These Are the Stages of Chickenpox in Pictures (2023)

Identifying chickenpox becomes easier when you know what chickenpox looks like. This highly contagious infection, caused by the varicella-zoster virus (VZV), typically begins with common symptoms before a blistering rash appears on the face, trunk, and then the rest of the body.

From the time symptoms first appear in the early stages of chickenpox, it usually takes a week or two for the immune system to bring the infection under control.

Chickenpox sores look much the same in adults as they do in children, although adults may have more serious cases and complications.

This article presents chickenpox pictures at the various stages of infection. It explains how the rash will progress, offers tips on dealing with itchy skin, and helps you to know when you're least likely to infect others.

Chickenpox Causes

These Are the Stages of Chickenpox in Pictures (1)

Once you have a chickenpox infection, it has to run its course. Symptoms will develop within 10 to 21 days after exposure.

The virus spreads easily from person to person.Chickenpox is largely a childhood disease, but anyone who hasn't had it before or hasn't been vaccinated is at risk.

The virus is mainly spread by touching or breathing in viral particles from open blisters. It can also be passed through tiny droplets of saliva as an infected person talks or breathes. This is why chickenpox sweeps quickly through schools where children are in close contact.

Chickenpox isnot life-threatening, but serious complications sometimes occur.

Adults newly infected with chickenpox are more likely to have a severe case. They're also more likely to have ​complications like pneumonia or encephalitis (inflammation of the brain).

A healthcare provider can prescribe antiviral drugs to keep the illness from becoming severe. These drugs can also shorten the illness.

Once a VZV infection occurs, the virus remains in your body for the rest of your life. In later years, it may suddenly reactivate, causing shingles (herpes zoster virus).

Is There a Chickenpox Vaccine?

There are two chickenpox vaccines approved for use in the United States, as well as a shingles vaccine for people over 50. If you get chickenpox without being vaccinated, though, the infection can't be prevented and must run its course.

Chickenpox Symptoms

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There are three distinct stages when a person has chickenpox. They typically follow similar patterns, so what chickenpox looks like in children is much the same as it is when adults are infected.

Stage 1: Prodromal Phase

The first stage of chickenpox is called the prodromal phase. It often causes these symptoms:

  • Headache
  • Nausea
  • Muscle aches
  • Malaise, or a feeling of being unwell
  • Runny nose
  • Cough

The prodromal phase begins four to six days after exposure. In this stage, the virus moves from the respiratory tract or eyes to the lymph nodes.

From there, the virus spreads to the bloodstream. That's when it triggers the first flu-like symptoms. This is referred to as primary viremia.

Even before a chickenpox rash is visible, the nasal secretions, saliva, and even teardrops are extremely infectious to anyone who comes into contact with them.

This photo contains content that some people may find graphic or disturbing.

These Are the Stages of Chickenpox in Pictures (3)

(Video) Chickenpox | Varicella Zoster Virus | Pathogenesis, Signs and Symptoms, Diagnosis, and Treatment

Stage 2: Secondary Viremia (Blister Stage)

Secondary viremia is also called the blister stage of chickenpox. It starts as early as 10 days after exposure. This is the stage where the virus shows up on the outer layer of skin, known as the epidermis. It spreads through tiny blood vessels that span the skin.

Chickenpox pictures show how the infection causes fluid-filled blisters known as vesicles. People often describe the rash as a "dew drop on a rose petal." That's because the blisters look bright, symmetrical, and almost see-through.

During this phase, people often have a low-grade fever. It can usually be treated with Tylenol (acetaminophen).

Stage 3: Scabbing Stage

Chickenpox blisters move on to the scabbing stage, although it's important to keep in mind that the blisters typically arrive in waves and appear at various stages.

As blisters break open, the sores crust over as they heal. These sores appear as dry, crusty scabs on the skin.

What Does Chickenpox Look Like?

Chickenpox blisters first appear on the skin more than a week after exposure, and follow the early cold-like symptoms.

Blisters

These itchy, red bumps rising from inflamed spots on the skin are a classic sign of the virus infection. The blisters will change in appearance as a chickenpox infection progresses, first becoming white- or yellow-filled bubbles similar to pimples and then scabbing over as they heal.

This photo contains content that some people may find graphic or disturbing.

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Mouth Sores (Enanthem)

Even before blisters appear on the skin, chickenpox pictures in these early stages show how they can break out in the mouth. This condition is called enanthem. The sores often look like tiny grains of white sand inside a red ring.

Chickenpox enanthem can be very painful. They make it hard to eat. You can try a topical oral analgesic (pain reliever). You can also opt for soft, bland, or cooling foods such as ice pops, milkshakes, or smoothies. Avoid spicy or acidic foods like tomatoes or citrus.

