Chickenpox: Symptoms, Treatment & When to See a Doctor

What Is Chickenpox and What Causes It?

Chickenpox is a highly contagious infection caused by the varicella-zoster virus (VZV), a member of the herpes virus family. It causes an itchy rash with fluid-filled blisters, along with fever and fatigue. The virus spreads through respiratory droplets and direct contact with blister fluid.

Chickenpox, medically known as varicella, has been a rite of passage for children for centuries before vaccines became available. The varicella-zoster virus (VZV) that causes chickenpox is remarkably efficient at spreading from person to person, making it one of the most contagious childhood diseases. In fact, if an unvaccinated person is exposed to someone with chickenpox, there is approximately a 90% chance they will become infected if they have never had the disease before.

The virus belongs to the herpesvirus family, which includes other well-known viruses such as herpes simplex (cold sores and genital herpes), Epstein-Barr virus (mononucleosis), and cytomegalovirus. Like other herpesviruses, varicella-zoster has the unique ability to remain dormant in the body after the initial infection. The virus retreats to nerve cells near the spine and brain, where it can remain inactive for decades. In some people, the virus reactivates later in life, causing a condition called shingles (herpes zoster), which produces a painful, localized rash.

Before the introduction of the varicella vaccine in the 1990s, chickenpox was nearly universal - approximately 4 million cases occurred annually in the United States alone, resulting in about 10,500 hospitalizations and 100-150 deaths each year. Today, in countries with widespread vaccination programs, the incidence of chickenpox has decreased by more than 90%, and severe complications have become much rarer.

How Does Chickenpox Spread?

The varicella-zoster virus spreads primarily through two routes: respiratory transmission and direct contact. When an infected person coughs, sneezes, or even talks, they release tiny droplets containing the virus into the air. These droplets can be inhaled by nearby people, allowing the virus to enter through the respiratory tract. This is why chickenpox spreads so easily in close-contact settings like households, schools, and daycare centers.

The second transmission route is through direct contact with the fluid inside chickenpox blisters. This fluid contains high concentrations of the virus and is highly infectious. Touching the blisters or items contaminated with blister fluid (such as bedding or clothing) can spread the infection. Importantly, the crusted scabs that form as blisters heal are not infectious - the virus cannot spread once all lesions have completely crusted over.

One of the most challenging aspects of chickenpox control is that infected individuals become contagious before they know they are sick. The infectious period begins 1-2 days before the rash appears and continues until all blisters have crusted over, typically 5-7 days after the rash first develops. This pre-symptomatic contagiousness makes it extremely difficult to prevent outbreaks, as people unknowingly spread the virus before isolating themselves.

What Are the Symptoms of Chickenpox?

Chickenpox symptoms include fever, headache, fatigue, and loss of appetite, followed by an itchy rash that progresses from red spots to fluid-filled blisters to crusty scabs. The rash typically starts on the face, chest, and back before spreading to other body parts. New spots appear in waves over 3-5 days.

The symptoms of chickenpox typically develop 10-21 days after exposure to the virus, with most cases appearing around 14-16 days post-exposure. This extended incubation period is one reason why tracing the source of infection can be challenging. The illness usually begins with non-specific symptoms that can easily be mistaken for a common cold or flu, making the initial diagnosis difficult before the characteristic rash appears.

In the 1-2 days before the rash develops, both children and adults may experience prodromal symptoms including low-grade fever (usually 38-39°C or 100-102°F), mild headache, decreased appetite, and general fatigue or malaise. Children often have milder or no prodromal symptoms, while adolescents and adults typically experience more pronounced early symptoms. This prodromal phase is when the person becomes contagious, even though no visible signs of illness are present.

The hallmark symptom of chickenpox is the distinctive rash, which follows a predictable pattern of development. The rash typically begins as small, red, flat spots (macules) that quickly evolve into raised bumps (papules), then into fluid-filled blisters (vesicles) that resemble small drops of water on the skin. These vesicles are surrounded by a red halo of inflamed skin. After 1-2 days, the blisters become cloudy, break open, and form crusty scabs that eventually fall off, usually without leaving permanent scars unless the lesions become infected or are repeatedly scratched.

The Characteristic Rash Pattern

The chickenpox rash has several distinguishing features that help differentiate it from other skin conditions. The rash typically begins on the trunk (chest, back, and abdomen), face, and scalp before spreading to the arms and legs. The extremities usually have fewer lesions than the central body. One of the most characteristic features is the presence of lesions at different stages of development simultaneously - you might see red spots, fresh blisters, cloudy blisters, and healing scabs all at the same time on different parts of the body.

