Chickenpox (Varicella) is a common illness seen in childhood. It is usually mild, but it can be serious when it occurs in young infants and adults. The first physical signs of chickenpox are multiple small, red bumps that progress into thin-walled water blisters; then cloudy blisters or open sores. Most lesions are less than ¼ inch across. Each lesion dries into a brown crust or scab. The rash generally first appears on the head or back, and then spreads to all body surfaces. Ulcers can appear in the mouth, on the eyelids, and in the genital region. Fever, itching, and tiredness can occur.
Chickenpox is caused by exposure to a highly contagious virus 10-21 days prior to the onset of the rash. The virus can be spread from person to person through the air or by contact with fluid from the chickenpox blisters. A person is contagious and can spread the illness for 1 to 2 days before their rash appears.
Once they begin, new eruptions continue to crop up daily for 4 to 5 days. The fever is usually the highest on the third or fourth day. Patients usually start to feel better and stop having a fever once new bumps have stopped appearing. The average child can develop between 250 and 500 sores.
People infected with chickenpox are contagious until all the sores have crusted over. This usually takes about 6 to 10 days after the rash begins. Your child can leave the house when all of the lesions have developed scabs. The scabs do not have to fall off for your child to resume contact with people outside of your home, for this process may take up to two weeks.
Siblings will come down with chickenpox 11 to 21 days after exposure, if they are not immune. The second child may have many more lesions that then first child.
The American Academy of Pediatrics recommends administration of the varicella Vaccine to susceptible children within 72 hours (and possibly up to 120 hours) after exposure to another child with the illness. This may prevent or significantly modify the disease in the unprotected child. The vaccine will not prevent the disease from occurring in those unprotected children who were exposed at the same time as the first child who came down with the illness.
Do not purposely expose your child to other people in order for them to get the disease. About 12,000 people are hospitalized each year in the United States. Serious complications, including life-threatening bacterial skin infections, can occur. About 100 people die each year in the United States as a result of chickenpox.
Chickenpox usually does not leave permanent scars, unless the rash becomes badly infected or your child repeatedly picks off the scabs. Normal chickenpox can leave temporary marks on the skin, which take 6 to 12 months to fade. One episode of the chickenpox gives lifelong immunity. In very rare cases, a mild second attack may occur.
The treatment of chickenpox includes:
- Relieving itching and skin discomfort.
This is best accomplished with cool baths every 3 to 4 hours for the first few days. Adding Aveeno-Oatmeal® powder to the bath water is helpful. Calamine lotion can be applied to the itchiest spots after the bath.
If the itching is severe, give an over-the-counter antihistamine such as Benedryl Elixir®, ______ teaspoons every 4 to 6 hours. If this does not provide relief, your doctor may recommend prescription medications.
- Controlling the fever.
Acetaminophen (Tylenol®) or Ibuprofen (Advil® or Motrin®) may be given in the appropriate dosage for your child’s age for a few days. Aspirin or products containing aspirin should never be given to children and adolescents with chickenpox. There is an increased risk of developing a life-threatening illness called Reye’s Syndrome when aspirin is administered to young people with chickenpox
- Preventing infection of the sores and scabs.
To prevent the sores from becoming infected with bacteria, trim your child’s fingernails short. Keep the skin clean by washing it with an antibacterial soap such as Dial®, Safeguard®, Lever 2000®, or Phisoderm®.
Complications can occur. Call immediately if:
- The lesions look infected (i.e., yellow pus draining from the lesions; spreading redness around the lesions; red streaks along the skin).
- Bleeding occurs into the chickenpox.
- Your child starts to act very sick