out. But there are antiviral drugs that can slow down the process and cause a milder disease. It may be relevant for those groups who risk a more difficult course of the disease, for example adults or people with weakened immune systems. Antiviral therapy should be started as early as possible to be effective. Therefore, certain risk groups are recommended to seek care immediately if they suffer from chickenpox. Read more under when should I seek care.
Chickenpox – vaccine
Chickenpox is highly contagious and spreads even before the disease has given symptoms. Therefore, it is difficult to protect oneself from getting the disease.
There is a vaccine against chickenpox (varicella). The vaccine provides good protection and has few side effects. However, it is not included in the general vaccination program, but it involves a cost that you must bear for yourself. The vaccine is for adults and children over nine months. The vaccine is not recommended for pregnant women or people with weakened immune systems.
A vaccination protects against both chickenpox and shingles.
When should I seek care?
If you need to seek care, keep in mind that chickenpox is highly contagious and can cause great inconvenience to other patients in waiting rooms and hospitals. Therefore, contact the care before a physical visit, or use digital care.
Some groups should contact healthcare if chickenpox is suspected, as there is a risk of a more difficult course of the disease that can be alleviated with early treatment. It applies to:
- Children younger than six months
- Adults and children in their late teens
- Pregnant women – contact healthcare already in case of suspicion of infection
Children (over six months) with chickenpox rarely need to seek care, unless the disease worsens or is very bothersome. This applies, for example, if one of the following is true:
- that the rash spreads to the eyes and causes discomfort
- severe itching symptoms that do not go away with over-the-counter medication
- that the rash changes character and becomes hot, sore and irritated. This may indicate that the rash has become infected with bacteria
- rash in combination with symptoms such as dizziness, confusion, difficulty breathing, stiff neck, vomiting and h