• 1 week ago

Chickenpox (Varicella) in Children

What Is Chickenpox?

Chickenpox is a highly contagious viral illness caused by the varicella-zoster virus. It most commonly affects children between the ages of 1 and 10 and is known for its itchy, blister-like skin rash. While generally mild, chickenpox can cause complications in infants, immunocompromised children, and adults.

After a child recovers, the virus remains dormant in the nervous system and may reactivate later in life as shingles (herpes zoster).

Symptoms of Chickenpox

The illness typically begins with:

  • Mild fever, fatigue, loss of appetite
  • 1–2 days later, red spots appear—first on the face, chest, or back
  • Spots evolve into fluid-filled blisters, then burst and crust over
  • Rash appears in waves—so blisters, scabs, and fresh spots may coexist
  • Intense itching is common
  • Blisters may also appear in the scalp, mouth, eyes, or genital area

Most children recover within 7–10 days, but care is needed to prevent secondary infections and manage symptoms.

How Does It Spread?

Chickenpox is extremely contagious.

  • Spreads through respiratory droplets (coughing, sneezing)
  • Direct contact with the fluid in blisters
  • A person is contagious from 1–2 days before the rash appears until all blisters are crusted over
  • Easily spreads in schools, daycare, and among siblings

Diagnosis

Chickenpox is usually diagnosed clinically—no lab tests are needed in typical cases.

  • A characteristic rash pattern and recent exposure are key clues

  • In uncertain or complicated cases:
     
    • Varicella IgM test (blood)
       
    • PCR test (to detect viral DNA)
       
    • Rarely required unless complications arise

Home Care and Symptom Relief

Itching:

  • Cool baths with baking soda or colloidal oatmeal
  • Antihistamines (with pediatrician’s advice)
  • Keep nails short to avoid skin infections from scratching
  • Apply soothing lotions (calamine, aloe vera)

Fever:

  • Use paracetamol (acetaminophen) for fever and discomfort
  • Avoid aspirin—risk of Reye’s syndrome

Nutrition:

  • Offer plenty of fluids and soft foods
  • Avoid acidic, salty, or spicy items if blisters are present in the mouth

Clothing:

  • Dress in lightweight cotton clothing
  • Keep skin cool to reduce itching

Who Is at Higher Risk for Complications?

  • Infants under 1 year
  • Children with weakened immune systems (due to illness or medication)
  • Children taking long-term steroids
  • Those with chronic illnesses (e.g., diabetes, asthma)

In these groups, chickenpox can lead to:

  • Skin infections
  • Pneumonia
  • Encephalitis (brain inflammation)
  • Dehydration

In such cases, antiviral treatment (e.g., acyclovir) may be needed and must be initiated early.

Prevention: The Chickenpox Vaccine

  • The varicella vaccine is safe and effective

  • Recommended in 2 doses:

    • 1st dose: 12–15 months
       
    • 2nd dose: 4–6 years
       

  • Not part of all national immunization schedules but highly recommended

  • Vaccinated children may still get chickenpox, but it is typically very mild

Care and Guidance with Dr. Ekin Pasinlioğlu

  • Confirming the diagnosis and guiding home isolation
  • Providing a personalized care plan for itch, fever, and skin protection
  • Assessing for antiviral need in high-risk children
  • Monitoring for signs of bacterial superinfection
  • Supporting school/daycare re-entry timing
  • Advising household contacts and reviewing vaccination status