Prevention

The best way to prevent chickenpox is to get the chickenpox vaccine. Everyone—including children, adolescents, and adults—should get two doses of chickenpox vaccine if they have never had chickenpox or were never vaccinated. Chickenpox vaccine is very safe and effective at preventing the disease. Most people who get the vaccine will not get chickenpox. If a vaccinated person does get chickenpox, the symptoms are usually milder with fewer or no blisters (they may have just red spots) and mild or no fever. The chickenpox vaccine prevents almost all cases of severe illness. Since the chickenpox vaccination program began in the United States, there has been over 97% decrease in chickenpox cases. Hospitalizations and deaths have become rare. For more information about chickenpox vaccine, see Vaccination.

Treatments at Home for People with Chickenpox

There are several things that you can do at home to help relieve chickenpox symptoms and prevent skin infections. Calamine lotion and a cool bath with added baking soda, uncooked oatmeal, or colloidal oatmeal may help relieve some of the itching. Try to keep fingernails trimmed short and minimize scratching to prevent the virus from spreading to others and to help prevent skin infections. If you do scratch a blister by accident, wash your hands with soap and water for at least 20 seconds.

Over-the-counter Medications

Laughing baby examined by female doctor Do not use aspirin or aspirin-containing products to relieve fever from chickenpox. The use of aspirin in children with chickenpox has been associated with Reye’s syndrome, a severe disease that affects the liver and brain and can cause death. Instead, use non-aspirin medications, such as acetaminophen, to relieve fever from chickenpox. The American Academy of Pediatrics recommends avoiding treatment with ibuprofen if possible because it has been associated with life-threatening bacterial skin infections.

When to Call a Healthcare Provider

For people exposed to chickenpox or shingles, call a healthcare provider if the person:

  • Has never had chickenpox and is not vaccinated with the chickenpox vaccine
  • Is pregnant
  • Has a lowered ability to fight germs and sickness (weakened immune system) caused by disease or medication; for example:
    • A person with HIV/AIDS or cancer,
    • A person who has had a transplant, or
    • A person on chemotherapy, immunosuppressive medications, or long-term use of steroids.

If you have symptoms, call your healthcare provider. Contacting a healthcare provider is especially important if the person:

  1. Is at risk of serious complications from chickenpox because he or she:
    • Is less than 1 year old
    • Is older than 12 years of age
    • Has a weakened immune system
    • Is pregnant

OR

  1. Develops any of the following symptoms:
    • Fever that lasts longer than 4 days
    • Fever that rises above 102°f (38.9°c)
    • Any areas of the rash or any part of the body becomes very red, warm, or tender, or begins leaking pus (thick, discolored fluid), as these symptoms may indicate a bacterial infection
    • Difficulty waking up or confused behavior
    • Difficulty walking
    • Stiff neck
    • Frequent vomiting
    • Difficulty breathing
    • Severe cough
    • Severe abdominal pain
    • Rash with bleeding or bruising (hemorrhagic rash)

Treatments Prescribed by Your Healthcare Provider for People with Chickenpox

Your healthcare provider can advise you on treatment options. Antiviral medications are recommended for people with chickenpox that are more likely to develop serious illness, including:

  • Otherwise healthy people older than 12 years of age
  • People with chronic skin or lung disease
  • People receiving long-term salicylate therapy or steroid therapy
  • Pregnant women
  • People with a weakened immune system

There are antiviral medications licensed for treatment of chickenpox. The medication works best if it is given as early as possible, preferably within the first 24 hours after the rash starts. For more information, see Acyclovir Treatment. For most people, treatment for chickenpox simply involves letting it run its course. Most cases do so without complications in a week to 10 days. Oatmeal baths, calamine lotion, over-the-counter pain relievers and antihistamines, and other options are often used to ease discomfort and itching in the meantime. Some people, however, may benefit from an anti-viral medication. Healthcare providers tend to prescribe this only when particularly vulnerable individuals are affected. The 2 Stages of Chicken Pox Rashes Verywell / Emily Roberts

Home Remedies

Chickenpox is a case where Mom and Dad’s tried-and-true methods for relief are usually the best course of action. These home remedies can help.

Colloidal Oatmeal Baths

Finely-ground (colloidal) oatmeal has been shown to contain a number of compounds that can relieve irritation, inflammation, and itching from chickenpox (and other skin problems). You can buy colloidal oatmeal bath products at your drugstore, supermarket, big-box store, or online. These typically come in pre-measured packets that you add to bath water. But it’s easy to make your own oatmeal bath by grinding oatmeal into a fine powder in the food processor and adding it to warm bath water (it should look milky when mixed). Soak for 15 to 20 minutes.

Baking Soda

For blisters that have ruptured and are oozing fluid, a soak in lukewarm bath water mixed with baking soda can help dry out the blisters and also relieve itching. Aim to do this two or three times a day. Measure the depth of your bathtub, then get a rough sense of how many inches of water you’ve added. Nationwide Children’s Hospital recommends adding one cup of baking soda per inch of water. Remember: Never leave a small child alone in a tub even for a few seconds. Alternatively, you can add just enough water to baking soda to make a paste and then apply it directly to open blisters.

