Chicken Pox (Varicella)
By Alan S. Peterson, MD

Chicken pox (varicella) is usually a relatively minor illness. For the first couple of days, your child may feel ill, with cold-like symptoms, cough, fever, and abdominal pain. Then a rash of red, pimple-like spots will appear. A child may have as few as 30 spots, or the rash may cover the child’s entire body including the throat, mouth, ears, groin, and scalp.

The spots turn into clear blisters that become cloudy, break open, and crust over.  The rash itches a lot. Spots continue to appear for one to five days and subside over one to two weeks. 

Prevention

The chicken pox vaccine can be given to children age 12 months and older and to teens and adults who have not had the illness and have not completed 2 immunizations. Two immunizations are now urged by the Centers for Disease Control. It is especially important to immunize teens and adults who have not had chicken pox, because the disease is much more severe in the older aged group. 

Home treatment

• Use acetaminophen (Tylenol) to relieve fever. Do not give aspirin to anyone younger than age 20 years who may have chicken pox because aspirin use is related to Reye’s syndrome. Reye’s syndrome is a rare, serious disease that can cause changes that affect many organs of the body, but are most harmful to the brain and liver.
• Control itching. Oral Benadryl (dyphenhydromine) and warm baths with baking soda or Aveeno colloidal oatmeal added to the water will help. Hot water or sweating in a hot humid atmosphere can make itching worse so make sure that the person is kept cool and the baths are no more than tepid or elbow temperature. Avoid Benadryl creams because it is difficult to control the dosage when the medicine is applied to the skin. Also Benadryl used on the skin can cause an allergic reaction, just as Neosporin or Triple Antibiotic ointments can do.
• Cut your child’s fingernails to prevent scratching. If scabs are scratched off too early, the sores may become infected. Obviously these scabs can eventually become permanent scars. 

When to call a health professional

• If the child is at risk for complications from chicken pox (is taking steroid medications like prednisone, or receiving cancer chemotherapy, or has a weakened immune system, or is on chronic aspirin therapy for rheumatologic conditions).
• If a child aged 3 months to 3 years has a fever of 103° or higher for 24 hours or more.
• If severe itching cannot be controlled by oral Benadryl and oatmeal baths.
• If bruising appears without any obvious injury.
• If sores appear in a child’s eyes.
• If you notice signs of encephalitis. These may include:
• Fever
• Severe headache, and stiff neck
• Unusual sleepiness or confusion.
• Persistent vomiting.