Do oral vesicles occur with varicella (chickenpox)?

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Last updated: April 29, 2025View editorial policy

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From the Guidelines

Yes, vesicles can appear in the mouth during chicken pox infection, although the provided evidence does not directly address this specific question, it is known that the varicella-zoster virus can infect mucous membranes, including those in the mouth. The varicella-zoster virus is known to cause a widespread rash that can affect multiple areas of the body, including the mouth. These oral vesicles, also called enanthem, can appear on the palate, gums, inside of cheeks, and tongue, and are caused by the varicella-zoster virus infecting the mucous membranes of the mouth 1.

For relief, patients can use topical oral anesthetics like viscous lidocaine (for adults) or over-the-counter products containing benzocaine, maintaining good oral hygiene, consuming cool soft foods, and avoiding spicy, acidic, or rough foods that might irritate the sores. Staying hydrated is important despite potential discomfort from swallowing. If oral lesions are severe or prevent adequate fluid intake, medical attention should be sought promptly. High-dose IV acyclovir remains the treatment of choice for VZV infections in compromised hosts, while oral acyclovir, famciclovir, and valacyclovir are beneficial for VZV infections in otherwise healthy hosts 1.

Some key points to consider:

  • The varicella-zoster virus can cause a range of symptoms, including a rash, fever, and headache, in addition to oral lesions.
  • The virus can infect mucous membranes, including those in the mouth, and cause vesicles to form.
  • Topical oral anesthetics and good oral hygiene can help relieve discomfort caused by oral lesions.
  • In severe cases, medical attention should be sought promptly to prevent complications, such as dehydration or secondary infections.
  • The treatment of choice for VZV infections in compromised hosts is high-dose IV acyclovir, while oral acyclovir, famciclovir, and valacyclovir are beneficial for VZV infections in otherwise healthy hosts 1.

From the Research

Vesicles in the Mouth with Chicken Pox

  • Chicken pox, caused by the varicella-zoster virus, can lead to various symptoms, including the appearance of vesicles or lesions on the body and sometimes in the mouth 2.
  • The presence and number of oral lesions can vary depending on the severity of the disease, with more severe cases tend to have a higher number of lesions in the mouth 2.
  • A study examining oral manifestations of varicella-zoster virus infections in otherwise healthy children found that oral lesions were more common and numerous in severe cases of varicella, suggesting a correlation between disease severity and oral involvement 2.
  • While the primary literature provided does not extensively detail the characteristics of these oral lesions, it implies that vesicles can indeed occur in the mouth as part of the varicella infection, particularly in more severe cases 2, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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