This photo contains content that some people may find graphic or disturbing.

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Early-Stage Rash

Chickenpox blisters spread quickly.The rash starts as tiny red dots on the face, scalp, torso, and upper arms and legs. Within 10 to 12 hours, blisters cover the whole body.

Many of the vesicles join together into larger, cloudy blisters. The itching can be intense. In some cases, an oral antihistamine may be prescribed to relieve itching and aid with sleep.

These Are the Stages of Chickenpox in Pictures (6)

Rash Distribution

Chickenpox can spread to parts of the body that are not usually affected by infections. The palms, soles, scalp, eyelids, anus, and genitals can all be involved.

Treatment optionsare limited, though in most cases treatment isn't necessary.

Some healthcare providers may prescribean oral antiviral drug called Zovirax (acyclovir)to people with weakened immune systems. This medication may lower the risk of complications. It's sometimes prescribed for pregnant mothers to avoid fetal harm.

(Video) Chickenpox, Causes, Signs and Symptoms, Diagnosis and Treatment.

Zovirax is most effective if started within 24 hours of the first signs of rash.

This photo contains content that some people may find graphic or disturbing.

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Formation of Pustules

As the infection grows, the immune battle can lead to pus in the blisters. Pus is made up of dead white blood cells along with bits of tissue and body fluids.Many of the blisters open on their own as they rub against clothing.

It's best to avoid scratching, which can cause scars. It can also make it more likely that the virus will spread. Lesions can spread infection even after they've crusted over.

To reduce itching, try:

  • Oatmeal baths
  • Calamine lotion
  • Benadryl (diphenhydramine), which helps with itching and sleep
  • Trimming the fingernails
  • Cooling the skin with a cold, moist cloth
  • Wearing mittens or soft socks on the hands
  • Wearing loose-fitting cotton clothes
  • Keeping the bedroom cool at night

When you bathe, use a mild soap. Blot, rather than rub, the skin dry with a towel.

This photo contains content that some people may find graphic or disturbing.

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Umbilication and Scarring

After four to five days, the vesicles start to crust over. They may harden and form little indentations called umbilication.

During this stage, the disease gradually becomes less contagious. Healing begins.

Watch closely during this phase. The sores can easily become infected. Staphylococcal or streptococcal bacteria can lead to:

  • Impetigo: Also known as school sores
  • Erysipelas: Also known as St. Anthony's Fire
  • Cellulitis: A potentially serious skin infection

These secondary infections are not common. When they develop, they can sometimes spread into the bloodstream. The result can be a life-threatening condition known as sepsis.

A secondary skin infectionmay be treated with a topical, oral, or injected antibiotic, depending on how severe it is. Cellulitis may need intravenous (IV) antibiotics and fluids given in the hospital.

You can reduce the risk of a secondary infection by washing your hands regularly with soap and trimming your nails. Avoid touching any open or crusted lesions.

Recovery

These Are the Stages of Chickenpox in Pictures (9)

Most chickenpox infections resolve within two weeks. Some may take up to three, especially if a secondary infection stretches out the recovery time.

When to Call Your Healthcare Provider

Most chickenpox infectionsare not complicated and can be managed at home. Call your healthcare provider if your child has any of the following:

  • A red, warm, or tender rash that looks like a secondary infection
  • A rash in one or both eyes
  • High fever (over 102 degrees), disorientation, stiff neck, shortness of breath, tremors, vomiting, and rapid heartbeat, which are signs of encephalitis and sepsis

Summary

Chickenpox is an infection caused by the varicella-zoster virus. It spreads very easily from person to person. Once you're infected, the virus stays in your body your whole life. It can cause shingles (herpes zoster) later in life.

The good news is that there's a vaccine to prevent most cases of chickenpox. The vaccine is available for adults and children.

(Video) Chicken Pox: A Parents Guide to the different stages of Chicken Pox (Varicella Zoster Virus)

When you've been infected with varicella, flu-like symptoms usually show up within four to six days. Around 10 days after infection, small round blisters spread over the skin. They are itchy and full of fluid. Some people also have painful mouth sores.

Four or five days later, the blisters crust over. Chickenpox is still contagious at this point. Other skin infections can take hold, especially if you've scratched the blisters or your immune system isn't working well. These infections can be serious.

Most of the time, chickenpox heals on its own in a week or two. Until then, you can treat the itch and pain with baths or over-the-counter medications. If you think another infection is developing, contact a healthcare provider right away.