Clipped Fingernails

The best defense against scratching is not having anything to scratch with at all (at least anything sharp). Scratching a chickenpox rash can cause the blisters to open, leaving skin vulnerable to secondary infections and permanent scarring. A small child with the disease may not have the self-control to keep her hands off her rash, so keep her fingernails trimmed and her hands very clean. Adults, of course, can also benefit from this. You also can try putting cotton mittens or socks on a child at night, so she’s less likely to scratch in her sleep.

Over-the-Counter Therapies

Some well-known drugstore options may be worthwhile if itching, pain, or other symptoms become too much to handle or are disruptive to sleep or other parts of your day. Treating chickenpox. Ellen Lindner / Verywell

Calamine Lotion

Calamine lotion is an OTC product containing either zinc oxide or zinc carbonate, ingredients commonly used to treat diaper rash and contact dermatitis. It’s an effective itch-reliever when dabbed directly on the affected area and allowed to dry. You may remember this as the pink lotion you put on bug bites as a child, though it is now also available in clear forms. Calamine lotion comes in different strengths, so it’s important to closely read and follow any directions on the bottle. Take care not to get calamine lotion in your eyes, and don’t apply it to the mucous membranes of the mouth, nose, genitals, or anus.

Tylenol (acetaminophen)

Chickenpox typically causes viral symptoms such as a headache, fever, fatigue, and muscle aches in addition to the itchiness and inflammation of the rash. Tylenol (acetaminophen) or Motrin (ibuprofen), both non-steroidal anti-inflammatory drugs (NSAIDs), can help relieve many of these symptoms. If you have a young child with chickenpox, it’s important to make sure the dose you give her is appropriate for her age and weight. This information is on the medication’s package, but check with your child’s healthcare provider if you’re in doubt. However, do not give aspirin (or any medication that contains aspirin) to a child under 16. Aspirin has been found to put kids at risk of Reye’s syndrome. This potentially life-threatening illness is characterized by vomiting, confusion, personality changes, seizures, liver toxicity, and loss of consciousness.

Oral Antihistamines

For severe itching, an oral antihistamine such as Benedryl (diphenhydramine) may help. This OTC medication, commonly used to treat symptoms of allergies and asthma, causes drowsiness, though, so it’s best taken at night. For daytime relief, a newer-generation antihistamine such as Claritin (loratadine), Zyrtec (cetirizine), or Allegra (fexofenadine) can help relieve itching without the sedating effects.

Prescriptions

For most people, a prescription medication is not part of their chickenpox treatment plan. If the itching from chickenpox rash is so severe that over-the-counter antihistamines aren’t strong enough, your healthcare provider may prescribe a prescription-strength antihistamine, but that is not typically necessary.

Chicken Pox Doctor Discussion Guide

Get our printable guide for your next doctor’s appointment to help you ask the right questions. Doctor Discussion Guide Child Download PDF

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Because chickenpox is caused by a virus (varicella), it won’t respond to antibiotics, but there is an antiviral drug used to treat herpes outbreaks called Zovirax (acyclovir) that’s sometimes helpful for certain people with chickenpox. The timing is tricky, though. To be effective, Zovirax must be taken within 24 hours of the first sign of a breakout. What’s more, the payoff of this perfect timing is negligible for otherwise healthy kids and adults: At most, it will cut the illness short by about a day and decrease the severity of the rash. On the other hand, Zovirax is strongly recommended for newborns, children with an underlying skin condition such as eczema, or those with a compromised immune system. Certain people who are at risk of becoming seriously ill from chickenpox sometimes are advised to receive a drug called VariZIG (varicella zoster immune globulin). According to the Centers for Disease Control and Prevention, persons at risk of severe varicella include children with leukemia or lymphoma who haven’t been vaccinated; people taking immune-system-suppressing drugs and those with immune deficiencies; newborns whose mothers become infected with varicella from five days before until two days after birth; certain premature babies exposed to the virus; and certain pregnant women.

Frequently Asked Questions

    • How long does chickenpox last?The active stage of chickenpox lesions lasts about four to seven days. However, anyone who contracts it is considered contagious—able to transmit the virus to others—from a period of one to two days before its characteristic rash appears until its lesions crust over. Generally, this amounts to a period of one to two weeks.
    • Are there home remedies for chickenpox?Skin-soothing treatments, such as calamine lotion and oatmeal or baking soda baths, can help reduce the itching associated with chickenpox lesions, while over-the-counter pain relievers can reduce discomfort.
    • Is the vaccine for shingles the same as for chickenpox?No. The only currently available vaccine for shingles in the U.S., called Shingrix, differs from the chickenpox vaccine in that it does not contain a live, weakened version of the virus. Instead, it contains a protein isolated from the varicella zoster virus that allows the human immune system to recognize the virus and develop an immune response to it.

By Heather L. Brannon, MD Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years. Thanks for your feedback!


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