Diagnosing and treating chickenpox

How is chickenpox diagnosed?

Any rash, especially if it is accompanied by cold or flu symptoms, including a fever, should be assessed by a medical doctor. These are often signs of any number of viral and sometimes bacterial infections. Many infections are contagious and will require careful treatment.

A doctor will assess the overall symptoms being experienced and conduct a physical exam, assessing the nature of rash and blisters on the body.

Your doctor may ask you a series of questions which can include:

• When did you first begin to feel unwell?
• What symptoms or changes to your body have you noticed?
• Do you know of anyone with chickenpox you may have recently been exposed to?
• Have you, or has your child, been vaccinated against chickenpox?
• If yes, how many doses of the vaccine have been administered?
• Are you, or your child, currently taking any medications or supplements (over-the-counter or prescribed)?
• Is your child attending a child care facility or school?
• Are you pregnant?
• Are you a new mom and breast-feeding?

Confirmation of chickenpox can be done with the assistance of blood tests or a culture of lesion samples.

Those who are potential high-risk cases, especially, will need to be diagnosed by a doctor as soon as any suspicion arises, so as to avoid any potential complications.

Chickenpox Treatment

In most instances a mild chickenpox infection will require homecare. A doctor will likely advise way to best manage the infection symptoms while the virus works through the body’s system. A doctor will also insist on keeping away from public places, work or school while an infection is contagious.

Treatment recommendations will take into account a person’s age, overall health condition, how long ago exposure to the virus took place, the symptoms being experienced, as well as whether you fall into a high-risk category.

• A generally healthy child experiencing itching and fever will be required to stay home. A doctor will prescribe or recommend non-aspirin based medications to help reduce fever. It is vitally important that children with a viral infection are never given aspirin as it places them at high risk of developing Reye’s Syndrome, which is a condition that severely affects the liver and brain, and can result in death.
• Teenagers and adults experience more severe symptoms and are thus at higher risk for possible complications. In this case, as well as if there are signs of a weak immune system, or a woman is pregnant, a doctor may prescribe antihistamine medications to help protect against the virus and topical ointments to help alleviate itching.
• If high-risk, antiviral medications may be prescribed to reduce or prevent possible complications as a result of the viral infection. The medications are not prescribed as a ‘cure’ for chickenpox, but more so to alleviate any potential complication risks, reduce chickenpox symptoms and assist the body with healing.

Treating chickenpox at home

For the most part, homecare treatment recommendations will be made by your doctor to best ensure relief from symptoms, and prevent any further infections. Unless a case of chickenpox is complex, the following self-care measures can be easily implemented at home:

• Avoid scratching: Although blisters and rash can be quite itchy and broken blisters which leak can also sting, scratching such a tender area can lead to sores becoming infected, as well as scarring once healed. Scratching also slows down the healing process. It is a good idea to trim down fingernails or wear gloves to try and reduce the possibility of causing scarring damage to the itching rash and blistered areas of the body. It is also a good idea to wash hands often to reduce bacteria build-up, which can aggravate an infection when in contact with the inflamed areas of the body. It can sometimes help to provide children with distraction in order to deter them from scratching as a means of alleviating itch.
• A cool or lukewarm bath: Soothing ingredients you can put into a cool or lukewarm bath include just a handful of baking soda, colloidal oatmeal (a finely ground oatmeal) or uncooked oatmeal (this can be ground down to a powder). A 20 to 30-minute soaking in cool or lukewarm water as often as is needed can help to alleviate itching and keep you clear, reducing any chance for bacteria to worsen the infection. A doctor may recommend a mild soap (if any at all) to use that is made for sensitive skin. It is best to blot or pat the skin dry instead of rubbing which will aggravate blisters, rash and sores.
• Calamine, antihistamine and oatmeal lotions: Those that contain antihistamines should only be recommended by your doctor and used sparingly (too much lotion can be damaging to the already very sensitive skin). Typically, any antihistamine treatment that is prescribed to alleviate itching may be recommended orally (taken in pill form by mouth), especially at night before bed, and not as a lotion. Calamine (camphor, menthol and phenol) and oatmeal lotions can be used to dry out and soothe blistered areas of the body. Dab on itching and stinging blisters and sores to help soothe inflammation.
• Cool compresses: A soft, absorbent cloth can be wet with cool water and applied directly to the skin to help alleviate itching and stinging. Oatmeal can also be made into a paste (ground oatmeal mixed with warm water) and applied to itching areas of the body using a soft paper towel to relieve discomfort. It is best to apply the paste directly on the towel and place on an infected area of the body, and then hold it there for between 10 and 15 minutes. A soft cloth can then be used to gently wash the area clean, and then pat dry with a clean towel.
• A bland diet: Although it doesn’t sound very appealing, if blisters and rash develop around the mouth, a soft and bland diet can help to alleviate aggravation to sensitive and tender areas.
• General hygiene practices: Wear loose-fitting clothing – cotton is soft and won’t cause any aggravated inflammation or discomfort. Use a mild laundry detergent to clean linens and clothing (clothes and bedsheets should be washed daily). It is also a good idea to be mindful of getting hot (doing activity that increases body temperature and leads to sweating) as this can aggravate itching. It sometimes helps to stay out of sunlight until the infection has cleared.

What is the long-term outlook for chickenpox?

In less complex instances, chickenpox infections typically clear themselves and work through the system. Within a few weeks, normal activities can resume. Once an infection clears, most become immune to the VZV virus (when it becomes dormant in the body).

It is rare, but a person can experience a second round of chickenpox in adulthood when their immune system temporarily weakens (due to illness or advanced aging). The VZV virus can either reactivate as chickenpox or morecommonly as shingles (also triggered by varicella-zoster virus).