Many People Are Immune to Chickenpox but Some Can Get It Twice (2023)

It is possible to getchickenpox(varicella) twice, though it is not common. After getting chickenpox, children typically build lifelong immunity and will not get it again. Sometimes, a child's immunity to the virus is incomplete, so they could get a secondchickenpox infection.

This article will go over what happens if you get chickenpox twice, how to tell if a rash is from chickenpox, how chickenpox looks and feels in adults, and what to do if you think you have chickenpox.

What Happens If You Get Chickenpox a Second Time?

It’s not common but it is possible for people to get chickenpox twice. Having a second chickenpox infection in your life is more likely if you:

• Got your first case of chickenpox when you were very young—especially younger than 6 months old
• Had a very mild (subclinical) chickenpox infection the first time you got it
• Have a problem with your immune system

If you’re generally healthy, you probably do not have to worry about having serious complications if you get chickenpox a second time.

Symptoms of Chickenpox in Adults

The signs and symptoms of chickenpox in adults are similar to those in kids and can include:

• Flu-like symptoms. The first symptoms of chickenpox are often fever, body aches, and fatigue. Some people also get cold-like symptoms such as a runny nose, sore throat, and headache. In some people, gastrointestinal symptoms (e.g., stomach pain, loss of appetite, nausea, diarrhea) are common.
• A rash. At first, the spots can look like pimples or bug bites. The rash usually starts on the face or middle of the body (e.g., chest, belly, back) but eventually spreads everywhere. Over the next few days, the bumps fill with fluid (blisters) and get itchy. The blisters break open and leak fluid, then crust over as they start to heal (usually within a week). The crusty scabs of a chickenpox rash usually fall off within about 10 days but can take up to a few weeks.

By the time a chickenpox rash is in full swing, there can be hundreds of spots on the body.

Are Adults More Likely to Get Complications From Chickenpox?

Chickenpox can be a serious illness for adults, especially if they already have weak immune systems. Adults who get chickenpox can not only get quite sick from the virus but can develop other health problems that can be very serious. Adults are more likely than kids to end up hospitalized if they get chickenpox.

Possible complications of chickenpox in adults include:

• Infections from the rash (e.g., skin, bone)
• Lung infections (e.g., pneumonia)
• Blood infections (e.g., sepsis)
• Inflammation (e.g., brain, liver, joints)

Pregnant people who get chickenpox are at a higher risk for complications themselves, but can also pass the risk on to the fetus. A serious but rare complication of chickenpox in pregnant people is fetal (congenital) varicella syndrome.

Treatment for Chickenpox in Adults

Chickenpox treatment for adults and kids is about easing your symptoms while you are healing. You do not take antibiotics for chickenpox because it's caused by a virus and not bacteria. If you are very sick, your provider might prescribe you an antiviral medication like valacyclovir.

If you have a fever and body aches, you can take an over-the-counter (OTC) pain reliever and fever-reducing medication like Tylenol and Advil.

Using soothing lotions (like calamine) on your skin and taking a cool bath or shower can help ease the itching from chickenpox.

Vaccination After Chickenpox Infection

Most children who get chickenpox will be naturally immune and do not need a chickenpox vaccine.

However, you might want to have your child vaccinated if they were very young when they got sick or had a very mild case of chickenpox.

Since many kids have been vaccinated against chickenpox, there are fewer people around to expose an immunocompromised child or adult to chickenpox. These factors make it even less likely for a child to get a repeat chickenpox infection.

How Rare Is It to Get Chickenpox Multiple Times?

The Centers for Disease Control and Prevention (CDC) states that "immunity following varicella infection is considered to be long-lasting and second cases of varicella are considered rare" but that second cases might be more common "among immunocompetent persons than previously considered."

Today, most kids get the chickenpox vaccine, so first and second cases of chickenpox are not very common.

What Can Be Mistaken for Chickenpox?

A common reason for a child to have a second bout ofchickenpoxis that the first case was misdiagnosed. It’s also possible that the second “chickenpox” infection was misdiagnosed, and is actually another infection or skin problem.

There are a few conditions that can be mistaken for chickenpox in kids and adults.

Shingles

Later in life, some people who have had chickenpox will getshingles, a condition that happens when the chickenpox virus gets reactivated.

The shingles rash is usually a “band” on just one side of the body. It is usually very painful.

Ashingles vaccineis available to people aged 50 and older and can help prevent shingles.

Herpes

Herpes is caused by viruses. It’s often transmitted through sex. Herpes can show up as sores in the mouth or on the genitals, depending on the type of infection.

The first herpes outbreak a person has is often the worst and can come along with flu-like symptoms.

Impetigo

Impetigo is a very contagious skin infection that usually happens in kids. It causes crusty, honey-colored sores on the skin. The sores can also look like blisters on different parts of the body, most commonly the face and limbs.

Scabies

Scabies is an itchy rash on the skin caused by mites. It’s often itchier at night and intense scratching can lead to skin irritation and infection. A clear sign of scabies is seeing lines (burrows) in the skin.

Bug Bites

Insect bites and stings can look like red dots on the skin and are often itchy or painful. Most bug bites are not serious and get better on their own; however, a more serious bite (e.g., from certain kinds of spiders) might need medical attention.

Can You Get Tested for Chickenpox?

A full-blown case ofchickenpox is hard to miss, but other viral infections and even insect bites can be misdiagnosed as mild cases of chickenpox, especially by people who are not healthcare professionals (e.g., parents, teachers, daycare workers).

Testing for chickenpox is rarely required, but some tests can confirm if a child has chickenpox. These can be helpful in mild cases or when a child has a suspected second case of chickenpox.

Tests for chickenpox can include:

• PCR or DFA of cellular matter from an unroofed vesicle
• Viral culture of fluid from chickenpox lesion
• IgG and IgM antibody levels

Summary

A second case of chickenpox is possible but not likely. In some cases, the first (or second) case of chickenpox is misdiagnosed. Conditions like impetigo, herpes, and even bug bites can easily be mistaken for chickenpox. In adults, the reactivation of the chickenpox virus can happen in the form of shingles.

However, if your child had chickenpox very young, only had a mild case, or has problems with their immune system, they could get a second bout of chicken pox. Since there’s a vaccine for chickenpox, first and second infections are less common today than they were in the past.