Chickenpox (Varicella) (cont.)
Sandra Gonzalez Gompf, MD, FACP
Sandra Gonzalez Gompf, MD, FACP is a U.S. board-certified Infectious Disease subspecialist. Dr. Gompf received a Bachelor of Science from the University of Miami, and a Medical Degree from the University of South Florida. Dr. Gompf completed residency training in Internal Medicine at the University of South Florida followed by subspecialty fellowship training there in Infectious Diseases under the directorship of Dr. John T. Sinnott, IV.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Chickenpox facts
- What is chickenpox? What causes chickenpox?
- What are risk factors for chickenpox?
- How does chickenpox spread? What is the contagious period for chickenpox?
- What are chickenpox symptoms and signs? How long does chickenpox last?
- What does chickenpox look like?
- What types of specialists treat chickenpox?
- What are treatment options for chickenpox?
- Are there home remedies for chickenpox?
- What are the possible complications of chickenpox?
- Can a vaccine prevent chickenpox?
- What is the prognosis of chickenpox?
- Chickenpox FAQs
What are treatment options for chickenpox?
Most of the treatments for chickenpox are aimed at decreasing the symptoms, such as severe itching. A non-aspirin analgesic like acetaminophen (Tylenol) can be used to decrease the fevers and aches. Children should never be given acetylsalicylic acid (aspirin) or aspirin-containing cold medications because of the risks for developing Reye's syndrome (a severe brain disease associated with liver and brain dysfunction and death).
Frequent oatmeal baths (plain oatmeal in water, Aveeno, etc.) can decrease the itching associated with chickenpox. In addition, soothing lotions and moisturizers such as calamine lotion or any other similar over-the-counter preparation can be applied to the rash. Diphenhydramine (Benadryl) or other antihistamines can be helpful in controlling the itching. Always discuss these treatment options with your health-care practitioner.
In addition to medications, there are also preventive measures that are needed. For young children, it is important to keep nails trimmed in order to minimize injury due to scratching and to control the risks for secondary bacterial infections like impetigo or Staphylococcus (staph infection).
Lastly, in severe cases or people at high risk for severe disease, acyclovir (Zovirax) can be prescribed. Acyclovir is an antiviral drug that has been used to shorten the duration of the infection. This medication has only been shown to be effective if started within one to two days of onset of the chickenpox rash. Most commonly, this treatment is reserved for patients with other diagnoses that put them at risk for severe disease (adults, pregnant women, severe skin diseases, immunodeficiency).
Are there home remedies for chickenpox?
Chickenpox is usually treated at home with over-the-counter medications, soothing oatmeal baths, and calamine lotion.
What are the possible complications of chickenpox?
Complications can and do occur from chickenpox. Infection of the open pox sore by bacteria can injure the skin, sometimes causing scarring, especially if the patient scratches the inflamed area. Bacterial skin infection with group A Streptococcus ("strep" or "impetigo") is, in fact, the most common complication of chickenpox in children. Other complications are much less common. In children, the central nervous system may be affected. A disorder of the cerebellar portion of the brain ("cerebellitis" or "cerebellar ataxia") may occur with wobbliness, dizziness, tremor, and altered speech. Encephalitis (inflammation of the brain with headaches, seizures, and decreased consciousness) may occur as well as damaged nerves (nerve palsies). Reye's syndrome, a potentially fatal combination of liver and brain disease, may occur in children that take aspirin or salicylate products. (Children with fever should not take aspirin.) Other complications include bloodstream infection (sepsis or "blood poisoning" from skin infection) and dehydration.
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Pneumonia is the more common complication in teens through adults. Death from varicella may occur even in healthy children. Most adults who have died of varicella were infected by unvaccinated children.
People with certain conditions are at risk of severe complications and death:
- Human immunodeficiency virus (HIV or AIDS)
- Lupus and other connective tissue or autoimmune diseases
- Leukemia and other cancers
- People taking immune-suppressing drugs, such as cortisone-related medications, tumor necrosis factor inhibitors, and chemotherapy
- People who have had transplants
- Infants, teens, and adults
A pregnant woman who has never had chickenpox or the vaccine should avoid touching or being in the same room as a person with suspected chickenpox. Not only is she at risk for pneumonia caused by the chickenpox virus, the fetus is at risk for infection in the womb (congenital varicella syndrome) up until 20 weeks gestation. Congenital varicella causes multiple birth defects, such as skin scarring and malformed limbs. It is fortunately very, very rare. Newborn infants whose mothers develop chickenpox five days before or two days after birth are at highest risk of severe chickenpox. These babies may develop symptoms within two weeks of birth. This is because there is not enough time for the mother to develop varicella antibody to pass on to the baby. The fatality rate for these babies is up to 30%. If the baby develops symptoms at 10-28 days of age, it is likely to be mild.
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