Chickenpox

See More Appropriate Topic (instead of this one):

• Doesn't look like chickenpox, see Rash or Redness - Localized
• If NOT, try one of these: Rash or Redness - Widespread

Is this your child's symptom?

• A rash all over the body caused by the chickenpox virus.
• The chickenpox rash starts as small red bumps. The bumps change to blisters or pimples. The bumps change to open sores, and finally they scab over.
• A doctor has told you that your child has chickenpox.
• Or your child had close contact with another person who has it (or shingles). The contact should be 10-21 days earlier.

Symptoms of Chickenpox

• 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 or shingles 10 - 21 days earlier
• Main related problems: skin infections from scratching.

Cause of Chickenpox

• Chickenpox is caused by a virus. It is called Varicella.
• Chickenpox can be prevented by getting this vaccine against this virus.

Call 911 Now

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

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 over 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 for Chickenpox

1. 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.
2. 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.
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. Allergy Medicine for Itching:
   • If itching becomes severe, give a dose of Benadryl.
   • No prescription is needed. Age limit: 1 and older.
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 products (such as Advil). 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 (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.
9. 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.
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
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.