Chickenpox Also called as Varicella.

Overview

Chickenpox is a viral infection caused by the varicella zoster virus (VZV, also known as chickenpox virus). It is an extremely contagious disease which mostly affects kids but can occur in adults as well. It is usually a mild and self-limiting disease but can lead to severe health complications in people with low immunity or infants. It is characterised by classic super itchy rashes and flu-like symptoms. Although the symptoms of chickenpox take their own course of time, home remedies and home care treatment options do play a key role in relieving the itching and pain. The treatment of chickenpox is mostly centred around managing the symptoms.

Key Facts

Usually seen in

  • Children below 10 years of age

Gender affected

  • Both men & women

Body part(s) involved

  • Skin

Mimicking Conditions

  • Insect bites
  • Impetigo
  • Drug reactions
  • Dermatitis herpetiformis
  • Urticaria
  • Viral exanthems
  • Pityriasis lichenoides et varioliformis acuta
  • Disseminated herpes simplex virus infection
  • Atypical herpes zoster
  • Rickettsial disease
  • Neonatal syphilis
  • Erythema multiforme
  • Contact dermatitis

Necessary health tests/imaging

Treatment

Specialists to consult

  • Pediatrician (in case of children)
  • Dermatologist
  • Infectious Disease Specialist
  • Internal Medicine Specialist

Symptoms Of Chikenpox

The symptoms caused by chickenpox infection appear 10 to 21 days after exposure to the virus and usually last about 5 to 10 days.The initial symptoms may resemble any other infection. At the beginning of chickenpox, a person may begin to feel unwell, have bodyache and headache, accompanied by loss of appetite. After one or two days these are followed by the appearance of the classic rash of chickenpox. One is contagious to close contacts up to 48 hours before the skin rash starts to occur. The common non rash symptoms of chickenpox are as follows:

  1. Fever is the most common symptom of chickenpox. It usually lasts for 3-5 days and is in the range of 101°–102°F (38.3°–38.8°C).
  2. Fatigue or Malaise which is the general feeling of being unwell
  3. Loss of appetite
  4. Headache
  5. Muscle or joint pain
  6. Flu-like symptoms such as a cough or runny nose

Once the chickenpox rash and blisters appear on the body, they go through the following three phases:

  • Red or pink-looking bumps (papules) are often first noted on the stomach, chest, back, or face areas, which then spread throughout the body.
  • The bumps eventually get filled up with fluid, forming blisters (vesicles)that begin to break open and leak.
  • The blisters develop a crust, scab, and begin to heal. 


All the blisters are not formed at the same time. New blisters keep on developing throughout the infectious period. However, they follow the same phases as explained above.


All symptoms are typically mild for young children. Those who have been vaccinated (including children and adults) can also still get an infection, but symptoms will be milder and produce fewer blisters on the body.


However, in severe cases of chickenpox rashes and blisters start spreading throughout the body. In some cases, small lesions may even form on the throat, around the eyes, and in the mucus membranes of the urethra, vagina or anus.


In some cases rashes are accompanied by symptoms of disorientation, dizziness, shortness of breath, a rapid heartbeat, a cough (which worsens), poor muscle coordination, and a stiff neck. These symptoms could indicate another possible medical condition or complication which may require prompt medical intervention.

Causes Of Chickenpox

Chickenpox is caused by the virus varicella zoster. It mostly spreads due to close contact with an infected person. The virus can spread through:

  • Coughing or sneezing via respiratory droplets
  • Kissing or sharing drinks or food through saliva
  • Handshaking or hugging through contact with the blisters or the fluid on the skin
  • Touching contaminated surfaces like door handles or tables, etc

Risk Factors For Chickenpox

You may be at high risk of getting infected with the chickenpox virus if you have not contracted the infection in your life. The risk increases if you:

  • Haven’t been vaccinated for the infection
  • Have been in contact with an infected child or adult
  • Are an adult who is living with an infected child
  • Work in a school, childcare facility, or healthcare setting
  • Have low or compromised immunity due to illness or use of any medications

Diagnosis Of Chickenpox

Chickenpox is usually easy to recognise and diagnose due to its classic skin rashes. 


However, if required, a confirmatory test by polymerase chain reaction (PCR) testing can be done. For this, the blister fluid or scabs are tested for the presence of the virus. 