New crops of spots continue to appear in waves over 3-5 days, each wave going through the same progression from red spot to blister to scab. A typical case of chickenpox produces 200-500 lesions, though this number varies widely. Some children, particularly those who have received one dose of vaccine but still develop "breakthrough" chickenpox, may have only 50 or fewer spots. Adults and immunocompromised individuals typically develop more extensive rashes with a higher number of lesions.

The rash can appear anywhere on the body, including inside the mouth, on the scalp, in the ears, on the genitals, and even on the eyes. Lesions in the mouth (enanthem) appear as small ulcers that can make eating and drinking painful. Genital lesions are particularly uncomfortable, especially during urination. The intense itching associated with the rash is often the most distressing symptom for both children and caregivers, and managing this itch is a primary focus of home care.

Symptoms Are Usually Milder in Young Children

The severity of chickenpox symptoms tends to increase with age at infection. Young children, particularly those between 1-4 years old, typically experience the mildest form of the illness. They may have only low-grade fever, minimal discomfort, and fewer than 200 spots. Many young children continue to play and remain active throughout the illness, with the itching being their primary complaint.

Older children and teenagers generally experience more significant symptoms, including higher fevers, more pronounced fatigue, and a greater number of lesions. The itching tends to be more intense, and the overall illness duration may be slightly longer. Adults who contract chickenpox typically have the most severe symptoms, with higher fevers (often above 39°C/102°F), more extensive rash covering a larger body surface area, and significantly more constitutional symptoms like muscle aches, headache, and fatigue.

Recovery time also varies by age. Most children feel better within 1-2 weeks after the first symptoms appear, with the rash typically crusting over completely within 7-10 days. Adults may take longer to recover fully, sometimes requiring 2-3 weeks before feeling back to normal. The residual scabs can take several additional weeks to fall off completely, though the person is no longer contagious once all lesions have crusted.

How Long Is Chickenpox Contagious?

Chickenpox is contagious from 1-2 days before the rash appears until all blisters have crusted over, typically 5-7 days after the rash begins. Children should stay home from school or daycare until all lesions have formed scabs. The virus spreads through airborne droplets and direct contact with blister fluid.

Understanding the contagious period of chickenpox is crucial for preventing spread to others, particularly to high-risk individuals like pregnant women, newborns, and immunocompromised people. The infectious period of chickenpox is one of the longest among common childhood illnesses, which contributes to its high transmissibility.

Infectivity begins approximately 1-2 days before any visible symptoms appear, during the late incubation period when the virus is multiplying in the respiratory tract. At this stage, the infected person feels fine and has no idea they are carrying and spreading the virus. This pre-symptomatic transmission is the main reason why chickenpox outbreaks are so difficult to control - by the time the first case is identified by its characteristic rash, the virus has likely already spread to other susceptible individuals.

Once the rash appears, the person remains highly contagious until every single blister has crusted over. New crops of lesions continue to appear for 3-5 days, and each new blister restarts the clock on the contagious period. A person is considered no longer contagious only when ALL lesions - including the most recent ones - have formed dry scabs. This typically occurs 5-7 days after the rash first appeared, but can take longer in more severe cases or in immunocompromised individuals.

Guidelines for Returning to School or Childcare

Most health authorities recommend that children with chickenpox remain at home and away from other children until all blisters have crusted over. This is not based solely on whether the child feels well enough to attend - even a child who feels perfectly fine but still has fresh blisters can spread the virus to others. Before returning to school or childcare, all of the following criteria should be met:

• All chickenpox blisters have dried and formed scabs - no new blisters appearing
• The child has been fever-free for at least 24 hours without fever-reducing medication
• The child feels well enough to participate in normal activities

It's important to notify your child's school or childcare center when chickenpox is diagnosed, as other families may need to be alerted. Parents of children who may be at high risk for complications (such as those with weakened immune systems) need to know about potential exposure so they can consult with their healthcare providers about preventive measures.

While your child is contagious, they should avoid contact with anyone who has never had chickenpox or been vaccinated, especially pregnant women (particularly those in their first or third trimester), newborn babies, and anyone with a weakened immune system. However, children who are feeling well can still go outside for fresh air - outdoor transmission is much less efficient than indoor transmission, and brief outdoor encounters pose minimal risk.

