Chickenpox (cacar air): symptoms, stages, how long it’s contagious, and the vaccine

What is chickenpox?

Chickenpox is caused by the varicella-zoster virus, a member of the herpes family. It is also known in Malay as cacar air, and in some places as jintungan or bertih. It spreads very easily through coughs and sneezes, and by touching or breathing in virus from the fluid in the blisters.

Most people only get chickenpox once and are then immune. But the virus stays in the body, and can wake up years later as shingles (kayap).

Chickenpox symptoms and rash stages

Symptoms appear 10 to 21 days after contact, usually about 2 weeks. A mild fever, aches, tiredness and loss of appetite often come a day or two before the rash. Then the spots go through stages:

1. Red spots appear, often first on the face, scalp, chest, tummy or back, then spread over the body, sometimes inside the mouth.
2. The spots fill with fluid to become very itchy blisters, which break within a day or two.
3. The blisters dry into scabs, which fall off over 1 to 2 weeks.

New spots keep appearing for a few days, so you often see spots, blisters and scabs at the same time. Chickenpox is usually milder in children and more severe in teenagers and adults, in whom pneumonia is the most common serious complication. In children, the most common complication is a bacterial skin infection from scratching.

How long is chickenpox contagious?

A person with chickenpox can spread it from 1 to 2 days before the rash appears until all the blisters have crusted over, usually about 5 days after the spots first appear.

Keep your child home from nursery, kindergarten (tadika) or school, and stay off work yourself, until every spot has crusted. Keep away from pregnant women, newborn babies and people with weak immunity during this time.

Home care: easing the itch and fever

• Paracetamol for fever and discomfort.
• Don’t give ibuprofen or other anti-inflammatory painkillers unless a doctor advises it, as they may raise the risk of serious skin infections with chickenpox. Never give aspirin to anyone under 16.
• Calamine lotion or cooling gels on the spots, and antihistamines from a pharmacy to reduce itching and help sleep.
• Bathing is fine and helps. A cool or lukewarm bath soothes itching. Pat the skin dry rather than rubbing.
• Keep nails short, and put socks or mittens on young children’s hands at night to stop scratching, which can cause infection and scars.
• Drink plenty of fluids, and wear loose cotton clothes.

There is no need to follow special food restrictions (pantang). A normal, varied diet and plenty of fluids are best.

When to see a doctor

See a doctor within 24 hours of the rash appearing if you are an adult or teenager, pregnant, have a weakened immune system, or the person is a newborn baby. Antiviral medicine (aciclovir) can make chickenpox milder, but works best when started within 24 hours of the rash.

Chickenpox in pregnancy

Most women are already immune from childhood chickenpox. If you aren’t, chickenpox in pregnancy can cause pneumonia in the mother, and infection in the first 20 weeks carries a small risk (about 1–2%) of birth defects affecting the baby’s limbs, eyes or brain. Chickenpox around the time of delivery can make a newborn seriously ill.

If you are pregnant and have been near someone with chickenpox or shingles, and you aren’t sure you have had chickenpox, see your doctor straight away. A blood test can check your immunity, and preventive treatment may be offered. Don’t wait for a rash.

The chickenpox vaccine in Malaysia

• The chickenpox (varicella) vaccine is not part of Malaysia’s free National Immunisation Programme, but private clinics and hospitals offer it.
• It is given as 2 doses, from age 12 months. Ask your doctor about the interval between doses for your child’s age. Teenagers aged 13 and over and adults who have never had chickenpox also need 2 doses.
• Two doses are about 90% effective at preventing chickenpox, and those who still catch it usually have a much milder illness.
• Given within 3 to 5 days of contact with chickenpox, the vaccine can prevent or reduce illness in people who aren’t immune.
• Healthcare workers who aren’t immune are advised to be vaccinated.

Paediatricians in Malaysia have called for the vaccine to be added to the national programme. Some countries have recently added it to their routine schedules, including the UK from January 2026. See also our baby vaccination schedule.

Where to see a doctor or get the chickenpox vaccine

Call the clinic before you go if you think you have chickenpox, so staff can keep you away from vulnerable patients. Our directory lists GP clinics across Kuala Lumpur, Selangor and other states, many of which offer vaccinations, including clinics open in the evening and at weekends.

Browse the clinic directory

Frequently asked questions