CHICKENPOX
(Symptoms and Treatment)
The symptoms of chickenpox start one to three weeks after becoming infected.
The main symptom is a rash that develops in three stages:
spots – red raised spots develop on the face or chest before spreading to other parts of the body.
blisters – over the next few hours or the following day, very itchy fluid-filled blisters develop on top of the spots.
scabs and crusts – after a further few days, the blisters dry out and scab over to form a crust; the crusts then gradually fall off by themselves over the next week or two.
Chickenpox is contagious until all the blisters have scabbed over, which usually happens about five or six days after the rash appeared.
How to treat chickenpox at home.
Chickenpox can usually be treated at home.
You or your child will probably feel pretty miserable and uncomfortable, but treatment can help relieve the symptoms.
The following can help:
use paracetamol to relieve fever and discomfort – don’t use anti-inflammatory painkillers, such as ibuprofen, as they can sometimes make people with chickenpox very ill
use calamine lotion, moisturising creams or cooling gels to ease itching
tap or pat the skin rather than scratching it – it’s important to avoid scratching because this can lead to further problems
drink plenty of fluids to stay hydrated
You should also take steps to stop chickenpox spreading, such as staying away from school or work until the last blister has scabbed over.
When to get medical advice
Chickenpox is normally mild and gets better on its own. But some people can become more seriously ill and need to see a doctor.
It’s a good idea to contact your GP or NHS 111 for advice if:
you’re not sure if you or your child has chickenpox
your baby is less than four weeks old and has chickenpox
you develop chickenpox as an adult
the symptoms haven’t started to improve after six days
you’ve been in contact with someone who has chickenpox (or you have symptoms) and you’re pregnant or have a weakened immune system
you or your child has signs of chickenpox complications, such as swollen and painful skin, difficulty breathing or dehydration
Also consider getting advice if you’re originally from a country near the equator (the tropics) and you’ve been in close contact with someone who has chickenpox.
Chickenpox is much more common in adults from these areas and you may need treatment to help stop you becoming seriously ill.
How you catch chickenpox
Chickenpox is caused by a virus that spreads very easily to people who haven’t had it before. If you have had it before, you’ll usually be immune for life.
The infection is spread in the fluid found in chickenpox blisters and the droplets in the coughs or sneezes of someone with the infection.
You can catch chickenpox from:
contaminated surfaces
contaminated objects, such as toys or bedding
touching chickenpox blisters or the shingles rash
face-to-face contact with an infected person, such as having a conversation
being in the same room as an infected person for 15 minutes or more
Someone with chickenpox is infectious from one or two days before the rash appears until all the blisters have dried out and crusted over.
Possible complications
Most people with chickenpox will make a full recovery. But occasionally serious complications can occur.
These are more common in adults, pregnant women, newborn babies and people with weakened immune systems.
Possible complications include:
a bacterial skin infection – this can cause the skin to become red, swollen and painful
a lung infection (pneumonia) – this can cause a persistent cough, breathing difficulties and chest pain
pregnancy problems – including the infection spreading to the unborn baby
Some people with chickenpox may develop shingles later in life. This is a painful, blistery rash caused by the chickenpox virus becoming reactivated.
Chickenpox is usually mild and can be treated at home. Most people feel better within a week or so.
There’s no cure, but the treatments below can help relieve the symptoms while the body fights the infection.
It’s also important to take steps to prevent chickenpox spreading, such as staying off work or school until the last blister has dried and crusted over.
Painkillers
Use paracetamol if you or your child have a high temperature (fever) and feel uncomfortable.
Paracetamol is safe for most people to take – including pregnant women and children over two months of age. Special liquid versions are available for young children and babies.
Don’t use anti-inflammatory painkillers, such as ibuprofen, as they can sometimes make people with chickenpox very ill. Never give aspirin to a child under 16 as it can be dangerous for them.
Always read the packet or leaflet that comes with the medicine to check if it’s suitable and how much to take. Speak to a pharmacist or your GP if you’re unsure.
Prevent itching and scratching
Chickenpox can be very itchy, but it’s important not to scratch the spots as it can increase the chances of the skin becoming infected with bacteria and could result in scarring.
It can help to:
keep nails short and clean
tap or pat the skin instead of scratching it
wear cotton gloves at night (or socks over hands)
bathe in cool or lukewarm water – dab or pat the skin dry afterwards, rather than rubbing it
wear loose, smooth cotton clothing
You can also buy calamine lotion, moisturising creams, cooling gels or an antihistamine medicine called chlorpheniramine to help reduce itching and soothe the skin.
Food and drink
It’s important to drink plenty of fluids to avoid dehydration.
Water is better than sugary, fizzy or acidic drinks – particularly if you or your child has chickenpox spots in the mouth.
Sugar-free ice lollies are also a good way of getting fluids into children and can help soothe a sore mouth.
Avoid sharp, hard, salty or spicy foods that may make the mouth sore. Soft, cool foods are best, such as soup that has been left to cool down.
If you breastfeed or bottle feed your baby, continue to give them feeds regularly.
STRONGER TREATMENT FROM A DOCTOR
Antiviral medication or a treatment called immunoglobulin may be recommended if you’re at risk of developing severe chickenpox.
Those at risk include:
pregnant women
adults, especially those who smoke
newborn babies under four weeks old
people with a weakened immune system (the body’s defence system), such as people with HIV, those taking high doses of steroid medication and those having chemotherapy
Antiviral medication
An antiviral medicine called aciclovir may be recommended if you’re at risk of severe chickenpox and you already have symptoms.
It ideally needs to be started within 24 hours of the rash appearing. It doesn’t cure chickenpox, but makes the symptoms less severe.
It’s normally taken as tablets five times a day for seven days.
Immunoglobulin
Immunoglobulin is a treatment given by injection that can help prevent severe chickenpox if you’ve been exposed to someone with the infection but don’t have any symptoms yet.
It’s sometimes given to pregnant women, people with a weakened immune system and newborn babies who’ve been exposed to the chickenpox virus and haven’t had the infection before.
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