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monkeypox, chickenpox and smallpox

Monkeypox, Smallpox, Chickenpox: A Guide to Pox Differences

Monkeypox, Smallpox, and Chickenpox – These are one of the most commonly occuring skin conditions worldwide. While no one gets infected by them more than once, it is very likely for everyone to experience one of the three at least once in their lifetime; considering their contagious nature. 

These viral infections share a common nature and hence the suffix “Pox” – but all three exhibit distinct characteristics. In this guide by Manhattan Medical Arts, we will explain each – exploring their causes, symptoms, prevention methods, and more; to help you gain knowledge on these common skin conditions, enabling you to manage them effectively and timely.

What is Chickenpox?

Chickenpox is a highly contagious viral infection caused by the varicella-zoster virus (VZV). This virus belongs to the herpesvirus family and primarily affects children, although it can occur at any age.

The hallmark of chickenpox is the appearance of itchy, fluid-filled blisters on the skin, often accompanied by other systemic symptoms.

Causes of Chickenpox

  • Transmission: Chickenpox spreads through respiratory droplets or direct contact with the fluid from the blisters of an infected person. The virus is highly contagious, and individuals with chickenpox can transmit it to others even before they themselves develop symptoms.
  • Incubation Period: After exposure, there is an incubation period of approximately 10 to 21 days before symptoms manifest.
  • Risk Factors: Certain factors increase the risk of contracting chickenpox, including not being vaccinated, spending time in crowded places, and having a weakened immune system.

Symptoms of Chickenpox

  • Prodromal Phase: The onset of chickenpox is often marked by a prodromal phase with symptoms such as fever, fatigue, headache, and appetite loss.
  • Skin Lesions: Characteristic red spots appear, evolving into fluid-filled blisters over the course of several days. These lesions can be found all over the body, including the scalp and mucous membranes.
  • Itchiness: The blisters are intensely itchy, and scratching can lead to complications such as bacterial infections and scarring.
  • Systemic Symptoms: Chickenpox can cause additional systemic symptoms, including muscle aches, nausea, and abdominal pain.


  • Vaccination
  • Isolation
  • Good Hygiene Practices
  • Post-Exposure Prophylaxis

What is Monkeypox?

Monkeypox shares similarities with both smallpox and chickenpox. It is caused by the monkeypox virus, a member of the Orthopoxvirus genus. While it is less severe than smallpox, monkeypox can cause significant illness in humans, often presenting as a febrile rash illness.

Causes of Monkeypox

  • Animal Reservoirs: Monkeypox primarily originates in animals. Various animals, including rodents and primates, serve as natural hosts for the monkeypox virus.
  • Transmission to Humans: Human infections occur through direct contact with infected animals or through the consumption of undercooked meat from these animals. Additionally, human-to-human transmission can occur, especially in close and prolonged contact with respiratory droplets, bodily fluids, or contaminated materials.

Symptoms of Monkeypox

  • Incubation Period: After exposure, there is an incubation period of 5 to 21 days before the symptoms start appearing.
  • Prodromal Phase: The initial symptoms resemble flu-like illness, including fever, headache, muscle aches, and fatigue.
  • Rash Development: A distinctive rash then develops, typically beginning on the face and then spreading to other parts of the body. The rash evolves from raised papules to pustules, eventually forming scabs.
  • Systemic Symptoms: Monkeypox may also cause systemic symptoms such as swollen lymph nodes, chills, and exhaustion.


  • Avoidance of Animal Contact
  • Safe Food Handling
  • Personal Hygiene
  • Vaccination

What is Smallpox?

Smallpox, an infectious disease caused by the variola virus, has been a problem for centuries. Though smallpox has been eradicated through successful vaccination campaigns, understanding its causes, symptoms, and preventive measures remains crucial for historical context and biodefense considerations.

Causes of Smallpox

  • Variola Virus: Smallpox is exclusively caused by the variola virus, which belongs to the Orthopoxvirus genus. Variola comes in two forms: Variola major, a more severe and often fatal form – and Variola minor, a milder form.
  • Human Transmission: This virus is highly contagious and spreads through respiratory droplets or by direct contact with the lesions of an infected person. Additionally, it can be transmitted through contaminated surfaces.
  • Lack of Natural Reservoir: Unlike some other viruses, variola virus lacks a natural animal reservoir, making humans the sole host for the virus.

Symptoms of Smallpox

  • Incubation Period: Following exposure, an incubation period of 7 to 17 days precedes the onset of symptoms.
  • Initial Symptoms: Symptoms start with a sudden onset of fever, headache, muscle aches, and overall malaise.
  • Characteristic Rash: The hallmark of smallpox is the appearance of a skin rash. Lesions progress from red spots to raised bumps, then to fluid-filled vesicles, and finally to pustules that eventually scab over.
  • Distribution of Lesions: The rash is widespread, covering the face, limbs, and trunk, and lesions develop in the same stage at any given time.


  • Vaccination
  • Isolation and Quarantine
  • Surveillance and Rapid Response

Smallpox vs Chickenpox vs Monkeypox


  • Duration of Illness: The active phase of chickenpox typically lasts about 5 to 10 days. During this time, the characteristic rash evolves through different stages, from red spots to fluid-filled vesicles and finally to scabs.
  • Contagious Period: Individuals with chickenpox are contagious from about 1 to 2 days before the rash appears until all the lesions have crusted over.