A Word From Verywell

Chickenpox can be easily prevented with the Varivax vaccine. The two-shot series is recommended as part of a child's routine vaccination series. It provides complete protection in 98% of cases.

If your child hasn't been vaccinated, speak with your healthcare provider to start the series as soon as possible. You can also get vaccinated if you have a higher risk of exposure.

Frequently Asked Questions

  • What rash can be mistaken for chickenpox?

    Chickenpox sores may be similar to those seen with the herpes simplex virus or enteroviruses, including coxsackievirus (hand-foot-and-mouth disease).

    Learn More:Enterovirus and Its Different Strains

  • What does chickenpox look like on a Black person?

    Chickenpox sores don't appear quite as red on black and brown skin. However, the pattern of raised lesions, with a blistering rash and then crusty sores during the healing stage, will remain the same.

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Papaloukas O, Giannouli G, Papaevangelou V. Successes and challenges in varicella vaccine. Ther Adv Vaccines. 2014;2(2):39-55. doi:10.1177/2051013613515621

  2. Gershon AA. Is chickenpox so bad, what do we know about immunity to varicella zoster virus, and what does it tell us about the future? J Infect. 2017;74(1):S27-S33. doi:10.1016/S0163-4453(17)30188-3

  3. National Institute on Aging. Shingles.

    (Video) How Do I Know if a Spot is Chickenpox? | This Morning

  4. Centers for Disease Control and Prevention.Chickenpox vaccine: What everyone should know.

  5. Gershon AA, Gershon MD. The Jeremiah Metzger Lecture: Varicella zoster virus: From outside to inside. Trans Am Clin Climatol Assoc. 2016;127:282-299.

  6. Nemours Children's Health. Chickenpox (for Parents).

  7. Cohen J, Breuer J. Chickenpox: treatment. BMJ Clin Evid. 2015;2015:0912.

  8. Stevens DL, Bryant AE. Impetigo, erysipelas and cellulitis. In: Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes: Basic Biology to Clinical Manifestations. Oklahoma City (OK): University of Oklahoma Health Sciences Center; 2016.

  9. National Health Service. Chickenpox.

  10. Bonanni P, Gershon A, Gershon M, et al. Primary versus secondary failure after varicella vaccination: implications for interval between 2 doses. Pediatr Infect Dis J. 2013;32(7):e305-13. doi:10.1097/INF.0b013e31828b7def

  11. St. Luke's Hospital. Conditions with Similar Symptoms as Varicella-Zoster Virus.

  12. Centers for Disease Control and Prevention. Chickenpox (Varicella) Photos.

Additional Reading

By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.

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FAQs

What the stages of chickenpox look like? ›

The rash begins as many small red bumps that look like pimples or insect bites. They appear in waves over 2 to 4 days, then develop into thin-walled blisters filled with fluid. The blister walls break, leaving open sores, which finally crust over to become dry, brown scabs.

How many stages are in chickenpox? ›

Once the chickenpox rash appears, it goes through three phases: Raised pink or red bumps (papules), which break out over several days. Small fluid-filled blisters (vesicles), which form in about one day and then break and leak. Crusts and scabs, which cover the broken blisters and take several more days to heal.

What do chickenpox look like when they are healing? ›

The scabs are yellow and pink and the skin around the scabs is pink. The smaller spots look like tiny pink blisters.

How many days do new spots appear with chickenpox? ›

It normally takes 14 days for the symptoms of chickenpox to show after you have come into contact with the virus. However, this can vary from person to person – from as little as 7 days, up to 21 days. This is called the "incubation period".

Can we bath during chicken pox? ›

Give your child warm or cool baths with oatmeal bath products, such as Aveeno. This will reduce itching. You can also add a handful of oatmeal (ground to a powder) to your child's bath. After a bath, pat—rather than rub—your child's skin dry.

How can I make chicken pox scab faster? ›

Calamine lotions and creams are dabbed directly onto itchy spots to provide relief, and can also help to dry these spots out so they scab over and fall off faster. Painkillers – chickenpox can sometimes cause pain and a high fever, which can be relieved by over the counter painkillers.

How do you know if chicken pox spots are infected? ›

Signs of a bacterial infection include a high temperature (fever) and redness and pain around the chickenpox spots. Seek urgent medical help if you or your child develop these symptoms. Young children can also be at risk of becoming dehydrated.

What is the best treatment for chicken pox? ›

For relief, try: A cool bath with added baking soda, aluminum acetate (Domeboro, others), uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for soaking. Calamine lotion dabbed on the spots. A soft, bland diet if chickenpox sores develop in the mouth.

Is amoxicillin good for chickenpox? ›

They do not kill viruses.