What Can I Do to Help My Child at Home?

Home care for chickenpox focuses on relieving itching and fever while preventing complications. Keep skin clean with daily baths, use calamine lotion or cool compresses for itching, give paracetamol for fever (never ibuprofen or aspirin), keep fingernails short to prevent scratching, and ensure plenty of fluids. Most cases resolve without medical treatment.

Since chickenpox is a viral infection, antibiotics are not effective and the illness must run its course. Fortunately, most children recover completely with supportive home care alone. The primary goals of home treatment are to manage the uncomfortable symptoms (especially the intense itching), prevent secondary bacterial infections of the skin, and ensure the child stays hydrated and as comfortable as possible during recovery.

Creating a comfortable environment can make a significant difference in how your child copes with the illness. Keep the room temperature cool and dress your child in loose, soft cotton clothing that won't irritate the skin. Heat and sweating can intensify itching, so avoid bundling up the child even if they have a fever. Some parents find that distraction techniques - favorite movies, audiobooks, gentle games - help children focus less on the urge to scratch.

Keep the Skin Clean

Contrary to old advice that suggested avoiding baths during chickenpox, daily bathing is actually beneficial. Keeping the skin clean helps prevent bacteria from entering open blisters and causing secondary infections. Use lukewarm (not hot) water and mild, fragrance-free soap. Adding colloidal oatmeal or baking soda to the bath water can provide additional itch relief.

Pat the skin dry gently with a soft towel - avoid rubbing, which can rupture blisters and increase irritation. Some healthcare providers recommend air-drying to minimize friction on the sensitive skin. After bathing, apply calamine lotion or other soothing preparations to itchy areas.

Prevent Scratching

Scratching is almost irresistible for children with chickenpox, but it can lead to scarring and bacterial skin infections. Keep your child's fingernails trimmed short and filed smooth to minimize damage from scratching. For young children and infants, consider putting cotton mittens or clean socks over their hands, especially at night when scratching often occurs unconsciously during sleep.

Teach older children to pat or press on itchy spots instead of scratching. Applying cool, wet compresses to particularly itchy areas can provide temporary relief. Some parents find that keeping hands busy with gentle activities helps reduce scratching.

Relieve the Itch

Managing itching is often the biggest challenge of chickenpox care. Several approaches can help:

• Calamine lotion: This classic pink remedy provides cooling relief when applied to itchy spots. Available over-the-counter at any pharmacy.
• Cool compresses: A clean cloth soaked in cool water and applied to itchy areas provides temporary relief.
• Oatmeal baths: Colloidal oatmeal products (like Aveeno) added to bathwater can soothe irritated skin.
• Baking soda baths: Adding 1/2 cup of baking soda to a shallow bath can help relieve itching.
• Oral antihistamines: Non-sedating antihistamines like cetirizine or loratadine can help reduce itching. Sedating antihistamines like diphenhydramine may help children sleep at night. Follow age-appropriate dosing.

Avoid using hydrocortisone cream on chickenpox lesions, as it may increase the risk of bacterial infection. Also avoid lotions containing alcohol, which can sting and dry out the skin.

Medication for Fever and Pain

Fever and general discomfort can be managed with paracetamol (acetaminophen), given according to age-appropriate dosing guidelines on the package. This medication is safe and effective for reducing fever and relieving minor aches.

Keep Your Child Hydrated

Fever and general illness can lead to decreased fluid intake, so encourage your child to drink plenty of fluids throughout the day. Water, clear broths, ice pops, and electrolyte drinks are all good options. If mouth sores make drinking painful, offer cool or cold beverages through a straw, and avoid acidic drinks like orange juice that can sting.

Soft, bland foods may be easier to eat if mouth sores are present. Avoid salty, spicy, or acidic foods that can irritate oral lesions. Smoothies, yogurt, mashed potatoes, and soup are often well-tolerated.

When Should I Take My Child to the Doctor?

Seek medical care if your child has: fever lasting more than 4 days, infected blisters (red, warm, swollen, or oozing pus), difficulty breathing, severe headache with stiff neck, confusion, extreme fatigue, or is under 6 months old. Adults with chickenpox should always see a doctor for possible antiviral treatment.

While chickenpox usually resolves on its own without medical intervention, certain symptoms and situations warrant prompt medical evaluation. Knowing when to seek care is important for preventing serious complications. Most children can be managed at home, but don't hesitate to contact a healthcare provider if you have any concerns about your child's condition.

