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Chickenpox - Treatment

Alternative Names

Varicella; Chicken pox

Treatment:

In most cases, it is enough to keep children comfortable while their own bodies fight the illness. Oatmeal baths in lukewarm water provide a crusty, comforting coating on the skin. An oral antihistamine can help to ease the itching, as can topical lotions. Trim the fingernails short to reduce secondary infections and scarring.

Safe antiviral medicines have been developed. To work well, they usually must be started within the first 24 hours of the rash.

  • For most otherwise healthy children without severe symptoms, antiviral medications are usually not used. Adults and teens, who are at risk for more severe symptoms, may benefit if the case is seen early in its course.
  • For those with skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or those who have recently taken steroids, the antiviral medicines may be very important. The same is also true for adolescents and children who must take aspirin on an ongoing basis.
  • Some doctors also give antiviral medicines to people in the same household who subsequently come down with chickenpox. Because of their increased exposure, they would normally experience a more severe case of chickenpox.

DO NOT GIVE ASPIRIN to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes Syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen may be used.

Until all chickenpox sores have crusted over or dried out, avoid playing with other children, going back to school, or returning to work.

Expectations (prognosis):

The outcome is generally excellent in uncomplicated cases. Encephalitis, pneumonia, and other invasive bacterial infections are serious, but rare, complications of chickenpox.

Once you have had chickenpox, the virus usually remains dormant or asleep in your body for your lifetime. About 1 in 10 adults will experience shingles when the virus re-emerges during a period of stress.

Complications:

  • Women who get chickenpox during pregnancy are at risk for congenital infection of the fetus.
  • Newborns are at risk for severe infection, if they are exposed and their mothers are not immune.
  • A secondary infection of the blisters may occur.
  • Encephalitis is a serious, but rare complication.
  • Reye's syndrome, pneumonia, myocarditis, and transient arthritis are other possible complications of chickenpox.
  • Cerebellar ataxia may appear during the recovery phase or later. This is characterized by a very unsteady walk.

Calling your health care provider:

Call your health care provider if you think that your child has chickenpox or if your child is over 12 months of age and has not been vaccinated against chickenpox.

  • Reviewed last on: 9/13/2009
  • Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Myers MG, Seward JF, LaRussa PS. Varicella-zoster virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 250.

American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents--United States, 2008. Pediatrics. 2008;121:219-220.

This article uses information by permission from Alan Greene, M.D., © Greene Ink, Inc.

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