Chickenpox  

This Care Guide Covers:

  • 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.

If not, see these topics
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Chickenpox Rash
Chickenpox Rash

Chickenpox on Abdomen
Chickenpox on Abdomen

Chickenpox Sores in Mouth
Chickenpox Sores in Mouth

When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Not moving or too weak to stand
  • You think your child is having a life-threatening emergency
Call Your Doctor 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 Your Doctor 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 Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
Parent Care at Home If
  • Chickenpox with no complications
Causes & Health Information

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.

Cause

  • 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

  1. 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.
  2. 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.
  3. 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.
  4. Benadryl Medicine for Itching:
    • If itching becomes severe or interferes with sleep, give Benadryl by mouth. See Dose Table.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. Call Your Doctor If:
    • Chickenpox look infected (draining pus, scabs become larger)
    • Gets any new chickenpox after day 6
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.