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 Han Jian Hua
Infectious Disease
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When to get the chickenpox vaccine?

Chickenpox primarily affects infants and children, and the target group for chickenpox vaccination is mainly 1-12 years old. During this age period, most children enter preschool or elementary school institutions, and the chickenpox virus is highly contagious, transmittable through droplets and contact. Once one child contracts chickenpox, the surrounding children are almost certain to be infected too. Additionally, since there are currently no effective medications to cure chickenpox, it is best to vaccinate within this age range, namely 1-12 years old. Adults can receive the chickenpox vaccine without age restrictions. The timing can be decided based on individual circumstances, but it is generally recommended to get vaccinated before the onset of the peak season for chickenpox, which is best before the spring and winter seasons.

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Symptoms and Treatment of Chickenpox

Chickenpox is primarily caused by an infection with the varicella-zoster virus, and the disease is generally transmitted through the respiratory tract. At the onset of the disease, red papules appear on the body, face, or scalp, which gradually develop into small vesicles. As the vesicles grow, they feel itchy. Scratching them can break the vesicles, leading to oozing and crusting. As the condition progresses, it can peak within two to three days, presenting with widespread vesicles throughout the body. In such cases, antiviral treatment should be promptly administered, such as acyclovir tablets or valacyclovir dispersible tablets. These can be combined with traditional Chinese antiviral medications, such as Scutellaria root oral solution.

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Written by Yuan Lin Yan
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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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Dermatology
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Is scabies chickenpox?

Scabies is caused by an infection of scabies mites and is highly contagious, generally being transmitted through direct contact, such as sharing clothes or sleeping in the same bed with shared bedding. Typically, the itching is milder during the day and worsens at night. Symptoms include itching, peeling, and blistering between the fingers. In males, red scabies nodules may appear on the scrotum. Chickenpox, caused by the varicella-zoster virus, is also highly contagious but primarily spreads through droplets and air. Once infected, it can be treated with antiviral medications. Scabies and chickenpox are entirely different diseases and must be diagnosed and treated separately.

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How is chickenpox treated?

Chickenpox generally has a good prognosis, and does not leave scars after the scabs fall off. Its treatment mainly includes three aspects: First, general and symptomatic treatment. Patients should be isolated until all the vesicles have scabbed over. Rest in bed during the fever period, consume easily digestible food, and ensure adequate hydration. Enhanced nursing care is important to keep the skin clean and avoid scratching, which could lead to secondary infections. Second, antiviral treatment. Early use of antiviral medications can be effective. Antiviral treatment within 24 hours of the appearance of the rash can control its progression and speed up recovery. Third, prevention of complications. Antibacterial drugs should be used in cases of secondary bacterial infections. For patients with encephalitis presenting with cerebral hemorrhage, dehydration treatment should be administered. Corticosteroids should not be used in chickenpox.