Health Reference / Children's Health / Chickenpox

Chickenpox

Date Posted: February 23, 2000

DEFINITION

Multiple small, red bumps that progress to thinwalled water blisters; then cloudy blisters or open sores, which are usually less than 1/4 inch across; and finally dry, brown crusts (all within 24 hours)
Repeated crops of these sores for 4 to 5 days
Rash on all body surfaces but usually starts on head and back
Some ulcers (sores) in the mouth, eyelids, and genital area
Fever (unless the rash is mild)
Exposure to a child with chickenpox 14 to 16 days earlier

Cause

Chickenpox is caused by exposure to a highly contagious virus 14 to 16 days earlier. A chickenpox vaccine is available for preventing chickenpox.

Expected Course

New eruptions continue to crop up daily for 4 to 5 days. The fever is usually the highest on the third or fourth day. Your child will start to feel better and stop having a fever once he or she stops getting new bumps. The average child gets a total of 500 sores.

Chickenpox rarely leaves any permanent scars unless the sores become badly infected with impetigo or your child repeatedly picks off the scabs. However, normal chickenpox can leave temporary marks on the skin that take 6 to 12 months to fade. One attack gives lifelong immunity. Very rarely, a child may develop a second mild attack.

Home Care

Itching and Cool Baths. The best treatment for skin discomfort and itching is a cool bath every 3 to 4 hours for the first few days. Baths don't spread the chickenpox. Calamine lotion can be placed on the most itchy spots after the bath. Itchy spots can also be massaged with an ice cube for 10 minutes. If the itching becomes severe or interferes with sleep, give your child a nonprescription antihistamine such as diphenhydramine (Benadryl).

Fever. Acetaminophen or ibuprofen may be given in the dose appropriate for Your child's age for a few days if your child develops a fever over 102'F (39'C). Aspirin should be avoided in children and adolescents with chickenpox because of the link with Reye's syndrome.

Sore Mouth. Since chickenpox sores also occur. in the mouth and throat, your child may be picky about eating. Encourage cold fluids. Offer a soft, bland diet and avoid salty foods and citrus fruits. For infants, give fluids by cup rather than a bottle because the nipple can cause pain. If the mouth ulcers become troublesome and your child is over age 4, have him gargle or swallow I teaspoon of an antacid solution 4 times per day after meals.

Sore Genital Area. Sores also normally occur in the genital area. If urination becomes very painful, apply some 21/2% lidocaine. (Xylocaine) or 1% dibucaine (Nupercainal) ointment (no prescription needed) to the genital ulcers every 2 to 3 hours to relieve pain.

Prevention of Impetigo (Infected Sores). To prevent the sores from becoming infected with bacteria, trim your child's fingernails short. Also, wash his hands with an antibacterial soap (such as Dial or Safeguard) frequently during the day For young babies who are scratching badly, you may want to cover their hands with cotton socks.

Contagiousness and Isolation. Children with chickenpox are contagious until all the sores have crusted over, usually about 6 to 7 days after the rash begins. To avoid exposing other children, try not to take your child to the physician's office. If you must, leave your child in the car with a sitter while you check in. Your child does not have to stay home until all the scabs fall off (this may take 2 weeks).

Most adults who think they didn't have chickenpox as a child had a mild case. Only 4% of adults are not protected. If you lived in the same household with siblings who had chickenpox, consider yourself protected. Siblings will come down with chickenpox in 14 to 16 days. The second case in a family always has many more chickenpox than the first case.

Call our office IMMEDIATELY if:

The chickenpox look infected (yellow pus, spreading redness, red streaks).-> Your child develops a speckled red rash.
Bleeding occurs into the chickenpox.
Your child starts acting very sick.

Within 24 hours if:

The fever lasts over 4 days.
The itching is severe and doesn't respond to treatment.
You have other concerns or questions.

Instructions for Pediatric Patients, 2nd Edition, - 1999 by WB Saunders Company. Written by Barton 1). Schtmitt. MD. pediatrician and author of )bur Child's Health Bantam Books, a book for parents.