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Chickenpox: contagion, symptoms, duration and treatments

The varicella-zoster virus causes a highly contagious viral infection. Although chickenpox mainly affects children, the vaccine has considerably reduced its prevalence. This disease causes a skin rash, accompanied by itching (pruritus), and small raised lesions (spots) that form crusts or pustules. How can these inflammatory skin lesions be treated? And when should you see a doctor? Feeli explains everything.

How is chickenpox transmitted?

Chickenpox is a viral infection mainly affecting children and babies. The varicella-zoster virus, which is highly contagious, is a type of herpesvirus responsible for other diseases such as herpes and shingles. It is transmitted:
   • By inhaling airborne droplets from an infected person: these contain the varicella-zoster virus;
   • By contact with a skin surface contaminated with chickenpox or shingles;
   • During pregnancy, from the pregnant woman to her foetus.
A vaccine was introduced in 1995, at a time when chickenpox affected around 90% of all children before the age of 15. Since then, the number of chickenpox cases per year has been reduced by 90%, particularly in France, thanks to vaccination. Highly contagious, this disease can be transmitted 2 days before symptoms appear and remains contagious until the skin rash has healed. All the blisters must therefore have turned into crusts. In children, chickenpox rarely causes complications, as the immune system is normal at this age. People affected by chickenpox generally develop ulcers in the mouth and on the skin. Nevertheless, the virus can sometimes spread to the lungs, heart, brain or liver. These severe forms are more common in newborns and in adults whose immune system is weakened (by certain treatments, HIV, or high doses of corticosteroids). Pregnant women also have an increased risk of complications. Fortunately, chickenpox can only be caught once: people then develop immunity. However, be aware that the virus lies dormant in the body and remains inactive, but it can reactivate later in life. This reactivation sometimes takes the form of shingles. An effective vaccine exists for older people and greatly reduces the risk of developing this infection.

Symptoms: how long does chickenpox last?

7 to 21 days after infection, the first symptoms of chickenpox appear:
   • Mild headaches;
   • A mild fever;
   • A feeling of tiredness or general malaise;
   • Loss of appetite.
However, young children often do not show these symptoms, which are, by contrast, severe in adults. Then, about 24 to 36 hours after the first symptoms appear, small, flat, red spots form on the skin. This rash is usually located on the face and upper body (trunk), before spreading to the arms and legs. The number of spots also varies from one patient to another: some people may be covered in them, including inside the mouth or on the scalp, while others have only a few spots. Then, over the following 6 to 8 hours, all the spots become raised. They start to form round, itchy blisters filled with fluid on a red base. The spots eventually turn into crusts. The chickenpox rash also has the characteristic of appearing in waves. The spots can therefore be at different stages of development on the infected areas of skin. Very rarely, these spots can become infected with bacteria, causing a severe skin infection. Most often, spots stop appearing around day 5; by around day 6, most of the spots have crusted over, and they disappear within 21 days. Lastly, when spots develop in the mouth, they can make swallowing painful. These open sores (ulcers) can also occur in the upper airways, on the eyelids, in the rectum and in the vagina. The disease's most difficult stage generally lasts between 4 and 7 days.

Prevention and treatments

Prevention essentially relies on:
   • Vaccination;
   • And isolating those who are ill.
Isolating infected people helps prevent the virus from spreading to those who have never had chickenpox. Adults should not return to work, nor should children go back to school. All the skin blisters must first have crusted over. Children are generally vaccinated at 12-15 months old, then again between the ages of 4 and 6. Adults and older children who have never had chickenpox can also be vaccinated, particularly women of childbearing age and vulnerable people with chronic conditions. Several treatments may be offered, depending on the patient's profile and the severity of symptoms:
   • Immunoglobulin treatment to limit the severity of the infection or prevent it;
   • For mild chickenpox in children: damp compresses applied to the affected areas can soothe itching, which can sometimes be intense, and reduce scratching. Scratching can also cause scarring. The skin should also be washed regularly with soap and water. Nails should be kept short to limit scratching and the risk of infection.
   • For severe itching: oral antihistamines;
   • Antiviral medications (aciclovir, valaciclovir, famciclovir): general practitioners may prescribe these to relieve symptoms and shorten their duration, particularly if there is a fever;
   • Pregnant women may also be prescribed antivirals, as they are at high risk of complications (pneumonia, Reye's syndrome, etc.).

Chickenpox: consult a GP online

Chickenpox presents with characteristic crusty, purulent skin lesions. It frequently affects the scalp, is accompanied by itching and sometimes causes ulcers inside the mouth. Complications can occur without treatment or in at-risk people: pregnant women, people with a weakened immune system, or people with chronic conditions. The most severe complications include bacterial infections such as pneumonia or Reye's syndrome. For your health, it is therefore important to see a doctor at the slightest doubt, as soon as a rash appears. Vaccines against the varicella-zoster virus offer the best prevention for children (particularly babies) and adults. If in doubt, do not hesitate to consult a GP on the Feeli platform to confirm the diagnosis. Online consultation lets you avoid waiting rooms and consult quickly without an appointment. A suitable treatment will then be offered to you if necessary. Don't forget to find out about vaccination too!