Moreover, tests for antibodies may be performed to determine if immunity is present against chickenpox. These include:

  • Varicella Zoster IgG test which is used to evaluate the level of antibodies IgG produced by the immune system to fight against varicella zoster virus. 
  • Varicella zoster IgM test is performed to diagnose chickenpox, and to distinguish between a recent, current, or old infection.

Prevention Of Chickenpox

One of the simple and effective ways to prevent chickenpox is through vaccination. Although routine infant vaccination has substantially reduced transmission of wild-type varicella, chickenpox vaccination is not a part of the Indian Universal Immunisation Program. Hence, get vaccinated for chickenpox if you have not yet as it can significantly lower the risk of suffering from an infection. Moreover, it is one of the safe and effective options to prevent chickenpox infection. Do consult your doctor for advice on vaccination.


As chickenpox is contagious in nature, it is recommended that if a person in a family is diagnosed with chickenpox, other family members must get vaccinated, if not vaccinated before.

Specialist To Visit

In most cases, the symptoms of chickenpox are usually mild and often go away on their own. However, visiting a clinician and early intervention may lead to slow progression and early resolution of disease. There are times, especially in adults, when the symptoms of chickenpox become severe and may fail to show any signs of improvement. In such a case it is wise to consult a doctor to get it treated. 


You must see a doctor if you experience symptoms such as:

  • Vomiting
  • Shortness of breath
  • Rash on the eyes
  • Stiffness of neck
  • High fever (over 102 F)
  • Bacterial infection
  • Loss of muscle control
  • Dizziness


In addition to a general physician, the specialists who can help treat this condition are

  • Pediatrician (in case of children)
  • Dermatologist
  • Internal Medicine Specialist
  • Infectious Disease Specialist

Treatment Of Chickenpox

Chickenpox usually runs its course in a week or 10 days. The treatment is mostly aimed at relieving the symptoms. Non Aspirin products such as Paracetamol can be taken to reduce fever.


In adults and those with severe symptoms of chickenpox, doctors might prescribe antiviral medication as it can make the symptoms less severe and improve the condition. However, ensure to follow the course of the treatment and do not self-medicate. Some of the common antivirals used include:

Do’s and Don’ts

  • As a protective measure, those infected are usually required to stay at home while they are infectious. 
  • It is advised to not use OTC medications such as aspirin for fever as it is associated with Reye’s syndrome in kids. It is a severe disease that affects the brain and may even cause death. 
  • Avoid the use of anti-inflammatory painkillers without consulting your doctor as it can increase the risk of severe skin infections.
  • Daily cleansing with warm water will help avoid secondary bacterial infection. 
  • Keeping nails short and wearing gloves may prevent scratching and reduce the risk of secondary infections. 

Home Care For Chickenpox

1. Do not scratch the itch

One of the key symptoms of chickenpox is itchy skin and hence, it is advised to avoid scratching. This is because it not only increases the risk of scars but also can lead to infection. As a safety measure, you can trim the fingernails of your kids, which can prevent skin infection caused due to scratching. Tap or pat on the itchy skin but do not scratch.


2. Use cold compress

Chickenpox also causes fever, which in turn can make you more prone to skin itching and scratching. Increased body temperature can make things worse for a person with chickenpox. This is the reason why it is advised to use a cold compress as it not only helps in lowering the body temperature but also soothes itchy skin. Apply a cool, damp compress over the itchy area as it acts as one of the effective chickenpox remedies. 


3. Eat healthy, home-cooked food

It is quite common to crave for spicy and processed food when you are ill. However, it is best to avoid indulging in spicy, oily or salty foods as these not only hinder your digestion process but can also increase heat in the body. Hence, it is best to opt for home-cooked foods, preferably bland foods, to improve the healing process. Also, up your intake of fruits which are rich in Vitamin C and boost immunity such as oranges, apples, grapes, lemons, etc.


4. Stay hydrated

Drink lots of fluids as it helps you to stay hydrated and prevent dehydration caused due to high fever. Moreover, it can also help to flush the viral toxins from the body and aid in quick recovery. However, avoid drinking sugary beverages and opt for fresh, plain water, especially if you or your kid has sores in the mouth. For kids, you can opt for sugar-free popsicles to replenish fluid stores in the body.


