Tips on Dealing With Chickenpox by Dermatologist Dr.Hanish Babu, MD

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CHICKENPOX

Chickenpox or Varicella is caused by varicella zoster virus. It is usually a disease of childhood, but those who have not contracted it in childhood, can suffer from it in adulthood as well. The severity of the infection will be higher when adults get chickenpox.

A very effective varicella vaccine is available for the immune compromised and the adults at risk. Whether all children should receive vaccine or not is a controversial issue.

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The disease begins as a mild febrile disease resembling a common cold with fever and body pain. In 1-2 days, there is an erythematous eruption behind ears, neck and body. These within one day bloom into itchy vesicles. These eruptions occur successive eruptions over 3-7 days with the whole disease course consisting of 3 to 4 such waves of eruptions.

When a new crop of vesicles appear, there may be rise in body temperature. In 2-3 days the vesicles become pustules, become crusted erosions in another 2-3 days and start shedding scabs in other 3-4 days. The whole disease process spreads over 10-14 days usually.
When patients come with severe febrile illness and generalized eruption with a possibility of severe scarring later on, I always put them on acyclovir or famcyclovir for a period of 5-7 days. Antiviral therapy helps in 6 ways:

It will reduce the duration of illness

It will reduce the severity of the eruptions

It will promote faster healing

It will reduce the chances of deep scarring

It will reduce transmission

It will reduce chances of complications like meningitis, encephalopathy etc.

The only precaution, is that it should be started as soon as the first few vesicles erupt. After 72 hours of onset of the illness, the antiviral therapy will not alter the course of the disease.

The varicella vaccine may be given to children above 1 year. Children below 12 years should receive a single dose while adults will have to receive two doses 1 month apart. Usually the vaccine gives lifelong protection. Those who do get chickenpox even after vaccination get a very mild attack.

When to Consult a Dermatologist?

When the eruption seems generalized and severe
If there is high grade fever
If there is severe headache or vomiting
If there are generalized eruptions on the face.
Consult as early as possible

Frequently Asked questions

Can a person get chickenpox again?

Usually one attack in childhood provides immunity throughout life. But there are exceptions: Immune compromised individuals can get second or third attacks. I have also come across at least half a dozen patients with normal immune status get second attacks, albeit in a mild manner, in later life. The reason may be contact with a particular virulent variant of the virus or temporary lowering of immune status. This is possible after about 25-30 years of the first infection.

Is it not better for the disease takes its on course than treating with anti viral drugs?

If the disease is severe, it can cause serious scars. Treatment can prevent this up to an extend. In immune-compromised individuals, the disease can cause serious complications like menigeal or lung infections and death. In adults, the sick leave can be reduced by half if treatment is instituted early.

When is the chickenpox infective?

Chickenpox patients are infective 2-4 days prior to the skin eruptions! The transmission is through the respiratory tract during this period. During the eruptive period, transmission is mainly through vesicular fluid. Once the lesion completely dry up and the crusts are devoid of any moisture, the disease in non infective.

If there are anyone in the household, who have not had chicken pox previously, they should keep away from the patient as far as possible, use of a mask covering both nose and mouth for both patient and other members will reduce the severity of infection in the next batch of sufferers. They should also not share the same toilet as the patient , as the viral shedding will be higher in toilets.

Can a patient with chickenpox take bath?

It is better to avoid bathing during the initial febrile eruptions and during the successive crops of eruptions. However, the patient can have tepid sponge bath when there is no fever. Calamine lotion may be applied to relieve itching and promote drying after bath. Once crusting starts, bathing can be taken daily.

What should be the diet?

Not cold, not hot. Not Spicy. No coffee, tea, colas. Avoid fries. Drink lots of water and fresh juice. Otherwise normal diet.

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About Your Online Dermatologist

Dr.Hanish Babu, MD is a non resident Indian Dermatologist & Venereologist practicing in Ajman, UAE. He is the author of the well known Stress management package 10 Days to Stress Free Life and a net-entrepreneur. He is also a certified hypnotist, stress management trainer and personality development trainer. He is the web editor of half a dozen web sites on the above subjects.

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Disclaimer

Information on this site is provided for informational purposes and is not meant to substitute for the advice provided by your own dermatologist or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. Many skin diseases have similar morphology and may resemble one another. But their treatment varies. Hence, self diagnosis and treatment are not advised. In case of doubt always be on the safer side and consult your dermatologist. Your online dermatologist will give you special tips to deal with specific skin and cosmetic problems.

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