Chickenpox

Diagnostic Findings of Chickenpox

  • Multiple small, red bumps that progress to thin-walled 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 a 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 16 days earlier.

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. Children start to fee better and stop having a fever once they stop 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 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 chickenpox. Calamine lotion can be placed on itchy spots after the bath. If the itching becomes sever or interferes with seep, give your child a non prescription antihistamine (Benadryl).

Fever. Acetaminophen may be given in the dose appropriate for your child's age for a few days if your child develops a fever over 1020 F (390 C). Aspirin should be avoided in children and adolescents with chickenpox because of the link with Reye's syndrome.

Sore Mouth.
Since chickenpox sores can 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. If the mouth ulcers become troublesome, have your child gargle or swallow 1 tablespoon of an antacid solution four times daily after meals.

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

Presentation of Impetigo (Infected Sores). To prevent the sores from becoming infected with bacteria, trim your child's fingernails short. Also, wash the 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 al the sores are 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 Your Doctor Immediately if

  • Your child develops a patch of red, tender skin.
  • Your child develops a speckled red rash that looks like scarlet fever.
  • Your child becomes confused or difficult to awaken.
  • Your child develops trouble walking.
  • The neck becomes stiff.
  • Breathing becomes difficult or fast.
  • Vomiting occurs three or more times.
  • Bleeding occurs into the chickenpox.
  • Your child starts acting very sick.

Within 24 Hours if

  • The scabs become larger.
  • The scabs become soft and drain pus. (Note: Use an antibiotic ointment on these sores until your child is seen by a physician.)
  • The fever lasts over 4 days.
  • A lymph node becomes larger and more tender than the others.
  • The itching is severe and doesn't respond to treatment.
  • Your child develops severe pain when urinating.
  • You have other concerns or questions.