Chicken Pox in Adults: Symptoms, Transmission & Treatment

Chicken pox in adults is an infection caused by the varicella-zoster virus. It can cause more intense symptoms in adults, especially in people who were not vaccinated during childhood.

Adults may develop more blisters on the body than children. They may also have high fever, ear pain, or sore throat in some cases.

Symptoms of chicken pox in adults usually appear 1 to 3 weeks after contact with the virus. It can spread through saliva droplets from coughing or sneezing, or through direct contact with fluid from the blisters.

Chicken pox symptoms in adults

The main symptoms of chicken pox in adults are:

• Red spots on the skin that usually begin on the face or chest and spread over the whole body

• Intense itching where the spots appear

• Itchy, fluid-filled blisters on the skin

• Skin sores that form when the blisters burst

Symptoms of chicken pox in adults are the same as in children, but they tend to be more intense.

About 1 to 2 days before the skin spots appear, flu-like symptoms may develop, such as fever, tiredness, headache, ear pain, sore throat, or loss of appetite.

Confirming a diagnosis

Chicken pox in adults is usually diagnosed by a primary care provider or infectious disease specialist based on symptoms, medical history, vaccination status, possible exposure, and a physical exam.

In most cases, no testing is needed. However, if the diagnosis is unclear or the case is severe, the doctor may collect a sample of fluid from the blisters to confirm the presence of the varicella-zoster virus.

Additional tests, such as blood tests, bronchoalveolar lavage, or lumbar puncture, may be used only in cases of complications or in people with weakened immune systems.

Can you get chicken pox twice?

It is possible to get chicken pox twice, but this is rare and is often due to a misdiagnosis of the first infection or, less commonly, a weakened immune system.

Most people develop long-lasting immunity after infection, which is why repeat cases are uncommon.

However, the varicella-zoster virus remains dormant in the body and can reactivate later in life, causing shingles, a different condition caused by the same virus.

How it spreads

Chicken pox can spread through:

• Direct contact with fluid from the blisters of a person with chicken pox

• Contact with saliva droplets from coughing or sneezing by an infected person

After a person becomes infected and develops chicken pox, the varicella-zoster virus stays dormant inside the nerves. It can reactivate when the immune system is weaker and cause shingles.

To help prevent chicken pox from spreading, it is important to avoid contact with other people, especially those who have not had chicken pox or have not been vaccinated. It is also important to avoid scratching the blisters that appear on the body.

Can you still get chicken pox if you’ve been vaccinated?

Chicken pox can occur in a vaccinated person because the vaccine does not provide complete protection against the virus. According to the CDC, breakthrough chicken pox is usually milder, with fewer or no blisters, low or no fever, and a shorter illness.

Treatment options

Treatment for chicken pox in adults should be guided by a primary care provider or infectious disease specialist. It may include antihistamines to relieve itching from skin blisters and fever-reducing medications, such as acetaminophen or ibuprofen.

It is also important to avoid scratching the blisters, as this can lead to skin infections. Staying well hydrated and applying calamine lotion can also help relieve itching.

In many cases, especially in adults or people at higher risk of complications, a doctor may prescribe antiviral medications such as acyclovir or valacyclovir, ideally within the first 24 to 48 hours after symptoms begin. According to the American Academy of Pediatrics, acyclovir or valacyclovir may be considered for people at increased risk of moderate-to-severe chicken pox.

Possible complications

The main complications of chicken pox in adults include:

• Infections in other parts of the body, with a risk of sepsis

• Dehydration

• Encephalitis or cerebellar ataxia

• Myocarditis

• Pneumonia

• Transient arthritis

Chicken pox complications can occur, especially in people with weakened immune systems or more severe infections.

In these cases, symptoms such as severe headache, persistent fever, confusion, reduced urine output, chest pain, shortness of breath, or dizziness may occur.

If these symptoms develop, prompt medical evaluation is important to confirm the diagnosis and begin appropriate treatment.