Chickenpox: Symptoms and Home Care

Chickenpox is a common infection that most children get through safely at home. The job for parents is to keep the child comfortable, stop them scratching, keep them away from people who could become seriously ill, and recognise the small number of signs that need a doctor.

What does chickenpox look like?

The NHS describes a rash that moves through three stages:

1. Spots appear. Small spots anywhere on the body, including inside the mouth and around the genitals. They can look red, pink or skin-coloured depending on skin tone.
2. Spots become blisters. They fill with fluid, become very itchy, and may burst.
3. Blisters form scabs. Some scabs become flaky, others leak fluid before drying up.

A person may develop as many as 500 blisters, and CDC says it usually takes about a week for all of them to scab over. Alongside the rash there is often a high temperature, aches and pains, loss of appetite and a general feeling of being unwell. The spots start appearing 1 to 3 weeks after catching the infection, and most people recover within 1 to 2 weeks.

How long is chickenpox contagious?

The NHS says chickenpox can spread from two days before the spots appear until every spot has formed a scab, which is usually about five days after the spots start. Stay away from nursery, school or work until all the spots have scabbed.

During this time, stay away from newborn babies, anyone who is pregnant, and anyone with a weakened immune system. CDC warns that chickenpox can be serious and even life-threatening during pregnancy, in babies, in teenagers and adults, and in people whose immune system is weak.

How do you care for chickenpox at home?

Things that help, according to the NHS:

• Drink plenty of fluids to avoid dehydration
• Cut fingernails short, and put socks on a small child's hands at night so scratching does less damage
• Bathe in cool water and pat the skin dry rather than rubbing it
• Wear loose, soft clothing
• Use a cooling cream or gel from a pharmacy to ease the itching

Things to avoid:

• Do not give aspirin to anyone under 16.
• Do not use ibuprofen for chickenpox unless a doctor has told you to.
• Do not scratch the spots, because scratching leads to scarring and skin infection.
• Do not go near newborn babies, pregnant women, or anyone with a weakened immune system.

Can chickenpox be prevented?

CDC recommends two doses of chickenpox vaccine for people who have never had the illness or the vaccine, and says most people who are vaccinated will not get chickenpox. Availability differs from country to country, so ask your doctor whether it is offered where you live. CDC also notes that a vaccinated person who does catch it is contagious until no new spots have appeared for 24 hours.

When to see a doctor

See a doctor if you are not sure the rash is chickenpox, or if you are breastfeeding and develop symptoms. Get medical help urgently if:

• The skin around the blisters becomes red, hot and painful, which can mean a bacterial skin infection
• A child shows signs of dehydration: very little urine, a dry mouth, no tears when crying, or unusual drowsiness
• Breathing becomes fast or difficult, or there is shortness of breath
• A newborn baby may have chickenpox
• You are pregnant or have a weakened immune system and have been near someone with chickenpox
• Symptoms are getting worse rather than better

For severe breathing difficulty or a child you cannot wake, call Rescue 1122 where available, or go to the nearest hospital emergency department.