Chickenpox (Child)

Chickenpox (varicella zoster) is a contagious illness caused by a virus. It occurs most often in children younger than 8 years old, but it can occur at any age. It causes an itchy skin rash that appears as bumps and blisters. The rash can spread all over the body.

In the past, chickenpox was very common. There is a vaccine that can protect your child from getting it. If your child has not had the vaccine, ask your child’s healthcare provider for more information about it.

Chickenpox can start with a slight fever, but some children have no fever at all. Your child may be tired and not interested in eating. After the fever starts, itchy red spots appear on the skin. The spots are more common on the face, head, and trunk. They appear less often on the arms and legs. The spots can occur all over the body, including inside the mouth. The spots then turn into small blisters. The blisters typically crust over and clear within 1 to 2 weeks.

Your child may be given antiviral medicine. Antiviral medicines are more commonly used in teens and children with asthma or eczema. Antihistamines and calamine lotion may help reduce itching. Skin care helps prevent infection.

Home care

  • Your child’s healthcare provider may prescribe medicines to treat the virus or reduce swelling and itching. Follow the healthcare provider’s instructions when giving your child these medicines.

  • Don’t give aspirin to a child younger than 19 years old. Aspirin can cause serious side effects such as liver and brain damage caused by Reye syndrome. This syndrome is rare, but it's closely linked to aspirin use during viral infections such as chickenpox.

  • Keep your child home from school or daycare for at least 1 week, or until all blisters have formed a crust.

  • Dress your child in clean, loose cotton clothing. It will absorb moisture and keep the skin cool. Change clothing often.

  • Bathe your child in lukewarm water to reduce itching. Oatmeal baths may be soothing and help with itching. You can buy oatmeal baths at a grocery or drugstore.

  • Put calamine lotion on the blisters to reduce itching if your provider tells you to.

  • Try to keep your child from scratching the blisters. Scratching will make the healing take longer. Put warm, wet compresses on itchy areas. Keep fingernails short to help prevent scratching.

  • Carefully wash your hands with soap and clean, running water before and after caring for your child. This will help keep the infection from spreading from the blisters.

Follow-up care

Follow up with your child’s healthcare provider, or as advised, if the above tips don’t bring relief.

Special note to parents

Chickenpox spreads easily. It's contagious from 1 to 2 days before a rash develops until all skin blisters are crusted over. Chickenpox is particularly dangerous to pregnant women if they have never had chickenpox or the vaccine. Keep your child away from friends and other family members, especially if they have not had chickenpox, have a weak immune system, or have not been vaccinated.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Signs of skin infection. These include colored drainage from the sores and redness or tenderness of the sores that gets worse.

  • Blisters that appear very near or in the eye

  • Cough with trouble breathing or fast breathing. In children age 6 weeks to 2 years, fast breathing is more than 45 breaths per minute. In children age 3 to 6 years, fast breathing is more than 35 breaths per minute. In those age 7 to 10 years, fast breathing is more than 30 breaths per minute. In those older than 10 years, it's more than 25 breaths per minute.

  • Chest pain

  • No interest in eating or drinking

  • Signs of dehydration. These include less urine than normal, very dark or strong-smelling urine, or sunken eyes.

  • Headache, confusion, or difficulty being awakened

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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