Signs and Symptoms of Chickenpox

In young children, chickenpox usually begins with rash, a low-grade fever, and general malaise. In adults, a fever, chills, malaise, headache, and possibly, sore throat appear 2 or 3 days before the rash. Chickenpox is usually more severe in adults.

The rash appears first on the face and scalp, then on the trunk, and then on the arms and legs. The very itchy blisters initially appear like water drops on a pink base.

New blisters appear as older ones form scabs and heal. The scabs resolve in 1 to 3 weeks, usually without scarring. Once all the lesions are crusted over, the virus is no longer contagious. Complications are rare and include pneumonia and nervous system involvement.

The first symptoms of shingles (zoster) are usually pain, burning, and discomfort in the area of nerve distribution. This pain can vary from mild to severe and generally precedes rash eruption by several days.

The rash is usually manifests as a band-like eruption on one side of the body. Redness in the area develops first, followed by bumps that rapidly become water blisters filled with pus. The lesions scab over and heal in about a week. Persistent, severe pain after the rash has subsided, called postherpetic neuralgia, occurs in 10–15 percent of cases and is common in the elderly.

Chickenpox Diagnosis

Chickenpox and shingles are diagnosed by clinical examination and symptoms. Although not routine, definitive diagnosis of varicella-zoster virus can be obtained by culturing infected cells.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 02 Sep 2000

Last Modified: 04 Sep 2015