Chickenpox is a very common childhood illness, caused by a virus called varicella. It starts with red bumps that become small, yellowish blisters affecting the whole body including the mouth and genitals (which can be very painful). They then open before scabbing over. These are very itchy and can make your child miserable. They may have a temperature, a cough and a runny nose. Children are able to pass the virus to others from the day before the rash appears until the last spot has scabbed over.
Chickenpox rarely needs treatment, unless in a new-born baby, or in a child with a known weak immune system (for example due to weakened immune system due to anti-cancer treatment, immunosuppressive treatment or genetic immunodeficiency). If you are not sure it is chickenpox look at other childhood rashes
If your child has any of the following:
Breathing very fast, too breathless to talk, eat or drink
Is pale, blue, mottled or feels unusually cold to touch
Difficult to wake up, very sleepy or confused
Weak, high-pitched cry or can’t be settled
Has a fit (seizure)
Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')
A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
Increasing pain and redness between the spots:
New blisters/spots appearing after 7 days Rash spreading to the eyes
Baby less than 4 weeks old
Breathing a bit faster than normal or working a bit harder to breathe
Dry skin, lips or tongue
Not had a wee or wet nappy in last 8 hours
Poor feeding in babies (less than half of their usual amount)
Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
Temperature of 38°C or above for more than 3 days, shivering with fever
(rigors) or if the temperature comes back after a few days
Temperature less than 36°C in those over 3 months
Getting worse or you are worried about them
A parent is pregnant and has not previously had chickenpox
Contact with a pregnant woman who has not previously had chickenpox, person with a weakened immune system who has not previously had chickenpox or a newborn baby (the contact should seek advice from a healthcare professional)
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If none of the above are present:
Watch them closely for any change and look out for any red or amber
symptoms
If your child has any other symptoms associated with their fever, you may
want to look at the information on sore throat, cough, earache, diarrhoea
and vomiting or tummy ache or our other pathways.
Additional advice is also available to young families for coping with crying of
well babies.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.
Usually the last spot has crusted over by 5-7 days after the rash first appears
It is highly contagious until spots have dried and scabbed over
Avoid nursery or school for 5 days from rash onset or until all spots are fully scabbed over
Avoid contact with new-born babies, people with a weakened immune system and pregnant women until all of their spots have scabbed over. If concerned regarding this contact your GP
The chickenpox vaccine
The chickenpox vaccine is a vaccine used to prevent catching and spreading the disease. It has recently been recommended but is not yet part of the standard vaccine programme but is offered to children who are at increased risk of severe chickenpox infection and to those with a family member at risk of complications. It is also available privately through travel clinics and pharmacies and costs between £120-£200. More information is available at Chickenpox vaccine overview - NHS (www.nhs.uk)
Seeing your child unwell with chickenpox can be very distressing for a parent and while there is usually no treatment for the virus itself, there are simple things you can do to make your child more comfortable:
Regular Paracetamol for temperature/pain
Antihistamines (eg piriton) can help with itching and aid sleep
Drink plenty of fluid and try ice lollies if your child is not drinking much
Calamine lotion/oat milk bath/Sodium bicarbonate bath for itch
Pat dry after bath rather than rubbing for comfort
Dress in loose clothes
Don’t give ibuprofen or aspirin unless advised to by a doctor
Cut nails/apply hand mittens at night to reduce damage to skin and try to