– Monkeypox

  • Duration of Illness: The active phase of monkeypox can last for several weeks. The initial flu-like symptoms and rash may persist, with the entire illness lasting approximately 2 to 4 weeks.
  • Recovery and Convalescent Period: Recovery from monkeypox can be gradual, with individuals experiencing fatigue and weakness for an extended period after the resolution of acute symptoms.

– Smallpox

  • Duration of Illness: The active phase of smallpox can extend for about 2 to 3 weeks. This includes the prodromal phase with flu-like symptoms, the appearance and progression of the characteristic rash, and the eventual scabbing of the lesions.
  • Contagious Period: Smallpox is highly contagious, and individuals are infectious from the onset of symptoms until the scabs have fallen off.

Home Remedies

For everyone who’s suffering from viral infections like chickenpox, monkeypox, or smallpox – effective home remedies that have been used for centuries play an important role in successfully managing the symptoms.

Remedies For Chickenpox:

  • Oatmeal Baths: Take oatmeal baths regularly to relieve skin irritation.
  • Cool Compresses: Use a clean cloth soaked in cool water and gently apply to affected areas.
  • Calamine Lotion: Apply a thin layer of calamine lotion on the infected ares of the skin.
  • Baking Soda Paste: Mix baking soda with water to form a paste and apply it to affected parts of the skin.
  • Honey: Apply a thin layer of honey to chickenpox sores.
  • Neem Leaves: Crush neem leaves into a paste and apply to affected areas; or the leaves can be boiled with water and that water can be used for bathing.
  • Aloe Vera Gel: Apply pure aloe vera gel to chickenpox lesions.
  • Chamomile Tea: Brew chamomile tea, let it cool, and apply with a clean cloth.
  • Lukewarm Baths: Take short, lukewarm baths to soothe the skin.
  • Stay Hydrated: Drink plenty of water and consume hydrating foods.

Remedies For Monkeypox:

  • Warm Compresses: Apply a warm, damp cloth to affected areas.
  • Hydration: Drink plenty of fluids, such as water, herbal teas, and clear broths.
  • Rest: Make sure to get sufficient sleep and take it easy during the recovery period.
  • Tea Tree Oil: Dilute tea tree oil and apply to affected areas with a cotton ball.
  • Green Tea: Drink green tea regularly during recovery.
  • Turmeric Paste: Create a paste with turmeric and water, apply to affected areas.
  • Proper Wound Care: Gently clean wounds with mild soap and water, and apply an antiseptic.

– Remedies For Smallpox:

  • Fever Management: Use fever-reducing medications as advised by a healthcare professional.
  • Hydration: Consume plenty of fluids, including water, to stay hydrated.
  • Rest: Ensure sufficient sleep and avoid strenuous activities.
  • Isolation: Follow public health guidelines on isolation during illness.
  • Proper Wound Care: Clean wounds gently with mild soap and water, and apply antiseptic.
  • Gentle Clothing: Choose breathable fabrics that don’t rub against lesions.
  • Air Circulation: Avoid tight clothing and allow skin lesions to breathe.
  • Healthy Diet: Consume a variety of fruits, vegetables, and protein-rich foods.

When To Seek Medical Attention

Knowing when to contact your healthcare provider is very important for timely intervention and appropriate care. If you or a loved one is going through severe symptoms or complications associated with chickenpox, monkeypox, or smallpox, make sure to reach out to healthcare professionals for expert guidance and assistance.


Be it Monkeypox, Smallpox, Chickenpox, or any other condition that affects the health – it is evident that knowledge is a powerful tool in the journey of managing the symptoms and successful recovery.

At Manhattan Medical Arts, we’re committed to your health and well-being. For personalized care and expert guidance, trust us as your partners in health. Stay informed, stay safe.

Frequently Asked Questions

Is monkeypox a form of herpes?

No, monkeypox is not a form of herpes. It is caused by the monkeypox virus, which is a different virus from the herpes simplex viruses.

Are smallpox and chickenpox the same thing?

No, smallpox and chickenpox are caused by different viruses. Smallpox is caused by the variola virus, while chickenpox is caused by the varicella-zoster virus.

Is monkeypox worse than chickenpox?

Monkeypox can be more severe than chickenpox, with a higher risk of complications. However, the severity can vary, and both diseases should be taken seriously.

Does my smallpox vaccine protect me from monkeypox?

While there is no specific monkeypox vaccine, the smallpox vaccine may provide partial protection against monkeypox due to their genetic similarities. However, this protection is not guaranteed, and additional research is ongoing.

– Disclaimer –

This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.

Medically Reviewed

Last reviewed by Dr. Syra Hanif, M.D. on 12/08/2023

Learn more about our editorial process.

  • About The Author

    Dr. Syra Hanif M.D.

    Board Certified Primary Care Physician

Dr. Syra Hanif is a board-certified Primary Care Physician (PCP) dedicated to providing compassionate, patient-centered healthcare.

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