Chickenpox vs. Bug Bites: How to Tell What’s Causing Your Skin Bumps (With Images)

Getting itchy bumps on your skin is never fun. And there are lots of things that can lead to a rash and make your skin itch. So, how do you find out where those bumps came from? 

Parents often find themselves wondering whether their child is dealing with bug bites versus chickenpox. After all, bug bites are pretty common, and many kids get chickenpox, too (though less often now, thanks to the chickenpox vaccine). But it’s not just kids. Adults can also get chickenpox, not to mention bug bites.

No matter your age, this guide will help you sort it out. Below, we break down the key differences between chickenpox and bug bites, including what they look like, how they spread, and how to treat them. 

Chickenpox (varicella) spread and symptoms

Chickenpox (varicella) is a highly contagious illness caused by the varicella-zoster virus (VZV). It spreads through close contact with someone who has the virus. You can catch it by touching blisters or by breathing in respiratory droplets released when someone coughs or sneezes. It can also be spread through contact with contaminated items, like clothing. 

The first symptoms of chickenpox usually include a low-grade fever and achy muscles. Other common symptoms include:

• Nausea

• Decreased appetite

• Headache

• Fatigue (feeling tired)

• Sores in the mouth

• Cough

More infamously, chickenpox also causes an itchy, widespread rash (more on that below). In children, the rash may be the initial sign of chickenpox. In adolescents and adults, the rash usually appears after the initial symptoms. 

Stages of chickenpox rash (with images)

The chickenpox rash moves through three predictable stages.

It usually starts as small, flat spots or bumps on the:

• Face

• Scalp

• Torso

• Upper arms and legs

Color can vary by skin tone. In fair skin, spots often look pink or red. In darker skin tones, they may appear violet, brown, or skin colored. 

Over the next few days, the spots change into blisters, which then scab and crust over.  

As the rash progresses, new spots continue to show up anywhere on the skin (including inside the mouth). People with chickenpox can have hundreds of spots at a time — all in different stages. After about 1 week, all the spots crust over and start healing. 

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Here are pictures of each stage of chickenpox on different skin tones.  

Stage 1: Spots and bumps 

The first stage of chickenpox includes small, flat spots and raised bumps. They may be mixed with bumps in other stages. 

Some early chickenpox spots in darker skin appear during the early stages of the infection.

Some early chickenpox spots in fairer skin have a red and pink hue.

Stage 2: Blisters

In the second stage, chickenpox spots turn into small blisters. Most of these are filled with clear fluid (called vesicles), but sometimes they can have cloudy fluid (called pustules). Blisters can be surrounded by red or violet skin.

Many different-sized blisters in chickenpox rash appear during the second stage of the infection.

Chickenpox blisters appear in a person’s mouth.

Stage 3: Crusts and scabs

In the final stage, the chickenpox blisters rupture and form crusts and scabs as they heal. 

A few chickenpox crusts and scabs represent the final stage of the chickenpox rash.

A chickenpox rash, with scab mixed with bumps and blisters, is in its final stage.

Bug bites commonly confused as chickenpox

Sometimes bug bites can be confused with the early stages of chickenpox. Bug bites that may look like the start of chickenpox include:

• Mosquito bites

• Flea bites

• Bedbug bites 

In the table below (in the section “Key differences between chickenpox and bug bites”), we’ll review the main differences between these common bug bites and chickenpox.  

Images of bug bites that look like chickenpox

The following pictures of common bug bites on different skin tones can help you tell them apart from chickenpox. 

Mosquito bites

Mosquito bites usually form smooth, itchy bumps. On dark skin tones, the bites tend to look violet, brown, or skin colored. On fair skin tones, they usually look pink or red. 

Mosquitoes can get through some types of fabric, but usually they bite on uncovered skin, like your arms and legs. Sometimes mosquito bites can form blisters. 

Mosquito bites can look dark red or brown on darker skin.

Sometimes a mosquito bite can form a blister.

Flea bites

Flea bites usually form small, smooth bumps that are itchy. On fair skin, they can look pink or red. On darker skin tones, they tend to look violet, brown, or skin colored. 

Fleas jump from the ground to bite. So the bites tend to show up in clusters around the ankles and lower legs, or another body part close to the ground (like the waist in a child who sits a lot).

Multiple flea bites surround a person’s waist.

Multiple flea bites look like red spots on a person’s ankle.

Bedbug bites

Bedbug bites usually form smooth, itchy bumps. On lighter skin tones, they’re pink or red in color. On darker skin tones, they tend to look violet, brown, or skin colored.  

They’re usually on uncovered skin (like the neck, arms, and legs) and often happen in a line or zigzag pattern.

A line of bedbug bites on the leg.

A line of bedbug bites on the arm.

Key differences between chickenpox and bug bites

To help you tell the difference between chickenpox and bug bites, it helps to pay attention to some key features. The table below includes an overview of what these different bumps and bites look like, where they show up, and how long they last (scroll right to view the full chart). 

How to prevent chickenpox vs. bug bites

Chickenpox and bug bites have very different causes, so their prevention looks different, too. Chickenpox spreads easily from person to person. The best way to reduce your risk is to:

• Get vaccinated — the vaccine is usually given during childhood, but adults without prior infection or vaccination can still receive it. 

• Avoid close contact with someone who has chickenpox or shingles (which is caused by the same virus).

• Practice good hygiene, like regular handwashing. 

Preventing bug bites focuses on minimizing exposure to insects. This means:

• Using insect repellent when outdoors

• Wearing protective clothing (like long sleeves and pants)

• Avoiding areas with high concentration of bugs (like standing water)

• Using a mattress cover to prevent bedbugs

When to get help

Most people with chickenpox don’t need any medical treatment and can manage symptoms at home. But you may benefit from antiviral medications if you have a higher risk of complications, like pneumonia. It’s a good idea to see a healthcare professional for chickenpox if you: 

• Have a chronic lung or skin condition

• Have a weakened immune system

• Are pregnant

• Are older than 12 years 

• Have a child younger than 1 year with suspected chickenpox

Most people can safely manage symptoms from mosquito, flea, and bedbug bites at home with over-the-counter (OTC) medications. Getting rid of the cause of bites is important to prevent them from happening. If you’re not sure what’s causing your bites, or if they’re not going away, it’s a good idea to visit a healthcare professional. 

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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:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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