- The chickenpox rash is a rash all over the body. It starts as small red bumps. The bumps change to blisters or pimples. The bumps change to open sores, and finally they scab over.
- Caused by the chickenpox virus.
- Chickenpox starts with some small water blisters or pimples on the head and trunk.
- Chickenpox progress within 24 hours through the next 5 stages:
- small red bumps
- thin-walled water blisters
- cloudy blisters
- open sores, and finally
- dry brown crusts
- Chickenpox is caused by a virus. It is called Varicella. Chickenpox can be prevented by getting this vaccine.
Return to School
- Your child can go back to school after all the sores have crusted over. Most often, this is day 6 or 7 of the rash.
When to Call Us for Chickenpox
Call 911 Now (your child may need an ambulance) If:
- Not moving or too weak to stand
- You think your child has a life-threatening emergency
Call Us Now (night or day) If:
- Your child looks or acts very sick
- Bright red skin or red streak
- Very painful swelling or very swollen face
- New red rash in addition to chickenpox rash
- Hard to wake up OR confused
- Trouble walking or stiff neck
- Trouble breathing
- Bleeding into the chickenpox
- Fever more than 104° F (40° C)
- Age less than 1 month old
- Vomits 3 or more times
- Eye pain or constant blinking
- Took a steroid medicine within past 2 weeks
- Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant)
- Chronic skin disease (such as eczema)
- Chronic lung disease (such as cystic fibrosis)
- You think your child needs to be seen urgently
Call Us Within 24 Hours (between 9 am and 4 pm) If:
- You think your child needs to be seen, but not urgently
- Age less than 1 year old
- Teen 13 years or older has chickenpox
- Been near to person with chickenpox or shingles in last 5 days. Also, healthy person who never had a chickenpox vaccine.
- One lymph node gets larger and more tender
- Fever lasts more than 4 days
- Fever returns after gone for more than 24 hours
- Scab or sore drains yellow pus
- One sore gets much larger in size than the others
- Gets new chickenpox after day 6
Call Us During Weekday Office Hours If:
- You have other questions or concerns
Parent Care at Home If:
- Chickenpox with no complications
Care Advice for Chickenpox
What You Should Know:
- Chickenpox is caused by the varicella virus.
- It’s now uncommon because of the chickenpox vaccine.
- Your job is to keep your child comfortable and to limit the itching.
- Here is some care advice that should help.
- For itching, give cool or lukewarm baths for 10 minutes as often as needed.
- Caution: Avoid any chill.
- Can add baking soda 2 ounces (60 ml) per tub.
- Baths don’t spread the chickenpox.
- Do not use soaps. Reason: Soaps cause dry skin and make the itch worse.
Calamine Lotion for Itching:
- Put calamine lotion on the chickenpox that itch the most.
- You can also use an ice cube on the itchy spots for 10 minutes.
- Don’t use any lotion containing Benadryl in it. Reason: It can be absorbed across the skin. This can cause side effects in kids.
Benedryl Medicine for Itching:
- If itching becomes severe or interferes with sleep, give Benadryl by mouth. See Dose Table.
Try Not to Scratch:
- Try not to let your child pick and scratch at the sores. This can lead to infected sores.
- Trim fingernails.
- Wash hands often with soap.
- Give acetaminophen (such as Tylenol) for fever above 102° F (39° C).
- Never use aspirin. Reason: Risk of Reye syndrome.
- Also, don’t use ibuprofen. Reason: May increase risk of bad strep skin infections.
Fluids and Soft Diet:
- The mouth and throat ulcers are painful. Try to get your child to drink adequate fluids.
- Goal: Keep your child well hydrated.
- Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
- Solids. Offer a soft diet. Also, avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is more important than eating any solids.
- For babies, you may need to stop the bottle. Give fluids by cup, spoon or syringe instead. Reason: The nipple can increase the pain.
Liquid Antacid for Mouth Pain:
- For mouth pain, use a liquid antacid such as Mylanta or the store brand. Give 4 times per day as needed. After meals often is a good time. Age: For children over 1 year old.
- For children over age 6, can use 1 teaspoon (5 ml) as a mouth wash. Keep it on the ulcers as long as possible. Then can spit it out or swallow it.
- For younger children age 1 to 6, put a few drops in the mouth. Can also put it on with a cotton swab.
- Caution: Do not use regular mouth washes, because they sting.
For Passing with Passing Urine:
- For girls with painful genital ulcers, put petroleum jelly on them as needed.
- For severe pain, use a numbing ointment such as 2.5% xylocaine ointment. No prescription is needed. Use this 4 times per day.
- For males with painful pox on the tip of the penis, this also works.
Return to School
- Your child can go back to school after all the sores have crusted over.
- Most often, this is day 6 or 7 of the rash.
What to Expect:
- Expect new chickenpox every day for 4 or 5 days.
- Most children get 400 to 500 chickenpox.
- They get less pox if they’ve had the vaccine.
Prevent the Spread of Chickenpox in the Office:
- If your child needs to be seen, call first to the office.
- Try to bring another adult. Have one adult enter the office first for instructions.
- For nonurgent problems, the doctor may do an exam in the car.
Call Your Doctor If:
- Chickenpox look infected (draining pus, scabs become larger)
- Gets any new chickenpox after day 6
- Your child becomes worse