Chickenpox is a highly contagious disease caused by a virus. The usual symptoms are: an itchy skin rash that looks like little blisters filled with fluid, less energy than usual, poor appetite and mild fever. Chickenpox is spread through the air when a child is in close contact with someone who has chickenpox. Touching the rash or objects that the infected child has handled also spreads chickenpox. Once a person has had chickenpox, it is very rare to get it again.
The chickenpox rash usually occurs around 14 to 16 days after exposure. About 24 to 48 hours before the rash appears, the child will have a slight fever, loss of appetite and less energy. After the rash appears, the child will continue to have a slight fever. He may be irritable and fussy because of the itching.
Children who have been immunized against chickenpox may rarely develop a very mild form of the disease. If this happens the rash is much less severe and it lasts for fewer days.
How to Keep from Spreading Chickenpox
The child with chickenpox is contagious (can give chickenpox to others who have never had it) from 48 hours before the rash appears until all the blisters have dried and crusted over. This is usually about 7 days. During this time, keep your child home and away from others who have not had chickenpox. Also keep him away from anyone whose immune system is not normal. A child with active chickenpox should not be in public places like malls, parks or churches.
- Call the child's school or day care. Tell them your child has chickenpox.
- Adults who get chickenpox can become very ill. If you have not had chickenpox, avoid contact with an infected child. If you think you’ve been exposed, call your doctor. If you have never had chickenpox and are pregnant, call your obstetrician.
- If infants have been near someone who has chickenpox or who develops it within 48 hours of exposure, his parents and doctor should be told.
- If another child is on steroid drugs (or has lowered immunity) and is exposed to your child, his parents and doctor should be told.
- Cancel clinic visits, doctor visits and elective surgery if: your child has active chickenpox or has never had chickenpox but has been exposed to it.
How to Care for your Child
- Do not give aspirin if your child has a fever and is uncomfortable.
- Aspirin can lead to a dangerous illness called Reye's syndrome.
- Instead, give acetaminophen (such as Tylenol®) or ibuprofen (such as Motrin®).
- Daily baths and clean clothes will prevent the blisters from becoming infected.
- Keep your child's fingernails clean and cut short. Put cotton mittens or socks on his hands at night to prevent scratching the rash.
- Try not to break the blisters or disturb the scabs. This could leave scars.
Ways to Relieve Itching
The rash can be very itchy. Most children get irritable and cry a lot. Here are some things you can do to help:
- Put calamine lotion (not Caladryl®) on the rash 2 to 3 times a day and at bedtime. You can buy calamine without a prescription. Or you can make a paste of baking soda and water to put on the rash to help stop the itching.
- Dress your child as you normally would. Loose, cool clothing is best. If clothing is too warm, it will make the itching worse. It might also increase the fever.
- Try a baking soda bath (Picture 2): add one cup of baking soda for each inch depth of lukewarm bath water. Gently bathe your child and let him play in the water for 15 to 20 minutes. You can do this 2 or 3 times a day. Be sure to stay with your child while he is in the tub. Accidents can happen quickly!
- Other products you can add to bath water include: Aveeno® Bath Treatment (use the soothing formula for itchy, irritated skin). Be sure to follow the directions on the package.
- Play games with your child to take his mind off the itching.
- If your child is old enough, teach him to put pressure with his fingers to the itchy areas for relief, rather than scratching.
- Note: The American Academy of Pediatrics recommends immunizing your child against chickenpox after the age of 12 months and again at age 4 to 5 years. For more information check with your child's doctor.
When to Call the Doctor
- Temperature above 102F.
- Chicken pox blisters look infected (redness, soreness, pus).
- A chicken pox blister is very close to the eyes.
- The child’s ears begin to drain and the child complains of pain.
- Itching is so intense that your child cannot sleep. Your doctor may prescribe an anti-itch medicine to take by mouth.
- Your child begins to cough.
- Your child has improved and then has sudden, repeated vomiting.
- Sudden tiredness or problems with his or her balance.
- Fever comes back after going away for more than 24 hours.
- New chickenpox rash develops after the 6th day.
If your child has chickenpox, and his brothers and sisters do not, your doctor may prescribe treatment for your other children when they develop chickenpox.
If you have any questions, be sure to ask your doctor or nurse, or call your child’s doctor. If you need a doctor for your child, call the Children's Hospital Referral and Information Line at (614) 722-KIDS.
HH-I-101 12/81 Revised 9/11 Copyright 1981-2011, Nationwide Children’s Hospital