Red flags & when to go in person for Chickenpox (Varicella) - Triage

Audience: adult

Chickenpox, also known as varicella, is a common viral infection that causes an itchy rash and flu-like symptoms. It often affects children but can occur in adults too. Most people recover at home without serious problems. However, chickenpox can sometimes lead to complications, especially in adults, pregnant women, or people with weakened immune systems. Recognizing warning signs or "red flags" is important to know when to seek in-person medical care promptly. Telemedicine can help assess mild cases, provide advice on symptom relief, and guide when to get urgent care. This guide explains key symptoms to watch for, what telemedicine can and cannot manage, and how to prepare for a virtual visit. Remember, this information is educational and not a substitute for professional medical diagnosis or treatment. If you or someone you care for has chickenpox symptoms and experiences severe or unusual signs, seek in-person medical evaluation without delay.

Red flags — go in person / ER

• Difficulty breathing or chest pain — seek emergency care immediately.
• High fever above 39°C (102°F) lasting more than 4 days — see a healthcare provider in person.
• Severe headache, stiff neck, confusion, or seizures — urgent medical evaluation needed.

What telemedicine can do

• Assessment of mild chickenpox symptoms.
• Advice on symptom relief such as fever and itch management.
• Guidance on hydration, rest, and preventing spread.
• Determining if in-person care is needed.

What telemedicine cannot do

• Emergency evaluation for breathing difficulties or severe complications.
• Physical examination or diagnostic testing.
• Administration of intravenous medications or hospital treatments.
• Management of severe or worsening symptoms requiring urgent care.

What is Chickenpox (Varicella)?

Chickenpox is an infection caused by the varicella-zoster virus. It usually starts with fever, tiredness, and a red, itchy rash that turns into fluid-filled blisters. These blisters eventually crust over and heal. The illness typically lasts about 5 to 10 days. Chickenpox spreads easily through coughing, sneezing, or direct contact with the rash.

Common Symptoms and Course

Symptoms often begin 10 to 21 days after exposure. Early signs include fever, headache, sore throat, and loss of appetite. The rash usually appears on the face, chest, and back, then spreads elsewhere. The rash can be very itchy and uncomfortable. Most healthy adults recover without complications, but rest and symptom relief are important.

When to Seek In-Person Medical Care (Red Flags)

Some signs mean you should get urgent medical help in person:

If you notice any of these, go to an emergency room or urgent care immediately.

What Telemedicine Can Do for Chickenpox

Telemedicine providers can:

Telemedicine is useful for mild cases without red flags.

What Telemedicine Cannot Do

Telemedicine cannot:

If symptoms worsen or red flags appear, seek in-person care immediately.

Preparing for Your Telemedicine Visit

Before your virtual appointment:

This helps your healthcare provider give the best advice.

After Your Telemedicine Visit: What to Do Next

Follow the care plan given by your provider. This may include:

Stay in touch with your provider if you have concerns or questions.

How to prepare for your tele-visit

• Write down when symptoms started and their progression.
• List current medications, allergies, and medical conditions.
• Prepare to show your rash clearly on camera if possible.
• Have a quiet, well-lit space with good internet connection for the visit.
• Prepare questions or concerns to discuss with the provider.

After your tele-visit

• Follow provider's advice on medications and symptom management.
• Keep skin clean and avoid scratching to prevent infection.
• Rest and drink plenty of fluids to support recovery.
• Watch for any worsening symptoms or new red flags.
• Seek in-person care promptly if advised or if red flags develop.

FAQs

Can adults get chickenpox if they never had it as children?

Yes, adults who have never had chickenpox or the vaccine can get infected. Chickenpox in adults can sometimes be more severe than in children.

Is chickenpox contagious before the rash appears?

Yes, chickenpox can be contagious 1 to 2 days before the rash appears and remains contagious until all blisters have crusted over.

How can I relieve the itching from chickenpox?

You can try cool baths, calamine lotion, and over-the-counter antihistamines to reduce itching. Avoid scratching to prevent skin infections.

Should I avoid contact with others if I have chickenpox?

Yes, chickenpox is highly contagious. Stay away from people who have not had chickenpox or the vaccine, especially pregnant women, newborns, and those with weakened immune systems, until all blisters have crusted.

Can chickenpox cause complications?

While most recover fully, chickenpox can sometimes lead to complications like bacterial skin infections, pneumonia, or inflammation of the brain, especially in adults and those with weakened immune systems.

Sources

1. Chickenpox (Varicella) — Centers for Disease Control and Prevention (CDC).
2. Chickenpox — MedlinePlus, U.S. National Library of Medicine.
3. Varicella (Chickenpox) — Mayo Clinic.
4. Chickenpox (Varicella) — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care, diagnosis, or treatment. If you have any concerning symptoms or red flags, seek medical attention promptly.