Chickenpox

Definition

• 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.

Symptoms

• Chickenpox starts with some small water blisters or pimples on the head and trunk.
• Chickenpox progress within 24 hours through the next 5 stages:
1. small red bumps
2. thin-walled water blisters
3. cloudy blisters
4. open sores, and finally
5. dry brown crusts
• Rash is all over the body. Most often, starts on the head and back.
• Repeated crops of new chickenpox keep appearing for 4 to 5 days. Therefore, all 5 stages are present at same time.
• Sores (ulcers) can also occur in the mouth, on eyelids, and on genitals.
• Fever is most often present. The more the rash, the higher the fever.
• Known contact to a child with chickenpox 10 – 21 days earlier
• Main complication: Skin infections from scratching.

Causes

• 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.

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.

Cool Baths:

• 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.

Fever Medicine:

• 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