Chickenpox Contagion After Acyclovir Treatment

Inquiry about transmission issues after chickenpox treatment?

Hello, I recently contracted chickenpox and after a doctor's diagnosis, I was treated with Acyclovir for a week.
It's been almost two weeks, and the lesions have crusted over.
I would like to ask if being crusted means I am no longer contagious, or do I need to wait until the scabs fall off? Additionally, I saw online that after five days of Acyclovir treatment, isolation is no longer necessary.
Is this correct?

Yingjie, 40~49 year old female. Ask Date: 2021/02/04

Dr. Wu Yuxin reply Dermatology

Once all the lesions have crusted over, the infectiousness is significantly reduced.

Reply Date: 2021/02/04

More Info

Chickenpox, caused by the varicella-zoster virus, is highly contagious and can be transmitted through respiratory droplets or direct contact with the fluid from the blisters. When a person contracts chickenpox, they typically develop a rash that progresses from red spots to fluid-filled blisters, which eventually crust over and heal. The question of contagion after treatment with Acyclovir is an important one, especially for those who have been diagnosed with the illness.

Acyclovir is an antiviral medication that is commonly prescribed to reduce the severity and duration of chickenpox symptoms. It works by inhibiting the replication of the virus, which can help to lessen the number of lesions and the overall duration of the illness. However, it is important to understand that while Acyclovir can help manage the symptoms and reduce the viral load in the body, it does not eliminate the virus completely.

Regarding contagion, a person with chickenpox is considered contagious from about 1 to 2 days before the rash appears until all the blisters have crusted over. This means that even after starting Acyclovir treatment, the individual can still be contagious until the lesions have fully crusted. The crusting process typically indicates that the person is no longer shedding the virus, but it is crucial to wait until all the blisters have dried and crusted over completely before considering oneself non-contagious.

In your case, since you mentioned that it has been almost two weeks since the onset of the rash and the lesions have crusted over, you are likely no longer contagious. However, it is advisable to wait until all the scabs have fallen off naturally before resuming close contact with others, particularly those who are at higher risk, such as pregnant women, newborns, or individuals with weakened immune systems.

As for the information you found online regarding isolation after five days of Acyclovir treatment, this is a bit misleading. While Acyclovir can help reduce the duration of symptoms, the standard guideline for determining contagiousness still relies on the appearance of the rash and the status of the lesions. Therefore, it is best to follow the guideline of waiting until all blisters have crusted over and fallen off before considering yourself non-contagious.

In summary, while Acyclovir can help manage chickenpox symptoms and potentially reduce the duration of contagion, it is essential to wait until all lesions have crusted over before assuming that you are no longer contagious. If you have any concerns or specific questions about your situation, it is always best to consult with your healthcare provider for personalized advice.

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