Stephen J. Schueler, M.D.

Varicella Home Care

Home care for chicken pox includes:

  • Apply 1% hydrocortisone cream for itching:
    • Apply to the skin, 4 times a day.
  • Avoid scratching: this can cause infection.
  • Apply a cold compress:
    • Compresses may reduce itching.
    • Apply for 20-30 minutes, every 1-2 hours.
  • Take cool baths to relieve itching.
    • Add Aveeno to the water.
  • Oral antihistamines for itching:
  • Take prescription medications as directed.
  • Wash your skin gently with mild soap twice a day.

Varicella Itching

General home care for itching include:

  • Cleanse itching skin with soap and water.
  • Take a cool bath or shower to reduce itching. Consider using colloidal oatmeal (Aveeno).

Medications for itching include:

Oral antihistamines can be sedating. Use with caution and do not mix with alcohol or other sedatives. Follow directions on product packaging

Varicella Mouth Ulcers

Chicken pox can cause painful ulcers inside the mouth.

Home care for mouth ulcers includes:

Varicella Pain and Fever Adults

Common medications used for pain and fever in adults with chicken pox include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Varicella Pain and Fever Children

Common medications used at home for pain and fever in children with chicken pox include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Varicella Vomiting in Adults

Home care for vomiting in adults with chicken pox:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea. Sports drinks are best. The absence of food allows the intestines to rest.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Varicella Vomiting in Children

Home treatment of vomiting in children with chicken pox includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte

ORT fluids used in older children include:
  • Sports drinks (Gatorade)
  • Broth
  • Dilute fruit juices
  • Flat soda
  • Weak tea with sugar

Strategies for breast-fed infants younger than 6 months:
  • If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
  • Provide additional ORT fluids to supplement breast milk.
  • Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for formula-fed infants younger than 6 months:
  • If the infant tolerates formula, continue to provide small amounts very frequently.
  • Provide additional ORT fluids to supplement formula.
  • Try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for children over 6 months:
  • Provide as much ORT fluids as your child desires.
  • If vomiting occurs, provide small amounts of ORT fluids more frequently:
    • Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
    • Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
    • Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Dietary Therapy
Most children with vomiting improve in a few hours and symptoms usually resolve in one day. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that are easiest to tolerate include:
  • Crackers
  • Oatmeal
  • Jell-O
  • Soft foods
  • Yogurt

Foods to avoid include:
  • Concentrated fruit juices
  • Junk foods
  • Milk products
  • Recently introduced foods
  • Spicy foods

Nonprescription medicines for vomiting should only be used under the direction of your doctor.

Varicella Warning Signs

Continue to Varicella Prevention

Last Updated: Dec 7, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Varicella References
  1. Arvin AM. Antiviral therapy for varicella and herpes zoster. Semin Pediatr Infect Dis. 2002 Jan;13(1):12-21. [12118839]
  2. Hambleton S. Chickenpox. Curr Opin Infect Dis. 2005 Jun;18(3):235-40. [15864101]
  3. Harris D, Redhead J. Should acyclovir be prescribed for immunocompetent children presenting with chickenpox? Arch Dis Child. 2005 Jun;90(6):648-50. [15908639]
  4. Swingler G. Chickenpox. Clin Evid. 2004 Dec;(12):1050-7. [15865701]
  5. Vazquez M. Varicella infections and varicella vaccine in the 21st century. Pediatr Infect Dis J. 2004 Sep;23(9):871-2. [15361729]
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