5. Wear gloves

This tip mostly applies to kids because they are the ones who are more prone to scratch an itchy skin. This is the reason why it is advised, especially for kids, to put gloves or socks over their hands to prevent scratching. This can not only prevent the direct content of the nail with the chickenpox blister but also lower the risk of infections and limit scarring. Also, wear loose, cotton clothes, which will help the skin to breathe and ease the itching.


6. Avoid self-medication

Most people tend to pop a pill for fever or a painkiller for body ache without a second thought when suffering from chickenpox. However, this is not a good idea. Aspirin, which is commonly used to relieve fever, can cause a deadly condition known as Reye’s syndrome in children below 16 years of age. Hence, do not self-medicate but consult your doctor before taking any pills. 

Complications Of Chickenpox

Chicken pox is usually a mild disease. However, complications can happen from chickenpox. They are more common in adults and people with weak immune systems like:

  • Infants
  • Pregnant women
  • Patients with conditions like HIV/AIDS, cancer, chemotherapy, steroid therapy, transplants


Some of the serious complications of chickenpox include:

  • Secondary Bacterial infections
  • Dehydration
  • Pneumonia (infection of the lungs)
  • Encephalitis (inflammation  and swelling of the brain)
  • Cerebellar ataxia (defective muscular coordination)
  • Transverse myelitis (inflammation of spinal cord)
  • Bleeding
  • Sepsis
  • Toxic shock syndrome
  • Reye’s syndrome in children and teenagers who take aspirin during chickenpox
  • Death

Chickenpox And Shingles

Although shingles and chickenpox are caused by the same virus, they are not the same illness. Chickenpox is usually a milder illness that affects children. Shingles results from a reactivation of the virus long after the chickenpox illness has disappeared.


The chickenpox virus stays in the body even after recovery. Later in life, the virus can reactivate and cause shingles. If you have shingles, you can spread the varicella virus to people who have never had chickenpox or never received the chickenpox vaccine. These people will develop chickenpox, not shingles. It takes from 10 to 21 days after exposure to chickenpox or shingles for someone to develop chickenpox. 

Alternative Therapies Of Chickenpox

In addition to antiviral medications, there are few home remedies that are known to help relieve the symptoms and help to get rid of scars caused due to scratching. However, make sure to consult your doctor before you try any of these chickenpox remedies.


1. Oatmeal bath

Oatmeal bath is one of the most popular natural remedies to relieve itchy skin caused due to chickenpox. For this, you need to cook two cups of oatmeal in two liters of water for around 15 minutes. Now, let it cool and tie the cooked oatmeal in a cotton cloth and allow it to float in a tub of warm water till the water becomes turbid. Splash this water all over the body to soothe itching.

2. Baking soda

This is also quite commonly used to get rid of itching in people with chickenpox. Add 1/4th teaspoon of baking soda in a glass of water. Dip a soft, cotton cloth in it and dab it on the skin such that the baking soda dries on the skin. This can keep you away from scratching the blisters.


3. Vitamin E oil

Rich in antioxidant, Vitamin E oil can help to relieve itching as well as prevent scars caused due to scratching of chickenpox blisters.  Gently apply Vitamin E oil all over the skin as it exerts a calming and soothing effect on the skin and thus, promotes healing. Moreover, regular application of this oil was found to lighten the scars/marks caused due to chickenpox.

Living With Chickenpox

For the short time, when a person has chickenpox, there’s little one can do other than make themselves as comfortable as possible. In most cases, once you have chickenpox, you will not have it again in your lifetime. Rarely, someone may get it more than once. Patients should take ample amounts of rest. Drink lots of water and other fluids to maintain hydration. Other drinks such as cinnamon, chamomile, and basil herbal teas can also boost the immune system. Diet should be simple and wholesome. Avoid fatty and spicy food. Food that is high in saturated fat causes inflammation which can slow the healing of the irritated area. Trim your fingernails to avoid scratching as this can form deep scars and wounds. Application of antihistamine lotion and cool baths can help to calm the itching.

 

Along with self care it is very important to prevent chickenpox from spreading at home. Make sure your family washes their hands frequently, especially after eating and using the restroom. Try not to expose unvaccinated family members, pregnant women, newborns, elderly people, or those with low resistance to infection. One should try to stay isolated until all blisters have crusted or dried.