Chickenpox (bulutong-tubig): symptoms, treatment and when to see a doctor

The main sign of chickenpox is an itchy rash of small spots that turn into blisters. In Filipino it is called bulutong-tubig ("water pox"), because of these fluid-filled blisters.

A day or two before the rash, many people have a fever, headache, tiredness, body aches, poor appetite and sometimes a mild stomach ache.

The rash usually starts on the face, scalp, chest or back, then spreads. It goes through three stages:

1. Spots. Small red or pink spots appear. On brown skin they can look darker or be harder to see.
2. Blisters. The spots fill with clear fluid. They are very itchy and may burst.
3. Scabs. After a day or two, the blisters turn cloudy, dry out and form scabs.

New spots keep coming in groups for about 5 to 7 days, so spots, blisters and scabs show at the same time. Spots can also appear inside the mouth, on the eyelids and around the genitals, which can hurt. Children with eczema can get many more spots.

Vaccinated people can still get chickenpox, but it is usually mild, with fewer spots. They can still pass it on.

A doctor can usually tell it is chickenpox by looking at the rash. Other illnesses, such as measles (tigdas), also cause rashes, so get it checked if you are not sure or the person seems very ill.

Chickenpox is caused by the varicella-zoster virus. It spreads very easily. Anyone who has never had chickenpox or the vaccine can catch it, and most people without protection who live with a sick person will get it.

You can catch it by:

• being in the same room as someone with chickenpox
• touching fluid from the blisters, or towels and bedsheets with fluid on them
• being near someone with shingles (kulebra), if you have never had chickenpox

The spots usually appear 10 to 21 days after contact, most often around 2 weeks.

After you get better, the virus stays asleep in your nerves for life. Years later it can wake up and cause shingles, a painful rash on one side of the body.

A person with chickenpox can spread it from about 2 days before the spots appear until all the spots have formed scabs, usually about 5 days after the first spots.

During this time:

• stay home from school, daycare or work
• keep away from pregnant women, newborn babies and people with a weak immune system
• use your own towel, and wash sheets and clothes that touch the blisters
• tell the clinic or health center before you go in, so they can keep you apart from other patients

Once every spot is dry and crusted, the person can usually go back to school or work, even if the scabs have not fallen off.

What helps

• Drink plenty of fluids. For a child who won't drink, try ice candy or cold juice.
• Paracetamol for fever and pain, taken exactly as the label says for the person's age or weight.
• Keep nails short, and put clean socks or mittens on a child's hands at night.
• Bathe in cool or lukewarm water with a little mild soap, then pat the skin dry. Do not rub.
• Calamine lotion or a cooling gel from the pharmacy can calm the itch.
• An antihistamine may help with itching at night. Some cause sleepiness, and not all are safe for young children, so ask a pharmacist which one suits the person's age.
• Wear loose cotton clothes and keep the room cool. Heat and sweat make itching worse.

What to avoid

• Aspirin. Never give it to a child or teenager under 16, and adults should not take it for chickenpox unless a doctor says so. With chickenpox it is linked to Reye syndrome, a rare but serious illness of the liver and brain. Check fever and flu medicine labels for aspirin.
• Ibuprofen, unless a doctor tells you to use it. It has been linked to serious skin infections in chickenpox. Mefenamic acid, often taken for pain in the Philippines, is in the same family of medicines as ibuprofen, so don't use it for chickenpox unless a doctor says so. Paracetamol is the usual choice.
• Scratching or popping blisters. It lets germs in and makes scars more likely.
• Antibiotics for chickenpox itself. It is a virus. A doctor may prescribe them only if the skin gets infected.

Not sure if a medicine is safe? Ask our free AI symptom guide or ask a nurse.

For most children, chickenpox gets better on its own in 1 to 2 weeks. It is more likely to be serious for:

• teenagers and adults
• pregnant women and their babies
• newborns, and babies under 1 year whose mothers never had chickenpox or the vaccine
• people with a weak immune system, for example from HIV, cancer treatment or long-term steroid medicines

People in these groups should see a doctor the same day. A doctor may prescribe an antiviral medicine, such as aciclovir, which slows the virus. It works best when started within 24 hours of the first spots, so don't wait. It may also be offered to people with eczema or lung problems such as asthma, and to a second person who catches it in the same home, because they often get sicker.

People at very high risk who were only exposed, such as pregnant women who never had chickenpox, may be given medicine or an injection of antibodies before any spots appear. Antivirals are prescription medicines: take them only as your doctor tells you.

