The Differences between Chickenpox and Hand, Foot, and Mouth Disease

Written by Zhang Jian Kang
Infectious Disease
Updated on February 21, 2025
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Chickenpox and hand, foot, and mouth disease are common infectious diseases in young children. Chickenpox is a febrile rash disease caused by the varicella-zoster virus. Its rash mainly manifests as maculopapular, vesicular, and crusted lesions, which appear simultaneously. Generally, these are primarily seen on the face and trunk with a centripetal distribution. Hand, foot, and mouth disease is mainly caused by viruses, such as enterovirus EV71 or Coxsackievirus A16. It causes a febrile rash disease with rashes typically found on the hands, feet, and around the mouth. Rashes on the chest, back, and face are relatively rare. Thus, the main clinical presentations of hand, foot, and mouth disease and chickenpox are the different forms of rashes.

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Written by Yuan Lin Yan
Infectious Disease
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Chickenpox Symptoms and Treatment Methods

Chickenpox is caused by an infection with the varicella-zoster virus and is highly contagious. The symptoms of chickenpox mainly include fever and rash. The fever presents as a low-grade fever, possibly accompanied by chills, headache, fatigue, sore throat, and loss of appetite. These symptoms last for one to two days, followed by the appearance of a rash. The rash first appears on the trunk, then on the head and face, and is relatively less common on the limbs. It begins as red maculopapular rash and turns into vesicular rash within a few hours. The chickenpox rash appears in batches, and maculopapules, vesicles, and crusts can be seen in the same area. Chickenpox is a self-limiting disease that can be cured in about ten days. Patients should be isolated until all the vesicles have crusted over. Early in the course of the disease, antiviral treatment with acyclovir can be used. It is important to keep the skin clean and avoid scratching the vesicles to prevent infection.

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Written by Hu Qi Feng
Pediatrics
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Can chickenpox in children be transmitted to adults?

Chickenpox is a highly contagious exanthematous disease caused by varicella-zoster virus infection. Its clinical characteristics include the successive or simultaneous appearance of papules, vesicles, and crusts on the skin and mucous membranes. Both chickenpox and herpes zoster patients are sources of infection, primarily from those with chickenpox. From one to two days before the onset of the disease until crusting, it is highly contagious, mainly transmitted through airborne droplets and the respiratory tract, or by contact with vesicular fluid. The general population is susceptible, especially pregnant women and people with low immunity, making it possible to transmit to adults.

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Written by Yuan Lin Yan
Infectious Disease
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Chickenpox prevention measures

Chickenpox is an acute infectious disease, and prevention of the infection mainly involves the following three aspects: First, control the source of infection. Patients with chickenpox are the only source of infection, so they should be isolated until all the chickenpox blisters have crusted over. Second, cut off the transmission route. Avoid close contact with chickenpox patients, prevent airborne droplet transmission, and avoid contact with items contaminated with the chickenpox virus. Third, protect susceptible populations. Chickenpox is highly contagious and generally susceptible in the population. Infants over one year old can be vaccinated with the chickenpox vaccine for prevention. Regular exercise, nutritional enhancement, physical strengthening, frequent hand washing, and maintaining ventilation in indoor environments are also advisable.

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Written by Yuan Lin Yan
Infectious Disease
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What are the symptoms and treatments for chickenpox in children?

Symptoms of chickenpox in children vary with age. Infants often show no symptoms or only mild symptoms, which can include mild fever, irritability, and refusal of breast milk, accompanied by a rash. Older children may experience mild fever, headache, fatigue, sore throat, coughing, and decreased appetite. These symptoms persist for one to two days before a rash appears. The rash initially appears on the trunk and then spreads to the face and limbs. Chickenpox rashes often emerge in batches, so the same area may show maculopapular lesions, vesicles, and crusts at the same time. The crusts typically fall off about a week later, usually leaving no scars. Secondary bacterial skin infection, pneumonia, encephalitis, and hepatitis are possible complications. In terms of treatment, infected children should be isolated until all the vesicles have crusted over. During the fever, they should rest in bed, consume an easily digestible diet, stay hydrated, and practice enhanced skincare to prevent infection of the vesicles. Antiviral treatment within 24 hours of rash onset can control the progression of the rash and speed up recovery. If a secondary bacterial infection develops, antibiotics should be used. In cases where encephalitis causes cerebral edema, dehydration treatments should be administered. The use of corticosteroids is not advisable for treating chickenpox.

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What fruits can you eat with chickenpox?

When children have chickenpox, they can eat foods and fruits rich in vitamins, such as kiwis, apples, and cherry tomatoes. During chickenpox, it is important to maintain a light and easily digestible diet, avoiding overly greasy and spicy foods. If the chickenpox is particularly itchy, topical calamine lotion can be applied to help relieve itching and prevent scratching, which can lead to infections. It is necessary to treat children with antiviral medications, as chickenpox is caused by a viral infection. (The use of medications should be under the guidance of a physician.)