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Chickenpox
Chickenpox is a very common childhood illness, caused by a virus called varicella.
It starts with red bumps that become small, yellowish blisters affecting the whole body – including the mouth and genitals (which can be very painful). They then open before scabbing over. These are very itchy and can make your child miserable. They may have a temperature, a cough and a runny nose. Children are able to pass the virus to others from the day before the rash appears until the last spot has scabbed over.
Chickenpox rarely needs treatment, unless in a new-born baby, or in a child with a known weak immune system ( i.e. weakened immune system due to anti-cancer treatment, immunosuppressive treatment or genetic immunodeficiency). If you are not sure it is chickenpox look at other childhood rashes here.
Other symptoms
Before or after the rash appears, you might also get:
- a high temperature
- aches and pains, and generally feeling unwell
- loss of appetite
Chickenpox is very itchy and can make children feel miserable, even if they do not have many spots.
The chickenpox spots look the same on children and adults. But adults usually have a high temperature for longer and more spots than children.
It's possible to get chickenpox more than once, but it's unusual.
If you're not sure it's chickenpox
Check other rashes in children
Stay off school or work
You'll need to stay away from school, nursery or work until all the spots have formed a scab. This is usually 5 days after the spots appeared.
Do
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drink plenty of fluid (try ice lollies if your child is not drinking) to avoid dehydration
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take paracetamol eg Calpol to help with pain and discomfort
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cut your child's fingernails and put socks on their hands at night to stop them scratching
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use cooling creams or gels from a pharmacy
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speak to a pharmacist about using antihistamine medicine to help itching
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bathe in cool water and pat the skin dry (do not rub)
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dress in loose clothes
Don’t
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do not use ibuprofen unless advised to do so by a doctor, as it may cause serious skin infections
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do not give aspirin to children under 16
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do not go near newborn babies, people who are pregnant and people with a weakened immune system, as chickenpox can be dangerous for them
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do not scratch the spots, as scratching can cause scarring
Contact your GP surgery if:
- you're not sure it's chickenpox
- you're concerned about your child
Tell the receptionist you think it might be chickenpox before going in to a GP surgery.
Get advice from 111 now if:
- the skin around the chickenpox blisters is hot, painful and red, but redness may be harder to see on brown or black skin
- your child has chickenpox and is dehydrated
- chickenpox symptoms suddenly get worse
- you're pregnant and have not had chickenpox before, or you're not sure, and you've been near someone with chickenpox
- you have a weakened immune system and have been near someone with chickenpox
- you think your newborn baby has chickenpox
Some people may be able to take medicine to prevent complications. It needs to be started within 24 hours of the spots appearing.
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.
Go to 111.nhs.uk or call 111.
It's easy to catch chickenpox
You can catch chickenpox by being in the same room as someone with it. It's also spread by touching things that have fluid from the blisters on them.
When chickenpox can be spread
You can spread chickenpox to other people from 2 days before your spots appear until they have all formed scabs – usually 5 days after your spots appeared.
How soon you get symptoms after catching chickenpox
The spots start appearing around 1 to 3 weeks after you caught chickenpox.
Chickenpox in pregnancy
Most people get chickenpox during childhood, so it's rare to get chickenpox when you're pregnant.
If you do get chickenpox when you're pregnant, there's a small risk of your baby being very ill when it's born.
Go to 111.nhs.uk or call 111 if you have not had chickenpox before and you've been near someone with it.
The chickenpox vaccine
You can get the chickenpox vaccine on the NHS if there's a risk of harming someone with a weakened immune system if you spread the virus to them.
For example, a child can be vaccinated if 1 of their parents is having chemotherapy.
You can also pay for the vaccine at some private clinics or travel clinics. It costs between £120 and £200.
Shingles and chickenpox
You cannot catch shingles from someone with chickenpox.
You can catch chickenpox from someone with shingles if you have not had chickenpox before.
When you get chickenpox, the virus stays in your body. The virus can be triggered again if your immune system is weak. This causes shingles.
This can happen because of stress, certain conditions, or treatments like chemotherapy.
Images in this section are from Don't Forget the Bubbles, used with permission
When should you worry?
- Has blue lips
- Too breathless to talk / eat or drink
- Becomes pale, mottled and feels abnormally cold to touch
- Becomes extremely agitated, confused or very lethargic (difficult to wake)
- Develops severe headache, neck stiffness or balance problems
- Has a fit or seizure
- Has a rash that does not disappear with pressure (the ‘Glass Test’)
- Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
- Increasing pain and redness between the spots:
- New blisters/spots appearing after 7 days
- Continues to have a fever of 38.0°C / 100.4°F or more for more than 5 days or if a fever returns after it initially settles
- Seems dehydrated (sunken eyes, drowsy, no urine passed in 12 hours)
- If the fever does not settle with paracetamol and simple cooling measures
- Rash spreading to the eyes
- Has extreme shivering or complains of muscle pain
- Is getting worse or if you are worried
- A parent is pregnant and has not previously had chickenpox
- Contact with pregnant women who has not previously had chickenpox, person with a weakened immune system who has not previous had chickenpox or a new-born baby (the contact should seek advice from a healthcare professional)
- Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If none of the above features present:
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111. Avoid nursery or school for 5 days from rash onset or until all spots are fully scabbed over.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
What can you do to help your child?
Seeing your child unwell with chickenpox can be very distressing for a parent and while there is usually no treatment for the virus itself, there are simple things you can do to make your child more comfortable:
- Regular paracetamol for temperature/pain
- Antihistamines (eg piriton) can help with itching and aid sleep
- Drink plenty of fluid and try ice lollies if your child is not drinking much
- Calamine lotion/oat milk bath/Sodium bicarbonate bath for itch
- Pat dry after bath rather than rubbing for comfort
- Dress in loose clothes
- Don’t give ibuprofen or aspirin unless advised to by a doctor
- Cut nails/apply hand mittens at night to reduce damage to skin and try to
- Avoid too much scratching if possible
How long does it last?
- Usually the last spot has crusted over by 5-7 days after the rash first appears
- It is highly contagious until spots have dried and scabbed over
- Avoid nursery or school for 5 days from rash onset or until all spots are fully scabbed over
- Avoid contact with new-born babies, people with a weakened immune system and pregnant women until all of their spots have scabbed over – if concerned regarding this contact your GP
The chickenpox vaccine
The chickenpox vaccine is a vaccine used to prevent catching and spreading the disease. It is not part of the standard vaccine programme but is offered to childrenwho are at increased risk of severe chickenpox infection and to those with a family member at risk of complications. It is also available privately through travel clinics and pharmacies and costs between £120-£200. More information is available here.
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.