Dr Morton's

medical empowerment

012 123 123 12

Email a GP Register for free Log in
  • Home
  • Real Doctors
  • Helpline prices
  • Prescriptions
  • FAQ
  • News
In the news...

Chickenpox treatment and potential complications

chicken pox photo showing blisters
Posted by Dr Mortons 2 Comments

Written by Dr Michael Ryalls, Consultant Paediatrician and adviser to Dr Morton’s – the medical helpline

See Dr Morton’s  diagnose skin rash  and understand your prescription

The chicken pox virus is widespread and most UK children have been infected by adolescence. Spread is by droplets and direct contact so being in the same room as someone with chicken pox, can lead to infection in those who are susceptible. Once infection has occurred, lifelong immunity ensues in most and those previously infected will not contract the virus or transmit it after contact with someone who has it.

For most children, chickenpox, or Varicella zoster (VZ), is a benign disease. For a small minority the disease can prove to be a nightmare

Groups who are more likely to suffer badly include older people; pregnant mums; babies less than a month old; anyone with an immune function problem such as AIDS, those on steroid treatment or on chemotherapy; people with eczema (in whom the rash can be particularly severe known as eczema herpeticum). If someone develops chicken pox and is away from school or work, it is important to inform the appropriate people there because there may be others who have come into contact who need to be aware because there is treatment available should they develop symptoms.

Prevention

In USA since 1995 a vaccination programme has reduced the infection rate drastically. Booster immunization is required and waning immunity in those who have been immunized in childhood much later in life may leave the very old, who are at severe risk of complications, vulnerable. In UK it is not felt that the benefits of the vaccination outweigh the cost of giving it. The vaccination is available privately.

Treatment

Most affected children do not require specific anti viral treatment. For those at risk of severe disease it is important to start treatment early and effectively which may mean admission to hospital for intravenous treatment. Non specific treatment to reduce the discomfort may include gentle bathing in water that is not too hot and patting dry rather than rubbing; keeping fingernails short, using mittens and socks to stop deep scratching and subsequent scarring; keeping up with fluid intake; DO NOT USE IBUPROFEN (JUNIFEN / NUROFEN) as this may increase the possibility of the pox becoming infected with bacteria and DO NOT USE ASPIRIN as this can increase the possibility of a rare serious complication called Reyes syndrome. Paracetamol (Calpol) in appropriate doses may help fever. Calamine lotion may make it even more itchy.

Worrying features

Unusual redness or swelling around the rash may indicate secondary infection requiring antibiotics; refusal to drink or frequent vomiting (the rash can involve mouth, eyelids and genitals making it painful to swallow, blink and pass urine) leading to dehydration; confusion, unusual irritability, extreme drowsiness or unsteadiness on walking, severe headache, stiff neck or back pain, photophobia, (may indicate VZV has infected the brain); difficulty in and rapid breathing, chest pain, wheezing or severe cough (may indicate lung complications); fever lasting more than four days or recurrence of fever once it has settled; unusual deterioration in symptoms. You should request an urgent home visit and if especially worried go to A&E but please ring them first to tell them you are coming in order that they may take appropriate precautions to prevent spread of infection.

Course of infection and appearance

The chicken pox incubation period comes 10–21 days after catching the virus. Then, a non-specific viral type fever with mild cough, sore throat and sometimes abdominal pain can begin. After another one to two days the rash begins. It starts as individual flat red spots which become small blisters with dimples measuring < 0.5cm and are hugely itchy, the blisters become reddened then pustular and eventually scab over five to six days later. They come in crops anywhere over the body appearing over three to five days so that at any stage there can be new spots developing whilst older spots are becoming scabbed. Once they have stopped appearing and have all scabbed they are no longer infectious. The lesions have usually healed by 16 days but may take up to five weeks. Those with prolonged healing are more likely to have some immune function defect. Infected individuals are infectious to others for one to two days before the rash develops. If three weeks after the initial contact no fever develops it is unlikely that infection has occurred.

Late complications

About one in 4000 can develop post infectious cerebellitis causing unsteadiness in gait two to three weeks after the initial infection. No specific treatment is available. After infection chicken pox can remain dormant in the sensory cells of the spinal cord. For no clear reason and sometimes decades later, these dormant virus particles can reactivate, move down the nerves and reappear at the skin in a patch supplied by the infected nerve as the painful shingles rash (or herpes Zoster). Shingles is contagious to those who have never had chicken pox but not as contagious as chicken pox itself. Other uncommon potential late effects include kidney, heart and eye problems.

Share on FacebookTweet about this on TwitterShare on LinkedInShare on TumblrEmail this to someoneShare on Google+
Tags: chickenpox

2 Responses

  • Benjamin Adams says:
    January 20, 2016 at 9:54 AM

    This was very informative and I do think that the chicken pox vaccine is good for those who are older and vulnerable, but as with young children it is better for them to get it over and done with to develop a lifelong immunity to it. I think the idea of only making it available privately is wise.

    Reply
  • Geraldine Walford says:
    June 19, 2015 at 3:55 PM

    A really helpful and informative article.

    Reply

Leave a Reply

Click here to cancel reply.
Name:
Email (will not be published):
Website (not required):
Comments:
Search for:

Recent posts

  • Cervical cancer symptoms
  • Chest infection symptoms: acute bronchitis
  • Chest infection symptoms: pneumonia
  • Help with Fertility
  • It’s never too late to start getting fit!
  • It’s time to take control of our health; hard data is what the doctor needs!
  • Choosing the right foods to manage healthy blood sugar levels
  • Why does COVID-19 (SARS-CoV-2) cause such damage in some people but not in others?
  • The value of having a dog or cat at this difficult time must be huge!
  • Coping with isolation: difficult times with COVID-19

Topics

  • Allergy, asthma or hay fever
  • Anxiety, stress or emotional health
  • Bereavement
  • Cancer
  • Charity
  • Cold Sores
  • Cold, coughs and flu
  • Diabetes
  • Domestic abuse
  • Dr Morton’s casebook
  • Ear, nose and throat
  • Email marketing
  • Ethics
  • Fatigue
  • Fever or high temperature
  • Gender pay gap
  • Grief
  • Heart disease
  • In the news
  • Infectious Diseases
  • Junior Doctor Cartoon Campaign
  • Junior Doctor Strike
  • Long-term medical conditions
  • Medical specialty
  • Medication enquiry
  • Men’s health
  • News
  • NHS
  • Nutrition
  • Other medical conditions
  • Pain, headaches and migraine
  • Pregnancy
  • Rash or skin condition
  • Sexual health
  • Sports injuries, bones, muscles and joints
  • Stem Cells
  • Stomach ache, diarrhoea or lower gut
  • Travel health
  • Uncategorized
  • Women's health

Real Doctors at Dr Morton's in the news...

Appearance of Dr Morton’s doctors, at the request of TV or other media channels to make expert comment on medical matters, does not amount to advertising or endorsement

  • About Us
    Our story
    Our values
    Our doctors
    NHS ♥
  • Getting started
    How it works
    Terms and conditions
    Our pharmacy
    Our laboratory
  • Trust & Security
    Privacy policy
    CQC Regulated
    Cookies
    Recommend us
  • Connect

    Contact us
    Delivery information
    Site map