An antibiotic will not help your child get better if they have a virus. Antivirals are drugs that doctors prescribe to treat some serious infections from viruses such as influenza or chickenpox.

How long is chickenpox itchy? ›

When Will the Itching Stop? You may feel like the itching will never stop, but the good news is that after 3 to 4 days, you'll start feeling better. In a week or so, the vesicles will have formed scabs and you won't be as itchy anymore. In the meantime, try your best not to scratch.

How do you sleep with chicken pox? ›

Itchy spots can play havoc with sleep, so apply cooling cream or gel liberally before bed. Soft bedding that doesn't make them too hot can also help.

How do you prevent chicken pox from spreading? ›

Try to keep fingernails trimmed short and minimize scratching to prevent the virus from spreading to others and to help prevent skin infections. If you do scratch a blister by accident, wash your hands with soap and water for at least 20 seconds.

Can we drink milk in chicken pox? ›

According to Rupali Dutta, "Person suffering from chicken pox needs to be well hydrated. Rather than giving plain water, liquids like fresh fruits juices, lassi, butter-milk and fresh soups work better as they give nutrients to the body and keep the person hydrated."

What cream is best for chickenpox? ›

Apply an anti-itch cream such as Eurax 10% Cream to soothe the skin and stop the spots from itching. Eurax is suitable for use on children over 3 and works for up to 10 hours.

Which soap is good for chicken pox? ›

Use a household cleaner such as Lysol or Pine-Sol to wash any items that are soiled with fluid from chickenpox blisters. Bathe daily with a soothing, mild soap that contains ingredients such as chamomile, aloe vera, or lavender.

How long do chicken pox take to dry out? ›

After about 24 to 48 hours, the fluid in the blisters gets cloudy and the blisters begin to crust over. Chickenpox blisters show up in waves. So after some begin to crust over, a new group of spots might appear. It usually takes 10–14 days for all the blisters to be scabbed over and then you are no longer contagious.

How often should I put calamine lotion on chickenpox? ›

Apply the lotion several times a day until your symptoms clear up or the bug bites are gone. Chickenpox: You can use calamine lotion to help relieve the symptoms of this infectious condition. It can also prevent further skin infections.

Can chicken pox go away without treatment? ›

If someone does get chickenpox, the infection and the rash it causes will go away without treatment. But chickenpox spreads easily from person to person, so a child who has the virus should stay home until the rash is completely crusted over.

How do you know if chicken pox spots are infected? ›

Signs of a bacterial infection include a high temperature (fever) and redness and pain around the chickenpox spots. Seek urgent medical help if you or your child develop these symptoms. Young children can also be at risk of becoming dehydrated.

What can be mistaken for chickenpox? ›

Beware: there are other diseases that can mimic varicella-zoster virus infection: Vesiculopapular diseases that mimic chickenpox include disseminated herpes simplex virus infection, and enterovirus disease. Dermatomal vesicular disease can be caused by herpes simplex virus and can be recurrent.

How long does chicken pox take to heal? ›

Thus, depending on the condition, the disease will take from 7 to 21 days to appear specific symptoms. After that, it will take another 7-10 days from the full stage to the complete recovery. However, for people with weakened immune systems, chickenpox can also take 2 to 3 weeks to completely heal.

When should I be concerned about chicken pox? ›

Most cases of chickenpox are mild and go away on their own. But see your doctor right away if you develop any of the following symptoms: The rash spreads to one or both eyes. The rash gets very red, warm, or tender.

How do you prevent chicken pox from spreading? ›

Try to keep fingernails trimmed short and minimize scratching to prevent the virus from spreading to others and to help prevent skin infections. If you do scratch a blister by accident, wash your hands with soap and water for at least 20 seconds.

Is chicken pox spread by touch? ›

Chickenpox spreads very easily by touching chickenpox blisters or through the air when someone with chickenpox coughs or sneezes. The virus does not live long on surfaces. Once someone comes in contact with the virus, it usually takes about 2 weeks for chickenpox to appear, but it can range from 10 to 21 days.

When does chicken pox become itchy? ›

Although the rash starts as small, itchy red spots, these develop a blister on top and become intensely itchy after about 12-14 hours. After a day or two, the fluid in the blisters gets cloudy and they begin to dry out and crust over. After one to two weeks, the crusting skin will fall off naturally.

Is there a test to see if you've had chickenpox? ›

The Varicella Test (also called the Varicella Titer Test) is a blood test that is performed for two main reasons. First, it is used to determine if a person has been previously exposed to the varicella zoster virus (VZV) through vaccination or previous infection and has developed immunity to the disease.

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