Complications are uncommon, but watch for them:

• Skin infection. Germs get into scratched or burst blisters. The skin turns red, hot, swollen and painful, sometimes with pus and a new fever.
• Pneumonia (lung infection), more common in adults and pregnant women, with cough, shortness of breath and chest pain.
• Brain problems. Rarely, swelling of the brain (encephalitis) causes severe headache, confusion, fits or deep sleepiness. A milder problem, an unsteady walk, can appear during or after recovery.
• Dehydration, when a sick child does not drink enough.

Chickenpox scars. Most spots heal without a mark. Scars are more likely when blisters are scratched or infected. To lower the chance:

• don't pick the scabs; let them fall off on their own
• keep nails short and the skin clean
• treat the itch early with cool baths and calamine

If a scar still bothers you after the skin has healed, a doctor or dermatologist can talk about options.

Chickenpox in adults is usually worse than in children, with a bigger risk of complications such as pneumonia. The WHO notes that in tropical countries like the Philippines, more people reach adulthood without having had chickenpox, so adult cases are more common than in cooler countries. Adults who catch it should see a doctor early, ideally on the first day of spots. Not sure if you had it as a child? Ask your parents, or ask a doctor about a blood test.

Chickenpox in pregnancy can be serious for mother and baby:

• The mother has a higher risk of pneumonia, especially near the time of birth.
• If she gets it in the first 20 weeks, there is a small chance (up to about 2 in 100) that the baby is born with scars or problems of the skin, eyes, limbs or brain, or with a low birth weight.
• If she gets it around the time of birth, the newborn can become very sick.

If you are pregnant and have spots, or were near someone with chickenpox or shingles and never had chickenpox, see a doctor today, and tell the team at your prenatal check-ups. The vaccine is not given during pregnancy, but it can be given before.

If you have chickenpox and are breastfeeding, talk to your doctor.

The chickenpox (varicella) vaccine is the best protection. The World Health Organization (WHO) updated its advice in November 2025:

• 2 doses protect much better than one, for children and for teenagers and adults who never had chickenpox.
• The first dose can be given from 9 months of age. Your pediatrician will tell you when the second is due. No booster is needed after that.
• For someone who never had chickenpox or the vaccine, a dose given within 3 to 5 days after contact with chickenpox may still prevent it or make it milder. Ask a doctor quickly.

After 2 doses, the vaccine prevents chickenpox in about 98 out of 100 children and 75 out of 100 adults. People who still catch it usually have a mild case. Side effects are mostly a sore arm, fever or a few spots.

Who should not get it: pregnant women, people with a very weak immune system, babies under 9 months, and anyone who had a serious allergic reaction to it. Avoid pregnancy for 1 month after the last dose.

In the Philippines, the free health center vaccines under the National Immunization Program do not include chickenpox, according to the Philippine Pediatric Society. The society recommends 2 doses for children and lists chickenpox among the extra vaccines to ask your pediatrician about. These are usually paid for at private clinics, so ask the price of each dose first. See our immunization schedule guide for the free vaccines.

Most children with chickenpox can be cared for at home. When you need a check-up:

• Your barangay health station or rural health unit (RHU) can check the rash. Tell them first that it may be chickenpox.
• PhilHealth YAKAP. As of July 2025, check-ups at your registered YAKAP clinic are free, though a private YAKAP clinic may charge up to ₱900 per person for the whole year. Medicines on the YAKAP list that your YAKAP doctor prescribes can be free at accredited pharmacies, up to ₱20,000 a year. Ask whether the medicine you were prescribed is on the list. See our PhilHealth YAKAP guide.
• Hospital care. Under PhilHealth Circular 2024-0037, the newest list of case rates we found as of November 2026, PhilHealth pays ₱7,800 for a hospital stay for chickenpox without complications and ₱29,250 for chickenpox with pneumonia. Ask the hospital's PhilHealth desk how much of the bill this covers.
• Malasakit Centers inside hospitals bring help from PhilHealth, the PCSO and the DSWD together in one office for patients who cannot afford their bills (see our Malasakit Center guide).

Use our care finder to find a health center or hospital near you, or book a call with a nurse.

Families have many ways of caring for bulutong. Here is what the evidence says about some of them.

"Bawal maligo." (Don't bathe.) Bathing is safe and helps. A cool or lukewarm bath eases the itch and keeps the skin clean, which lowers the chance of infection.

"Mas mabuti nang magkasakit habang bata." (Better to catch it as a child.) Adults do usually get sicker. But chickenpox can still be serious in children, and the vaccine protects without the risks of the illness.

Bathing in boiled guava (bayabas) leaves. We found no good studies showing it heals chickenpox faster. If your family uses it, let the water cool fully, use clean water, and stop if the skin gets red or sore. Do not rub leaves on the blisters.

"Bawal ang malansa." (Avoid fish, eggs or chicken.) The guidance we checked does not ask people to avoid these foods. The body needs food and fluids to heal. Soft, cool foods are easier if the mouth has sores.