Situations Requiring Medical Attention for Children

Contact your healthcare provider or seek medical care if your child with chickenpox experiences any of the following:

• Prolonged fever: Fever lasting more than 4 days, or fever that returns after initially improving (which may indicate a secondary bacterial infection)
• Signs of skin infection: Blisters that become very red, warm, swollen, or painful; pus draining from lesions; red streaks extending from lesions; or rapidly spreading redness around spots
• Breathing difficulties: Coughing, rapid breathing, shortness of breath, or chest pain (may indicate pneumonia)
• Neurological symptoms: Severe headache, stiff neck, sensitivity to light, confusion, extreme drowsiness, difficulty walking, or seizures
• Severe fatigue: Child is extremely lethargic, difficult to wake, or unresponsive
• Dehydration: No urination for 8+ hours, no tears when crying, dry mouth, or sunken eyes
• Eye involvement: Blisters on the eyeball, severe eye pain, or vision changes
• Bleeding: Blisters that fill with blood, or spontaneous bleeding from gums or nose

Special Situations Requiring Immediate Medical Care

Infants under 6 weeks: Newborns with chickenpox are at high risk for severe disease. If a baby under 6 weeks shows any signs of chickenpox, seek medical care immediately - don't wait for a regular appointment.

Infants 6 weeks to 6 months: Babies in this age range whose birth mother has had chickenpox usually have some protection from maternal antibodies. However, if the birth mother has NOT had chickenpox, the baby lacks this protection and should be seen by a doctor promptly if exposed or if symptoms develop.

Immunocompromised children: Children with weakened immune systems (from cancer treatment, HIV, immunosuppressive medications, or genetic immune disorders) are at high risk for severe chickenpox and complications. These children should be evaluated by a doctor as soon as chickenpox is suspected.

Adults with Chickenpox

If you are 18 or older and develop chickenpox, you should see a healthcare provider. Adult chickenpox is typically more severe than childhood cases, with higher fevers, more extensive rash, and significantly increased risk of complications like pneumonia. Antiviral medication (usually valacyclovir or acyclovir) is recommended for adults with chickenpox and is most effective when started within the first 24-48 hours of rash onset.

Pregnant Women

Pregnant women who have never had chickenpox or been vaccinated and who are exposed to someone with chickenpox should contact their healthcare provider immediately. While the overall risk of serious problems is low, chickenpox during pregnancy can occasionally cause complications for both mother and baby. Preventive treatment may be available if given promptly after exposure.

Call Before Visiting a Healthcare Facility

Chickenpox is highly contagious, and you can spread the virus simply by being in the same room as others. Before visiting a doctor's office, urgent care, or emergency department, call ahead to let them know about the suspected chickenpox. Staff can arrange for your child to be brought directly to an examination room to avoid exposing vulnerable patients in waiting areas - including pregnant women, newborns, and immunocompromised individuals.

How Is Chickenpox Treated?

Most children with chickenpox need only supportive care at home - rest, fluids, fever management, and itch relief. Antiviral medications like acyclovir or valacyclovir are reserved for adults, immunocompromised individuals, and those at high risk for complications. Prescription antihistamines may help severe itching.

For the majority of healthy children, chickenpox does not require any specific medical treatment beyond the supportive home care measures described earlier. The immune system successfully fights off the varicella-zoster virus, and the illness resolves within 1-2 weeks. Medical treatment is reserved for specific situations where complications are more likely or have already developed.

Prescription Medications for Severe Itching

If over-the-counter antihistamines and topical remedies fail to adequately control itching, a doctor may prescribe stronger medications. Prescription-strength oral antihistamines, available in liquid form for children who have difficulty swallowing pills, can provide more effective relief. Some of these medications cause drowsiness, which may be beneficial at bedtime when itching often intensifies and scratching occurs during sleep.

Antiviral Medications

Antiviral medications such as acyclovir and valacyclovir can reduce the severity and duration of chickenpox when given early in the illness. However, these medications are not routinely recommended for otherwise healthy children, as the benefits are modest and healthy children almost always recover completely without them.

