Symptoms of Chicken Pox

The princess has cickenpox
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Chicken pox is a viral infection that is becoming less common now that most children receive the chicken pox vaccine.

Children who still get chicken pox typically develop symptoms about 10 to 21 days after being exposed to someone with chicken pox (the incubation period) or shingles (herpes zoster).

Symptoms of Chicken Pox

Symptoms of chicken pox include:

  • A prodrome of fever, malaise, headache, lack of appetite, and mild abdominal pain for 1 to 2 days
  • A rash that typically first appears on a child's trunk, scalp, and face and consists of small, very itchy, flat red spots, which then turn into raised fluid filled vesicles, often described as looking like a 'dewdrop' that become umbilicated and cloudy and eventually crust over
  • fever that lasts about 2 to 4 days
  • New 'crops' of the rash on the child's trunk and then arms and legs continue for about 4 days
  • That all of the lesions are crusted over about 6 to 7 days after the illness began
  • That the crusts then fall off in another 7 days, although it sometimes takes up to 20 days, usually without scarring

Although not as common, children with chicken pox can also develop ulcers in their mouth.

More serious symptoms that might indicate a complication of chicken pox has developed include redness around the base of skin lesions, a cough and difficulty breathing, or any neurological symptoms, such as slurred speech, severe headache, vomiting, seizures, or trouble walking.

Symptoms of Breakthrough Chicken Pox

Although not as common, children who have been partially (one dose of the chicken pox vaccine) or even fully vaccinated (two doses), can still sometimes get chicken pox.

These children with breakthrough chicken pox are less contagious and have much milder symptoms, including:

  • Fewer chicken pox lesions; less than 50 lesions
  • An atypical appearance of the rash, with few or no vesicles
  • Lower fever or no fever at all
  • Faster recovery -] three to five days

Fortunately, even breakthrough chicken pox doesn't happen very often as children now get two doses of the chicken pox vaccine. The recommendation for a chicken pox booster dose began in 2006.

Chicken Pox Essentials

In addition to these tips, here are other things to know about chicken pox:

  • The average child with chicken pox gets about 300 lesions.
  • It is very typical or characteristic for children with chicken pox to have lesions in different stages at the same time, including the first flat red spots, the fluid filled vesicles, and the crusted vesicles.
  • The fever with chicken pox usually ranges from 100 to 102 F, but may be as high as 106 F in some cases.
  • Children with chicken pox are contagious for one or two days before they develop a rash and until all of their vesicles have crusted.
  • Chicken pox crusts that are scratched off or infected may lead to scars.
  • The chicken pox vaccine is not creating a surge in shingles cases. That's an anti-vaccine myth.
  • Since it is so mild, breakthrough chicken pox is sometimes misdiagnosed as bug bites or other childhood rashes.

    Would you be able to recognize chicken pox?


    Behrman: Nelson Textbook of Pediatrics, 18th ed. Saunders; 2007.

    Habif: Clinical Dermatology, 4th ed. Mosby; 2009.

    Manual for the Surveillance of Vaccine-Preventable Diseases (5th Edition, 2011).