Chicken Pox (Children)

What is chicken pox?

Chicken pox is a disease marked by an itchy rash that starts out as multiple small red bumps that quickly change into thin-walled water blisters. These blisters develop into cloudy sores, which finally become dry brown crusts. New waves of rashes often spring up over the next two to four days. The disease typically makes children tired and slightly feverish.

A germ called the varicella zoster virus, which passes from person to person with remarkable ease, causes chicken pox. People with the illness carry the virus on their hands and release it into the air whenever they sneeze, cough, or even breathe. Unless your child has received the chicken pox vaccine or has already had the disease, any protracted contact with an infected person will likely cause her a few days of misery.

Is chicken pox dangerous?

For healthy children, chicken pox is more of a nuisance than a real threat. If your child has a weak immune system, however, the infection can cause serious complications such as pneumonia or encephalitis, a serious brain disease. Children infected with the virus that causes AIDS are especially likely to suffer severe complications, but kids who are undergoing chemotherapy for cancer or taking high doses of corticosteroids for asthma or another condition are also vulnerable. If your child falls into one of these groups, call your pediatrician at the first sign of chicken pox -- or even if your child has merely been exposed to chicken pox: Some special protective measures can only be taken shortly after exposure.

Unfortunately, on rare occasions even healthy children may develop serious complications with chicken pox or a serious bacterial infection. So even if your child doesn't fall into a high-risk group, contact her doctor if she seems sicker than expected, if she develops a fever after the first few days, or if her skin around a chicken pox site or sites becomes swollen, painful, or very red.

Is there any way to prevent chicken pox?

Yes. There is a vaccine for it, and the Centers for Disease Control, the American Academy of Pediatrics and other organizations recommend the shot for any child over 12 months old who hasn't already had the illness. The first shot is given between 12 and 15 months of age and children should have a second dose between 4 and 6 years of age. Since the vaccine contains a live -- although weakened -- virus, experts don't recommend the shots for chemotherapy patients or anyone with a faulty immune system.

Not every pediatrician is sold on the vaccine. It causes few side effects in healthy children, but it also fails to completely immunize 10 to 30 percent of the kids who get it. Vaccinated children who later come down with chicken pox tend to have very mild cases and may not even develop a rash. But some doctors are concerned that vaccinated children might lose the chance to develop the mild childhood version of the illness and instead catch chicken pox as adults, when the disease can do serious damage.

Your child's doctor can help you weigh the pros and cons of the vaccine. Here's something to consider: If a bout of chicken pox would pose a huge inconvenience to you or your child, a vaccination may well be worth the small risk of future trouble.

How is chicken pox treated?

Your child should stay home for a week or more to get some rest and avoid spreading the disease. (Assume she's contagious until all the sores have crusted over.) While she's recuperating, she'll appreciate anything you can do to relieve the itching. Give her a cool bath every three to four hours, and mix 4 tablespoons of baking soda with the bathwater. Oatmeal baths are soothing, too. After the bath, put calamine lotion on the itchy spots. Oral diphenhydramine (Benadryl) may also be useful, though it can make her sleepy; do not use Benadryl ointment on your child's skin, however.

It may seem like an impossible task, but try to keep your child from picking and scratching her sores. Sores that aren't allowed to heal can leave scars or lead to skin infections such as impetigo.

Bring down her fever with acetaminophen. Do not give aspirin to your child (or to anyone under the age of 20) while she has chicken pox or any other viral infection. If you do, she faces a small but real risk of Reye's syndrome, a condition that can be deadly.

Doctors can prescribe an antiviral drug called acyclovir to treat chicken pox, but it's not generally recommended for otherwise healthy children. The drug can reduce the number of sores, but it doesn't make the itchiness go away faster and it doesn't prevent complications. For children with weak immune systems, however, acyclovir can be crucial.

Further Resources

Pantell, Robert H. M.D., James F. Fries M.D., and Donald M. Vickery M.D. Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care, Eighth Edition. Da Capo Lifelong Books.

References

Health Magazine editors. The Self-Care Advisor: The Essential Home Health Guide for You and Your Family. 2000. Time Life Medical.

Infectious Diseases and Immunication Committee, Canadian Paediatric Society. The uses of acyclovir in children. The Canadian Journal of Paediatrics; 1(6):192-196.

Centers for Disease Control. 2022 Childhood & Adolescent Immunization Schedules. http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm