Treatment for chickenpox - PART-III

 

 

For most children

Treatment is mainly aimed at easing symptoms and trying to make your child as comfortable as possible whilst the immune system deals with the virus.

 

• Advice on dealing with a high temperature (fever) is detailed below.
• A soothing cream (emollient) may help the itch. Calamine lotion is the one most used, although it is not known how effective it is.
• A sedating antihistamine (in a tablet or liquid medicine) may help with sleep if itch is a problem. This can be used in children over 1 year old. Give a dose at bedtime. You can buy these at pharmacies or get them on prescription. Chlorphenamine (Piriton®) is the one most used. It can also be helpful for itch during the daytime but may cause some sleepiness as a side-effect.
• Keep fingernails cut short to stop deep scratching.
• Dress children comfortably so they are not cold or overheated. Use cool smooth fabrics such as cotton.

 

Dealing with a fever:

A fever commonly occurs with chickenpox, and may make your child feel uncomfortable and irritable. The following are things that you can do that may bring the temperature down and make your child feel more comfortable:

 

ü  You can give paracetamol to lower a temperature. You can buy paracetamol in liquid form, or as melt-in-the-mouth tablets, for children. It comes in various brand names. The dose for each age is given with the medicine packet. 

Note - 01 : paracetamol does not treat the cause of the fever. It merely helps to ease discomfort. It also eases headaches, and aches and pains. You do not need to use paracetamol if your child is comfortable and not distressed by the fever, aches or pains.

Note - 02 : ibuprofen has been used with paracetamol in the past. The National Institute for Health and Care Excellence (NICE) has recommended that ibuprofen no longer be used for chickenpox. This is because some studies suggested that there may be an association with more severe skin reactions if ibuprofen is used for chickenpox. While more evidence is awaited, the advice is to avoid ibuprofen in this situation.

 ü  Take extra layers of clothes off your child if the room is normal room temperature. It is wrong to wrap up a feverish child. The aim is to prevent overheating or shivering.

 ü  Give lots to drink. This helps to prevent a lack of fluid in the body (dehydration). You might find that a child is more willing to have a good drink if they are not so irritable. So, if they are not keen to drink, it may help to give some paracetamol first. Then, try the child with drinks half an hour or so later when his/her temperature is likely to have come down.

 

Do not cold-sponge a child who has a fever. This used to be popular, but it is now not advised. This is because the blood vessels under the skin become narrower (constrict) if the water is too cold. This reduces heat loss and can trap heat in deeper parts of the body. The child may then get worse. Many children also find cold-sponging uncomfortable.

 

Some people use a fan to cool a child. Again, this may not be a good idea if the fanned air is too cold. However, a gentle flow of air in a room which is room temperature may be helpful. Perhaps just open the window or use a fan on the other side of the room to keep the air circulating.

 

Lifestyle and home remedies

For most mild cases of chickenpox, resting, staying home, and employing some home remedies or over-the-counter products to ease the itching and discomfort are all that’s needed. Adults and children at risk of complications may be prescribed antiviral drugs to reduce the severity and duration of chickenpox symptoms.

 

To help ease the symptoms of an uncomplicated case of chickenpox, follow these self-care measures.

 

Avoid scratching

Scratching can cause scarring, slow healing and increase the risk that the sores will become infected. If your child can't stop scratching:

• Put gloves on his or her hands, especially at night
• Trim his or her fingernails

Relieve the itch and other symptoms

The chickenpox rash can be very itchy, and broken vesicles sometimes sting. These discomforts, along with fever, headache and fatigue, can make anyone miserable.

 

For relief, try:

ü  A cool bath with added baking soda, aluminum sulfate and calcium acetate (Domeboro, others), uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for soaking.

ü  Calamine lotion dabbed on the spots.

ü  A soft, bland diet if chickenpox sores develop in the mouth.

ü  Antihistamines such as diphenhydramine (Benadryl, others) for itching. Check with your doctor to make sure your child can safely take antihistamines.

ü  Acetaminophen (Tylenol, others) for a mild fever.

 

If fever lasts longer than four days and is higher than 102 deg. Celsius , call your doctor. And don't give aspirin to children and teenagers who have chickenpox because it can lead to a serious condition called Reye's syndrome.

 

Talk with your doctor before giving any type of nonsteroidal anti-inflammatory drug (NSAID) — such as ibuprofen (Advil, Motrin IB, others) — to someone who has chickenpox. Some studies suggest this type of medication may lead to skin infections or tissue damage. 

 

For special at-risk groups

Some children have a higher risk of developing complications from chickenpox. In addition to the above treatments, they may need extra treatment such as aciclovir (an antiviral medicine) or vaccination. If your child has not already had chickenpox and is in one in the following groups, you should see a Medical Practitioner urgently if they have contact with chickenpox, or have symptoms of it.

 

• Children (babies) less than 1 month old.
• Children with a poor immune system. For example, children with leukaemia, immune diseases or HIV/AIDS.
• Children taking certain medication such as steroids, immune-suppressing medication or chemotherapy.
• Children with severe heart or lung disease.
• Children with severe skin conditions.

 

Antiviral medication is also used for adults and teenagers who develop chickenpox, as they too have a higher risk of complications. However, antiviral medication is not normally advised for healthy children aged over 1 month and under 12 years who develop chickenpox.

 

Is chickenpox infectious?

A person with chickenpox is very infectious. The virus spreads in the air from person to person. For example, if you have not already had chickenpox, you stand a good chance of catching it if:

• You are in the same room as someone with chickenpox for more than 15 minutes; or
• You have any face-to-face contact with someone with chickenpox, such as a conversation. 

Nine in ten people who have not had chickenpox would catch it after being exposed in this way. It takes between 7 and 21 days (most commonly 10-14 days) to develop symptoms after catching the virus (the incubation period).

  

Medication Options

Most of the time, no medications are needed to treat chickenpox. If you or your child has severe itching, talk to your doctor about taking an antihistamine to help control it.

If you or your child has a fever due to chickenpox, taking acetaminophen (Tylenol) can help lower it.

 

For people with an elevated risk of complications from chickenpox, doctors often prescribe an antiviral drug, such as acyclovir (Zovirax, Sitavig).

 

Other antiviral drugs that may be options for some people include valacyclovir (Valtrex) and famciclovir (Famvir).