Chickenpox: Pictures, Symptoms, Treatment, and Prevention

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Chickenpox - Photomicrograph of Infected Cells

Chickenpox is an infection caused by the varicella-zoster virus. Here is a photomicrograph picture of cells infected by the varicella virus. The rash of chickenpox—a widespread eruption of fluid-filled, itchy red blisters—develops about 10 to 21 days after a person is infected. The virus is highly contagious and is transmitted through either direct contact or air droplets.

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Chickenpox - Typical Early Lesion

Here is an example of classic early chickenpox lesions—the vesicles are also known as "a dew drop on a rose petal" because of their appearance. In chickenpox, clusters of vesicles on a red base usually come together after a couple of days to make one distinct lesion. 

It's good to note that about one to two days before the rash develops, a person may experience fever, headache, loss of appetite, and fatigue.

While Tylenol (acetaminophen) can be used to reduce the fever from chickenpox, remember to not give your child aspirin or any aspirin-containing product. The use of aspirin in children with chickenpox is linked to Reye's syndrome which can cause neurological damage and liver failure.

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Chickenpox - Another Typical Early Lesion

These chickenpox lesions are also in the early stage (around day three or four) and have started to clump together. 

Treatment options for chickenpox are limited and mostly consist of symptom control until the virus runs its course. 

Sometimes a doctor will prescribe an antiviral medication like Zovirax (acyclovir), especially if a person is at a higher risk of developing complications from chickenpox, like a pregnant woman (her unborn child is also at risk) or a person with a weak immune system.

Zovirax is taken by mouth and can shorten the duration of the virus, but only if started within 24 hours of the rash erupting. 

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Chickenpox - Evolving Lesions

These early chickenpox lesions are evolving and starting to crust over. The crust develops from the center of the lesion and spreads out over the course of a day or two. In the early stages of crusting, this rash may be confused with molluscum contagiosum, a common and benign rash in children.

In addition, note that the large central lesion (in the middle of the back) looks like it contains pus (a thick, yellow fluid). This is a sign of the chickenpox lesion and surrounding skin becoming infected with bacteria—called impetigo

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Chickenpox - Infected Lesion on Face

This is a closeup picture of a chickenpox lesion that has become infected with bacteria, as evidenced by the thick, yellow pus surrounding the vesicle.

Bacterial skin infections are the most common complication of chickenpox and can be prevented by not scratching the lesions.

Strategies to reduce itching may include:

  • oatmeals baths
  • calamine lotion
  • an antihistamine like Benadryl (diphenhydramine)
  • cutting fingernails down

Other complications of chickenpox include impetigo, furuncles, erysipelas, and lymphadenitis.

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Chickenpox - In the Mouth

In addition to itching problems, eating and drinking may be uncomfortable if a person has mouth lesions, which may occur in severe cases. This is a picture of an early chickenpox lesion in the mouth. Notice that even though it is in the mouth, the lesion looks similar to the early lesion on the skin. 

Treatment for mouth lesions often includes pain control with a topical anesthetic or analgesic and/or Tylenol, ample fluids to prevent dehydration, and avoiding acidic foods like tomatoes and citrus foods like oranges. The antiviral medication like Zovirax (acyclovir) can also help speed up the healing if started early enough. 

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Chickenpox - Close-Up of Day 6

This is a close-up of day six of the chickenpox rash. In people with darker skin, chickenpox lesions may look more atypical. For example, some of these lesions look more papular (meaning they do not appear to contain any fluid) than vesicular.

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Chickenpox - On the Hand

Chickenpox can spread to areas of the body that are not usually affected with other infections, like the hands, feet, scalp, and eyelids. 

Complications can occur if chickenpox lesions are present internally. For example pneumonia (lung infection) or encephalitis (brain infection) may develop.

A Word From Verywell

While this rash looks and feels painful, and has the potential for causing serious complications, the good news is that chickenpox can be prevented—by getting the chickenpox vaccine. According to the Centers for Disease Control and Prevention, most people who get the vaccine will not get chickenpox, and if they do, it is a mild case. In addition, the vaccine prevents almost all cases of severe disease, which can be fatal.

In fact, since widespread vaccination began in the mid-1990s, the incidence of chickenpox and its complications have gone down significantly.

Sources:

American Osteopathic College of Dermatology. Chickenpox

Centers for Disease Control and Prevention. (2016). Chickenpox (Varicella).

Gnann JW Jr. Varicella-zoster virus: Prevention through vaccination. Clin Obstet Gynecol. 2012 Jun;55(2):560-70.

Mortazavi H, Safi Y, Baharvand M, Rahmani S. Diagnostic features of common oral ulcerative lesions: An updated decision tree. Int J Dent. 2016; 2016:7278925.

 

 

 

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