Introduction
Chickenpox is a common virus in children that causes a red, spotty rash. It is also known as the varicella or varicella-zoster virus. It is the same virus that can cause shingles.
Chickenpox is most common in children between 2 – 10 years old. Children are at risk of getting chickenpox if they have never had the chickenpox vaccine or have never had the virus.
Signs and symptoms
The chickenpox rash looks like small red pimples or spots. This rash will start to show on the chest and back 1-2 days after your child becomes infected with the virus.
The rash can spread all over the body, including:
- face and scalp
- arms and legs
- inside the ears
- on the eyelids
- inside the nose
- inside the vagina.
The rash will continue to spread for 3 – 4 days. and is usually very itchy.
A few hours after each rash spot appears, a blister will form. Blisters are very itchy and can look like they are full of yellow liquid.
These spots are easily broken and will form a scab. The rash spots will heal at different stages, some faster than others. This means your child might have rash spots that are all at different stages of healing.
Some children will have only a tiny number of rash spots, and others can have hundreds across the body.
Other symptoms of a chickenpox infection include:
In families with several children, the chickenpox virus can last several weeks, spreading to others in the home.
Diagnosis
Your child’s doctor can diagnose chickenpox based on their skin rash. They will also ask about your child’s vaccination record and whether they have had any contact with someone sick.
Sometimes, the doctor may take a swab of the blister fluid to test.
Treatment
Most children do not need any treatment for chickenpox other than rest and fluids at home.
If your child has a fever or is in pain, you can give them paracetamol. Follow the directions on the packet carefully. Do not give your child aspirin.
Talk to your child’s doctor or pharmacist about medications or creams to help with itching. Avoid using Calamine lotion as it can dry out the skin and make the spots itchier.
Management
Spread of chickenpox
Chickenpox is highly contagious. This means it spreads quickly from person to person. If your child has not had chickenpox or the vaccine, they are more at risk of getting the virus.
Chickenpox has an incubation period of 10 – 21 days. This means there is a long amount of time before you can see any symptoms. You may not be able to tell if your child has had contact with someone who has the chickenpox virus.
The virus is spread by skin-to-skin contact and fluid droplets from coughing and sneezing. The chickenpox virus can also live on objects, like toys, clothing, and drink bottles, used by someone sick.
Your child will have been infectious for 2 days before the chickenpox rash starts to show. This means they can spread the virus to others. They will stay infectious until all the rash spots form scabs and dry out. This can take 5 – 7 days.
Chickenpox spreads very quickly in households, so it is essential that the whole family is immunised with the chickenpox vaccine.
Children who have chickenpox must stay home from daycare or school while they are infectious. Your child may return to school if the spots are all scabbed over and dry.
Preventing scarring
The chickenpox rash can be very itchy. Scratching the rash can cause bacteria to get into the skin and cause an infection. This can lead to scarring.
To help prevent itching and scarring, you can try:
- dressing your child in lightweight pyjamas or clothing
- clipping your child's fingernails as closely as you can
- putting mittens on the hands of very young children and babies
- changing your child's clothes and bed sheets daily
- applying a soothing lotion like sorbolene.
If your child is very itchy and struggling with scratching, their doctor may suggest medication or creams to help.
Chickenpox vaccine
Chickenpox can be prevented with the chickenpox vaccine. It is also called the Varicella vaccine.
The chickenpox vaccine is included in the National Immunisation Program Schedule for children in Australia, which means the vaccination is free.
Children can get the vaccine at:
- 18 months - included in the measles, mumps, rubella, and varicella (MMRV) vaccine
- up to 19 years - as a catch-up vaccine for anyone not immunised.
Your child should still get the chickenpox vaccine, even if they have already had chickenpox.
Side effects from vaccines are uncommon and usually mild but may include:
- pain and swelling where the needle was injected
- a low temperature
- feeling unsettled and sleepy.
Speak to your local doctor if you have any questions or concerns about the chickenpox vaccine.
When to see a doctor
See your local doctor as soon as possible if your child has chickenpox and:
- develops a high fever
- become very drowsy
- starts breathing fast
- is vomiting
- becomes dehydrated.