Chickenpox

When To Call

Call 911 Now

• Not moving or too weak to stand
• You think your child has a life-threatening emergency

Go to ER Now

• Stiff neck (can't touch chin to the chest)
• Hard to wake up or confused when awake

Call Doctor or Seek Care Now

• Bright red skin or red streak
• Very painful swelling or very swollen face
• New red rash in addition to chickenpox rash
• Walking is not steady
• Trouble Breathing
• Bleeding into the chickenpox
• Fever higher 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. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Chronic skin disease (such as eczema)
• Chronic lung disease (such as cystic fibrosis)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• 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 being gone 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
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Chickenpox with no other problems

Care Advice

What You Should Know About Chickenpox:

• 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.

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 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.

Allergy Medicine for Itching:

• If itching becomes severe, give a dose of Benadryl.
• No prescription is needed. Age limit: 1 and older.

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 higher than 102° F (39° C).
• Never use aspirin. Reason: risk of Reye syndrome.
• Also, don't use ibuprofen products (such as Advil). 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 (Age 1 Year and Older):

• 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 1 to 6 years. Put a few drops in the mouth. Can also put it on with a cotton swab.
• Age over 6 years. 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.
• Caution: do not use regular mouth washes, because they sting.

Ointment For Pain With Passing Urine:

• For girls with painful genital ulcers, use petroleum jelly (such as Vaseline).
• Put on the sores as needed.
• For males with painful pox on the tip of the penis, this also works.

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.

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.

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.

Call Your Doctor 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

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Photos

Chickenpox on Abdomen

The Chickenpox rash can occur on all body surfaces. The rash is raised, red and itchy.

The rash is no longer contagious when all of the spots are crusted over and no new spots are appearing. This usually takes 7 days after the rash first appears.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

Chickenpox Rash

Chickenpox is an infectious disease caused by the varicella-zoster virus. It results in an itchy blister-like rash, tiredness and fever.

It appears first on the trunk and face, but can spread over the entire body. It may cause between 250 and 500 itchy blisters. The rash is no longer contagious when all of the spots are crusted over and no new spots are appearing. This usually takes 7 days from the start of the rash.

Source: Wikimedia Commons
Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License. This is a public domain image file from Wikimedia Commons. Wikimedia is a freely licensed media repository.