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Treatment of varicella (chickenpox) infection

Mary A Albrecht, MD
Section Editors
Martin S Hirsch, MD
Morven S Edwards, MD
Deputy Editors
Jennifer Mitty, MD, MPH
Mary M Torchia, MD


Varicella-zoster virus (VZV) is one of eight herpesviruses known to cause human infection and is distributed worldwide. Primary infection with VZV causes varicella (chickenpox) in susceptible hosts. Most healthy children have self-limited infection with primary varicella. However, varicella can cause severe complications such as soft tissue infection, pneumonia, hepatitis, Reye syndrome, and encephalitis. Patients at increased risk of complications include adolescents, adults, pregnant women, and immunocompromised hosts.

The treatment of primary varicella infection will be reviewed here. Issues related to the transmission, clinical manifestations, and complications of varicella, as well as the management of pregnant women and neonates, are discussed separately. (See "Clinical features of varicella-zoster virus infection: Chickenpox" and "Varicella-zoster virus infection in pregnancy" and "Varicella-zoster infection in the newborn".)


Patients with varicella typically develop a fever and a vesicular rash that is pruritic. Many patients require supportive care to manage these symptoms. (See 'Supportive care' below.)

The decision to initiate antiviral therapy depends upon the patient’s age, the presence or absence of comorbid conditions, and the patient’s clinical presentation. Although varicella is usually a self-limited disease, if complications develop, they can be life-threatening. (See "Clinical features of varicella-zoster virus infection: Chickenpox", section on 'Complications of varicella'.)

Our approach to antiviral therapy is as follows (see 'Individuals without complications' below and 'Individuals with complications' below):

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Literature review current through: Nov 2017. | This topic last updated: Mar 30, 2017.
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