Antiviral treatment IS recommended for:

• Adults and teenagers (13 years and older) with chickenpox
• People with weakened immune systems
• Pregnant women with chickenpox
• Newborns whose mothers develop chickenpox around the time of delivery
• Children with chronic skin or lung conditions
• Children receiving long-term aspirin therapy
• Individuals receiving steroid medications

For antiviral medication to be most effective, treatment should begin as early as possible - ideally within 24 hours of the rash appearing, and no later than 72 hours. If you fall into one of the high-risk categories above, contact a healthcare provider promptly when you first notice symptoms.

Treatment for Exposed High-Risk Individuals

People who are at high risk for severe chickenpox and who have been exposed to the virus may benefit from preventive treatment, even before symptoms develop. Options include:

• Varicella vaccine: If given within 3-5 days of exposure, the vaccine can prevent illness or significantly reduce its severity
• Varicella-zoster immune globulin (VZIG): This product contains antibodies against the virus and can provide temporary protection for people who cannot receive the vaccine (such as pregnant women and severely immunocompromised individuals)

What Are the Possible Complications of Chickenpox?

Most chickenpox cases resolve without complications, but potential problems include bacterial skin infections from scratching, pneumonia (more common in adults), encephalitis (brain inflammation), and scarring. Complications are more common and severe in adults, pregnant women, newborns, and immunocompromised individuals.

While chickenpox is usually a mild, self-limiting illness in healthy children, complications can occasionally occur. Understanding the potential complications helps parents know what warning signs to watch for and when to seek medical attention. Fortunately, serious complications are uncommon in otherwise healthy children, particularly in the era of widespread vaccination.

Bacterial Skin Infections

The most common complication of chickenpox is secondary bacterial infection of the skin. When children scratch their itchy blisters, they can introduce bacteria (usually Staphylococcus or Streptococcus) into the open lesions. Signs of bacterial infection include increased redness, warmth, swelling, pain around lesions, pus draining from blisters, and sometimes fever. These infections typically respond well to antibiotic treatment but can occasionally become severe if left untreated.

In rare cases, bacterial skin infections can progress to more serious conditions like cellulitis (deeper skin infection), necrotizing fasciitis (flesh-eating bacteria), or sepsis (bloodstream infection). This is one reason why ibuprofen is avoided in chickenpox - some studies suggest it may mask the early signs of these severe bacterial infections, leading to delayed treatment.

Pneumonia

Chickenpox pneumonia occurs when the virus infects the lungs, causing inflammation and breathing difficulties. This complication is rare in healthy children but occurs in up to 1 in 400 adult cases of chickenpox, making it the most common serious complication in adults. Pregnant women are particularly susceptible. Symptoms include cough, rapid breathing, shortness of breath, and chest pain. Chickenpox pneumonia requires hospitalization and antiviral treatment.

Neurological Complications

Encephalitis (inflammation of the brain) and cerebellar ataxia (affecting balance and coordination) are rare but serious complications. Cerebellar ataxia, which causes unsteady walking and difficulty with coordination, is more common in children and usually resolves completely within a few weeks. Encephalitis is more serious, potentially causing permanent damage, and requires immediate medical treatment. Warning signs include severe headache, stiff neck, confusion, seizures, and altered consciousness.

Scarring

Permanent scarring from chickenpox is not a medical complication per se, but it is a concern for many families. Scarring is more likely to occur when lesions become deeply infected or are repeatedly scratched. The face is particularly prone to visible scarring. Keeping lesions clean, preventing scratching, and promptly treating any signs of infection can minimize scarring risk. Most minor chickenpox scars fade over time, though some may remain visible permanently.

How Can Chickenpox Be Prevented?

The varicella vaccine is highly effective, providing approximately 90% protection against infection and 95-99% protection against severe disease. Two doses are recommended for all children, adolescents, and adults who have never had chickenpox. The vaccine is safe and has few side effects.

Preventing the spread of chickenpox can be challenging because infected individuals are contagious before they know they're sick. However, vaccination has proven to be extremely effective at preventing chickenpox and its complications. Since the vaccine's introduction, chickenpox rates have declined dramatically in countries with widespread vaccination programs.

Varicella Vaccine

The varicella vaccine contains a weakened (attenuated) form of the varicella-zoster virus that stimulates the immune system to produce protective antibodies without causing significant illness. The vaccine is very safe and effective:

• One dose provides about 80-85% protection against any chickenpox and 95% protection against severe disease
• Two doses provide approximately 90% protection against any chickenpox and 98-99% protection against severe disease
• "Breakthrough" chickenpox in vaccinated individuals is typically much milder than natural disease, with fewer than 50 lesions and rapid recovery

The standard vaccination schedule recommends two doses: the first at 12-15 months of age, and the second at 4-6 years old. Children, adolescents, and adults who have never had chickenpox or been vaccinated can receive catch-up vaccination at any age. The vaccine can be given as early as 9 months in special circumstances, such as during outbreaks or before international travel.

