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Marlton Pediatrics

Chickenpox

Definition

  • Chickenpox is a viral rash all over the body
  • It starts as small red bumps. The bumps change to clear and then cloudy blisters. The blisters change to open sores, and finally they scab over.

Call or Return If

  • Chickenpox look infected (draining pus, scabs become larger)
  • Gets any new chickenpox after day 6
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Chickenpox starts with some small water blisters or pimples on the head and back.
  • Rash covers the entire body within a day.
  • Chickenpox progress from tiny water blisters to dry brown crusts within 24 hours.
  • Repeated crops of new chickenpox keep appearing for 4 to 5 days. Therefore, tiny blisters, sores and scabs are all 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.
  • Main complication: skin infections from scratching.

Diagnosis

  • Chickenpox can usually be diagnosed by how they look. Tests are not needed.
  • Known contact with a child with chickenpox 10 - 21 days earlier helps.

Cause

  • Chickenpox is caused by the Varicella virus

How It Is Spread

  • From fluid inside the blisters and from respiratory secretions. Very contagious.
  • Incubation period: 10-21 days.
  • Contagious period: 6 or 7 days.

Prevention of Spread to Others

  • Avoid all contact with other children until the sores have crusted over (7 days).
  • Chickenpox can be prevented by getting the varicella vaccine.
  • The vaccine has made it uncommon.

After Care Advice

Overview:
  • Chickenpox is an unpleasant disease
  • 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:
  • 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 rub 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. Too much can cause side effects in kids.
Benadryl Medicine for Itching:
  • If itching becomes severe or interferes with sleep, give Benadryl by mouth.
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).
  • Note: lower fevers are important for fighting infections.
  • 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: Use 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. Or put it on with a cotton swab.
  • Caution: Do not use regular mouth washes, because they sting.
For Pain 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.
What to Expect:
  • Expect new chickenpox every day for 4 or 5 days.
  • Most children get 400 to 500 chickenpox.
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.
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