Mild cases of chickenpox in children can be managed with simple measures to control the symptoms.
- Wear loose cotton clothing.
- Use cool wet compresses to relieve itching.
- Calamine lotion can be applied to the rash to help to relieve itching, but avoid applying it to the face.
- Serve foods that are cold, soft and bland because chicken pox in the mouth can make drinking or eating difficult.
- Sometimes an antihistamine with sedating effects may be given to reduce itching.
- If necessary, administer analgesics such as paracetamol to relieve pain or discomfort.
- Give cool drinks, preferably water, as frequently as possible.
- Prevent secondary skin infection by keeping your child’s fingernails clean and short to minimise harm from scratching.
Never use aspirin or Ibuprofen! Paracetamol is safe to use.
If a person who is at very high risk has been exposed to chickenpox – such as children with leukaemia or newborn babies of mothers with chickenpox – an immunoglobulin preparation known as Varicella Zoster immune globulin or VZIG can be given by intramuscular injection to provide immediate protection against chicken pox.
Importantly, VZIG may not prevent chickenpox unless given very early after exposure to an infected individual, but it does reduce the severity.
VZIG is prepared from blood donated by people with very high blood antibody levels to the chicken pox virus. In South Africa it is produced by the Kwa Zulu Natal Blood Transfusion Service. As it is scarce, it is only available to those at great risk.
Fortunately, the anti-viral drug Acylovir is effective and safe for the treatment of chickenpox.
Any patient who is at risk of severe chickenpox should be treated with Acyclovir at the earliest sign of the disease. It can be used safely even in very young babies.
Acyclovir can be given orally, but may be administered by intra-venous infusion in serious situations such as chickenpox pneumonia.
Because of the significantly increased risk of complications from chickenpox in adults, even if they are healthy, some experts recommend that all people older than 18 years be treated with Acyclovir within 24 hours of the start of the illness.
Acyclovir and newer drugs of this kind can also be of some benefit in reducing the symptoms in shingles.
Although in principle one should avoid most drugs in pregnancy, no adverse effects on the unborn child have been reported in pregnant women who have been treated with Acyclovir. For this reason the very significant risk to the pregnant mother should be the main consideration in deciding whether to treat chickenpox in pregnancy.
Unfortunately, there is no proof as yet that treatment with Acyclovir will protect the unborn baby from damage that may result from chicken pox infection in the first three months of pregnancy.
Causes of chickenpox
Diagnosing chickenpox Preventing chickenpox
Revised and reviewed by Prof Eugene Weinberg, Paediatrician and Paediatric Allergist, Health24 expert, February 2015.