Who Should Not Receive the Vaccine?

While the varicella vaccine is safe for most people, certain individuals should not receive it or should consult their healthcare provider first:

• People with severely weakened immune systems
• Pregnant women (vaccination should be delayed until after delivery)
• People who have had a severe allergic reaction to a previous dose or vaccine component
• People currently ill with a moderate to severe infection (should wait until recovered)

Breastfeeding women can safely receive the vaccine. Family members of immunocompromised individuals should be vaccinated to reduce the risk of exposing their vulnerable family member to chickenpox.

Can Chickenpox Cause Shingles?

The chickenpox virus remains dormant in nerve cells after recovery and can reactivate years later as shingles (herpes zoster). Shingles causes a painful, localized rash. Having chickenpox does not cause shingles in others, but a person with shingles can spread chickenpox to someone who has never had the disease.

One of the unique characteristics of the varicella-zoster virus is its ability to establish lifelong latency in the body. After you recover from chickenpox, the virus doesn't leave your body - it retreats into nerve cells called sensory ganglia near the spinal cord and brain, where it remains dormant (inactive) for the rest of your life. The immune system keeps the virus in check, preventing it from reactivating.

In some people, usually many years or decades later, the dormant virus can reactivate and cause a condition called shingles (herpes zoster). Shingles typically occurs when the immune system weakens due to aging, stress, illness, or immunosuppressive medications. Unlike chickenpox, which causes a widespread rash, shingles produces a painful, blistering rash in a band or strip on one side of the body, following the path of the affected nerve. Shingles can also cause long-lasting nerve pain called postherpetic neuralgia.

It's important to understand the transmission relationship between chickenpox and shingles:

• Chickenpox cannot cause shingles in others: Having contact with someone with chickenpox will not trigger your dormant virus to reactivate
• Shingles can cause chickenpox in others: A person with shingles can spread the virus to someone who has never had chickenpox or been vaccinated, causing them to develop chickenpox (not shingles)
• Shingles is less contagious than chickenpox: The virus can only spread from the fluid in shingles blisters through direct contact, not through respiratory transmission

A shingles vaccine is available for adults to reduce the risk of reactivation and its complications. This is separate from the childhood chickenpox vaccine.

What About Chickenpox During Pregnancy?

Chickenpox during pregnancy is uncommon but can pose risks to both mother and baby. The overall risk of serious problems is low, but pregnant women who develop chickenpox may need antiviral treatment. If you're pregnant and haven't had chickenpox, avoid contact with infected individuals and consult your doctor if exposed.

Most women of childbearing age are immune to chickenpox, either from childhood infection or vaccination. However, pregnant women who have never had chickenpox and contract the virus during pregnancy face some additional considerations. While most pregnant women with chickenpox recover without complications, the disease can occasionally be more severe during pregnancy, and there are potential risks to the developing baby.

The risks depend on when during pregnancy the infection occurs:

First trimester (weeks 1-12): Infection during early pregnancy carries a small risk (about 0.5-1%) of congenital varicella syndrome, which can cause birth defects including limb abnormalities, eye problems, and neurological issues. However, most babies are born healthy even when their mothers have chickenpox in early pregnancy.

Second trimester (weeks 13-27): The risk of congenital varicella syndrome is even lower during this period. Babies typically have good outcomes.

Third trimester (weeks 28-40): Chickenpox in the third trimester doesn't cause birth defects, but infection within 5 days before delivery to 2 days after delivery can be dangerous for the newborn. In this situation, the baby may be born before the mother's protective antibodies have passed through the placenta, leaving the newborn vulnerable to severe chickenpox.

Pregnant women who develop chickenpox are usually treated with antiviral medication to reduce the severity of maternal illness and potentially decrease risks to the baby. Pregnant women who are exposed to chickenpox but haven't been infected may receive varicella-zoster immune globulin (VZIG) if given within 10 days of exposure.

If you are planning pregnancy and uncertain whether you've had chickenpox, a blood test can check for immunity. If you're not immune, vaccination is recommended before becoming pregnant (wait at least 1 month after vaccination before trying to conceive).