What Does Chickenpox Look Like?

Chickenpox Pictures and How the Virus Progresses

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

Rear View Of Shirtless Girl With Chickenpox
Alex Tihonovs / EyeEm / Getty Images

The chickenpox rash first appears as small, raised, itchy, red bumps on the belly, chest, back, or face. Early stage chickenpox look like mosquito bites, acne, or hives. Within a day, more spots appear and the rash spreads across the body. 

After 12 to 24 hours, papules turn to watery blisters that are extremely itchy. The blisters often pop and release fluid that is highly contagious. Blisters that do not pop will turn cloudy as they dry out and crust over. It takes about four or five days for chickenpox sores to scab over. 

Chickenpox spots will continue to pop up in clusters on different parts of the body for three to five days. A person is contagious until all of the blisters have scabbed over. 

This article discusses more about what chickenpox looks like and how the rash progresses over three stages, offers tips on dealing with itchy skin, and helps you to know when you're least likely to infect others.

Before the Rash Appears

Chickenpox is a viral infection that spreads easily from person to person. Caused by the varicella-zoster virus, symptoms develop about two weeks after exposure—anywhere from 10 to 21 days. A person with chickenpox is contagious for up to two days before the telltale rash develops.

The phase that begins four to six days after exposure is called the prodromal phase, which is the period between initial symptoms and full development of the rash. During this stage, the virus moves from the respiratory tract or eyes to the lymph nodes.

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

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

These symptoms may last for a few days. Even before a chickenpox rash is visible, nasal secretions, saliva, and even teardrops are extremely infectious to anyone who comes into contact with them.

Early Stage Chickenpox Rash

Little girl with chickenpox
MilosBataveljic / Getty Images

As early as 10 days after exposure, the virus shows up on the outer layer of skin, known as the epidermis. It spreads through tiny blood vessels that span the skin.

The rash consists of small, raised pink or red spots called papules. They often start on the belly or back and face, and then spread over the entire body, including the scalp, arms, and legs.

Rash Distribution

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

The rash comes on in waves over the course of two to four days.

Mouth Sores

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.

Early Chickenpox on Darker Skin

Chickenpox sores don't appear quite as red on darker skin tones. The exact shade of red will depend on the skin tone. The sores will be bumpy and itchy.

Chickenpox Blisters

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

Rear View Of Shirtless Girl With Chickenpox
Alex Tihonovs / EyeEm / Getty Images

After about 12 hours, the red bumps begin to turn into 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.

These blisters will be itchy, but it's best not to scratch them. That's because the blister and the liquid inside the blister are highly contagious, so scratching the blisters may cause the virus to spread. It can also cause scars or let in germs that can lead to infection.

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

Chickenpox Blister on Darker Skin

Blisters will appear as skin-colored fluid-filled bumps. They may appear reddish on lighter skin tones.

Chickenpox Scabs

chickenpox scab

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.

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

Infected Chickenpox Sores

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chickenpox infection

If chickenpox sores become infected, they may begin leaking pus or areas of the body may become red, warm, or tender.

Staphylococcal or streptococcal bacteria can lead to:

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 infection may 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.

Chickenpox Scars

Chickenpox blisters don't usually leave scars, but they're more likely to if they're scratched or become infected.

Scars appear dark on light skin and light on dark skin. They may look like round indentations on the skin.

While scars that appear darker can fade over time, indentations on the skin may last. If you want to improve the appearance of a scar, a dermatologist can suggest options, such as laser treatments.

How to Prevent Scarring

Trying not to scratch is the best way to avoid scarring. 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.

Summary

Chickenpox is an infection caused by the varicella-zoster virus that spreads very easily from person to person. When you've been infected with varicella, flu-like symptoms usually show up within four to six days. Then a rash appears and, eventually, blisters form. Four or five days later, the blisters crust over.

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.

8 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. Centers for Disease Control and Prevention. Varicella.

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

  3. Centers for Disease Control and Prevention. Prevention and treatment.

  4. 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.

  5. The Royal Children's Hospital Melbourne. Chickenpox.

  6. American Academy of Dermatology Association. Scars: signs and symptoms.

  7. American Academy of Dermatology Association. Scars: diagnosis and treatment.

  8. 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

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.