Childhood Diseases

Updated 27 March 2018

Treating chicken pox

In children, mild cases of chicken pox can be managed with simple measures to control the symptoms.


For itching:
Make sure your child wears loose cotton clothing.

Use cool, wet compresses to relieve itching.

Calamine lotion can be applied to the rash to help relieve itching, but avoid applying it to the child’s 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.

For fever:
NEVER use aspirin or ibuprofen. Paracetamol is safe to use.

If a person who is at very high risk has been exposed to chicken pox, such as children with leukaemia or new-born babies of mothers with chicken pox, an immunoglobulin preparation known as varicella zoster immune globulin (VZIG) can be given by injection.

This will provide immediate protection against chicken pox.

Importantly, VZIG may not prevent chicken pox unless given very early after exposure to an infected individual. It will, however, 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’s produced by the Kwa-Zulu Natal Blood Transfusion Service. As it’s scarce, it’s only available to those at great risk.

Fortunately, the anti-viral drug acylovir is effective and safe for the treatment of chicken pox. Any person who is at risk of severe chicken pox 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 intravenous infusion in serious situations, such as chicken pox pneumonia.

Because of the significantly increased risk of complications from chicken pox in adults, even if they’re 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 shingles symptoms.

Although, in principle, women 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 chicken pox in pregnancy.

Unfortunately, there’s 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. 

When to call a doctor
It’s not usually necessary to ask a doctor to see a child with chicken pox.

However, the following warrants a visit to your GP:

• A very severe rash.
• If bleeding occurs in the skin blisters.
• If the chicken pox blisters occur in the mouth, and your child is unable to eat or drink. 
• If your child develops a persistent cough.
• If your child complains of a headache. 

Any adult who develops the typical rash of chicken pox must see a doctor as soon as possible.

Reviewed by paediatrician Prof Eugene Weinberg. MBChB; FCP (SA); PAED (SA). March 2018.