Symptoms

• 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 10 - 21 days earlier
• Main complication: Skin infections from scratching.

Cause

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

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.

1. What You Should Know:
   • 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, 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. Benadryl Medicine for Itching:
   • If itching becomes severe or interferes with sleep, give Benadryl by mouth. See Dose Table.
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. 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:
   • 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: For children over 1 year old.
   • For children over age 6, can 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.
   • For younger children age 1 to 6, put a few drops in the mouth. Can also put it on with a cotton swab.
   • Caution: Do not use regular mouth washes, because they sting.
9. For Pain With Passing Urine:
   • For girls with painful genital ulcers, put petroleum jelly on them as needed.
   • For severe pain, use a numbing ointment such as 2.5% xylocaine ointment. No prescription is needed. Use this 4 times per day.
   • 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
    • Your child becomes worse