What Chickenpox Looks Like in Black People and Darker Skin Tones (With Images)

Chickenpox is a highly contagious condition caused by the varicella-zoster virus (VZV). Because there’s an effective vaccine, chickenpox isn’t as common as it used to be. But when people do get chickenpox, they usually have symptoms like fever, body aches, and a widespread, itchy rash. 

The chickenpox rash is pretty characteristic, but it can look different on darker skin tones. Here, we’ll take a look at what chickenpox looks like in Black people and those with darker skin tones (with pictures).  

What does chickenpox look like on darker skin tones?

The chickenpox rash usually goes through three main stages. It usually first appears as small flat spots or bumps on the:

• Face

• Scalp

• Torso (chest, abdomen, and back)

• Upper arms and legs

In darker skin tones, these spots are usually violet, brown, or skin-colored. They may not be as obvious as in fairer skin tones. 

Over the next 24 hours or so, these spots will turn into blisters filled with fluid, and then crusts and scabs. You can often have hundreds of chickenpox spots at once. And it’s normal to have spots in different stages at the same time. After about a week, most spots will have scabbed over. 

Here are some pictures of what the different stages of chickenpox look like on darker skin tones. 

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• Hyperpigmentation in darker skin: Find out more about the different causes of this common problem and what you can do about it (with images).

Chickenpox stage 1: Spots and bumps

On darker skin tones, the small spots and bumps of early chickenpox may be more subtle. 

Early stage chickenpox on a person with a darker skin tone appears as bumps and spots.

A Black person has chickenpox in its early stages.

Chickenpox stage 2: Blisters

In the second stage, chickenpox spots turn into blisters. These are usually filled with clear fluid, but can sometimes have cloudy or yellow fluid. Blisters can be surrounded by a faint rim of red or violet skin. 

Many small chickenpox blisters appear on a person with darker skin.

Many chickenpox blisters appear on the skin of a Black person.

Chickenpox stage 3: Scabs and crusts

In the final stage, individual blisters break open and form scabs and crusts as they heal. 

Crusts and scabs form during the final stage of chickenpox in a person with darker skin.

Some blisters and scabs form during the final stage of chickenpox.

What are other symptoms of chickenpox?

In addition to the rash, chickenpox can cause other symptoms. In adults and adolescents, these symptoms usually come before the rash. In children, the rash may be the first sign of infection. 

Common chickenpox symptoms include:

• Low-grade fever 

• Achy muscles

• Nausea and decreased appetite

• Headache

What complications can happen from chickenpox in Black people and those with darker skin?

Most people recover from chickenpox without any problems. However, in darker skin tones, chickenpox spots are more likely to leave behind dark patches (post-inflammatory hyperpigmentation) or pale white spots (post-inflammatory hypopigmentation). These patches will usually fade, but it can take months or longer. 

In some situations, permanent scars can develop after chickenpox heals. These often look like sunken skin scars. This is more likely if you pick at the spots or they develop a skin infection. 

Here are some pictures of discoloration caused by chickenpox. 

Small spots from post-inflammatory hyperpigmentation caused by chickenpox and large spots from a skin infection can be seen in a person’s body.

A person with darker skin tone has post-inflammatory hypopigmentation caused by chickenpox.

What other rashes can be mistaken for chickenpox on darker skin?

There are some other rashes that may be mistaken for chickenpox in darker skin tones. These include: 

• Bug bites

• Hand, foot, and mouth disease

• Shingles

Shingles is caused by the same virus as chickenpox, but it develops years or decades later. After someone recovers from chickenpox, the virus stays inactive in the nerves. It can then reactivate later and cause shingles. 

Shingles also causes a rash with blisters, but it’s different from chickenpox in a few ways, including: 

• People often experience pain and tingling on the skin before the rash appears.

• Shingles just affects one area of skin on one side of the body.

• Shingles is usually very painful.

What does shingles look like on darker skin tones?

Here are some pictures of shingles on darker skin tones. 

A person with darker skin experiences a shingles outbreak.

A shingles rash covers a person’s eyelid and forehead.

How do you treat chickenpox?

For most people, treating chickenpox involves getting rest, drinking plenty of fluids, and managing symptoms. This often includes using medications like ibuprofen or acetaminophen for fever reduction and calamine lotion to help with itching. 

For people who are more likely to develop complications from chickenpox (like pneumonia), antiviral medications may be recommended. This includes people who:

• Are pregnant

• Older than 12 years 

• Have a weakened immune system 

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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Images used with permission from VisualDx (www.visualdx.com).