Chickenpox: Controlling the itch

Chickenpox (varicella) is a common contagious illness caused by the varicella-zoster virus, a type of herpes virus. Initial symptoms are typical of other minor infections, such as a fever, loss of appetite, fatigue, headache, and sore throat. The chickenpox rash usually develops 1 or 2 days later.

The chickenpox rash is very itchy and begins with red spots or bumps that change into pimplelike blisters filled with a clear or cloudy liquid. The blisters eventually break or burst, causing the fluid to leak. As the sores heal, a dry crust forms and protects the skin.

Test Your Knowledge

1. Scratching a rash from chickenpox is okay as long as I keep my fingernails short.

   1. True

      This answer is incorrect.

      You should try to avoid scratching as much as possible, regardless of the length of your fingernails. Bacteria can spread from your skin or from under your nails (even short nails) and infect the rash. Scratching also can lead to increased scarring.

   2. False

      This answer is correct.

      You should try to avoid scratching as much as possible, regardless of the length of your fingernails. Bacteria can spread from your skin or from under your nails (even short nails) and infect the rash. Scratching also can lead to increased scarring.

2. When my child or I develop a rash from chickenpox, I will need a prescription to stop the itching.

   1. True

      This answer is incorrect.

      Most healthy children and adults can treat the chickenpox rash at home with baths and certain over-the-counter medicines and lotions. Home treatment can help ease the discomfort and control itching.

   2. False

      This answer is correct.

      Most healthy children and adults can treat the chickenpox rash at home with baths and certain over-the-counter medicines and lotions. Home treatment can help ease the discomfort and control itching.

The most common complication of chickenpox is a skin infection. When you scratch the blisters that develop from the chickenpox rash, they can become infected from the bacteria on your hands and under fingernails, especially when sores break open. If you develop a skin infection, you will likely need to see a health professional for a prescription medicine to treat the infection.

Scratching the rash also can cause scars.

Test Your Knowledge

1. The most common complication of chickenpox is skin infection, which can be caused by scratching the rash.

   1. True

      This answer is correct.

      Even otherwise healthy children and adults can develop a skin infection from scratching a chickenpox rash. Because the rash itches a lot and can be very uncomfortable, skin infection is a common side effect of chickenpox.

   2. False

      This answer is incorrect.

      Even otherwise healthy children and adults can develop a skin infection from scratching a chickenpox rash. Because the rash itches a lot and can be very uncomfortable, skin infection is a common side effect of chickenpox.

2. Although it may cause a skin infection, scratching the chickenpox rash will not make it worse.

   1. True

      This answer is incorrect.

      In addition to causing a skin infection, scratching the chickenpox rash can create open sores, make the rash more severe, and cause scars.

   2. False

      This answer is correct.

      In addition to causing a skin infection, scratching the chickenpox rash can create open sores, make the rash more severe, and cause scars.

Home treatment methods can help reduce the itchiness of the chickenpox rash. The following are suggestions to make you or your child more comfortable and keep scratching under control.

Baths

Warm to cool baths can help relieve itching. Take baths for 20 to 30 minutes as often as needed to stay clean and soothe your itchy skin. Always stay with young children when they are in a bathtub.

• Do not use soap, or use only a mild soap. Soaps that are made for sensitive skin or recommended for babies are usually mild.
• You can add soothing ingredients to the bath.
  • Oatmeal baths such as Aveeno and Actibath can be bought in most food and drugstores.
  • You can make your own oatmeal bath by mixing 1 cup (240 mL) of oatmeal with 3 cups (720 mL) cold water and adding it to the bath water.
  • Other ingredients, such as cornstarch [about 2 cups (480 mL) per bath] or baking soda can also be added to the bath to help soothe skin.
• Blot the skin dry after bathing; don't rub the skin.

Compresses

You can apply cool compresses to itchy areas.

• Use a soft, absorbent cloth, such as a soft washcloth. Wet the cloth with cool water and apply the cool compress directly to the skin.
• You can also make an oatmeal paste and apply it to itchy areas.

Lotions

You can apply soothing lotions that can help dry chickenpox blisters, but talk to your doctor before using lotions that contain antihistamines. You could try lotions with:

• Phenol, menthol, and camphor, such as calamine lotion.
• Oatmeal, such as Aveeno Lotion.

Prevent skin irritation

Some general hygiene practices can help prevent skin irritation and scratching.

• Wear loose-fitting cotton clothing.
• Change clothes and bedsheets daily.
• Use a mild laundry detergent if clothes or linens seem to be irritating the skin.

Antihistamines

Lotions or creams that contain antihistamines should not be used for chickenpox. But sometimes antihistamines that are taken by mouth will help relieve itching.

• Antihistamines taken by mouth may help prevent you or your child from scratching the rash and blisters, especially during sleep.
• Some antihistamines can be bought over-the-counter. If you use them, carefully follow the directions on the label. Check with your child's doctor before you give them to your child.

Help children avoid scratching and infection

It can be especially challenging to control a child's scratching. Try the following methods to help keep your child from itching the rash or help prevent skin infection that can result from scratching:

• Clean and closely trim the child's fingernails.
• Have a small child wear mittens or clean cotton socks on his or her hands to prevent scratching, or use light bandages over open blisters.
• Wash the child's hands often.
• Distract the child when you find him or her scratching.

Use caution

Take general precautions to control itching and to prevent additional problems.

• Avoid getting hot and sweating because these trigger itching. Stay out of sunlight. A child can play outside in the shade.
• Avoid using antihistamine lotions. You may accidentally apply too much medicine, which can be harmful. Ingredients to avoid include:
  • Lidocaine.
  • Pramoxine.
  • Diphenhydramine.

Test Your Knowledge

1. Baths are a good way to help soothe a chickenpox rash and help control itching.

   1. True

      This answer is correct.

      Warm to cool baths cleanse the skin and help soothe itching. You or your child can soak in water alone or add a mild soap or oatmeal product (such as Aveeno) to help you feel more comfortable and possibly delay more itching.

   2. False

      This answer is incorrect.

      Warm to cool baths cleanse the skin and help soothe itching. You or your child can soak in water alone or add a mild soap or oatmeal product (such as Aveeno) to help you feel more comfortable and possibly delay more itching.

2. Give children nonprescription antihistamine medicines and lotions as much as needed to help control itching.

   1. True

      This answer is incorrect.

      Talk to your health professional before you give any antihistamine product to a child. It is difficult to monitor the amount of both oral and topical (lotion) antihistamine medicines being given and how much a small body absorbs. These products can be harmful to a child, especially when not given properly.

   2. False

      This answer is correct.

      Talk to your health professional before you give any antihistamine product to a child. It is difficult to monitor the amount of both oral and topical (lotion) antihistamine medicines being given and how much a small body absorbs. These products can be harmful to a child, especially when not given properly.

Talk with your doctor

Call your doctor right away if you or your child has a severe headache or constant vomiting, sensitivity to bright light, unusual sleepiness or confusion, trouble breathing, or coughing that won't go away. Call your doctor if you notice signs of skin infection, such as a continued high fever, increasingly reddening or swollen skin, bigger open sores, or unusual discharge or smell from chickenpox sores.

If you are older than age 12 and have not had chickenpox or the chickenpox vaccine, call your doctor if you have been in contact with someone who has chickenpox. This is especially important for pregnant women and for people with impaired immune systems, no matter what age they are.