Chickenpox – Diagnosis and Treatment
Diagnosis
Doctors usually begin by examining the rash, which often presents as an itchy cluster of red spots or fluid-filled blisters. These lesions tend to appear in waves, starting on the torso and face before spreading to other parts of the body.
A clinical diagnosis is typically based on the appearance of the rash and symptom history.
They also ask about other common signs, such as fever, fatigue, and general discomfort, especially if the patient has been exposed to someone with chickenpox or shingles.
In certain cases—such as when symptoms are unclear, the patient is immunocompromised, or confirmation is needed—doctors may order lab tests. These may include:
- Polymerase chain reaction (PCR) testing to detect the varicella-zoster virus
- Direct fluorescent antibody (DFA) testing from a lesion sample
- Blood tests to check for immunity or recent infection
Accurate diagnosis is especially important in adults, pregnant individuals, and those with weakened immune systems, as complications are more likely in these groups.
Treatment
Extra Steps for People More Likely to Get Sick
Pregnant women, newborns, adults, and people with weak immune systems may need special care if they get chickenpox. Doctors can prescribe antiviral medicines to fight the virus and make the illness milder.
These medicines work best when taken within the first day after the rash starts.
If someone is exposed to chickenpox, doctors may recommend the chickenpox (varicella) vaccine to lower the risk of illness. In special cases, doctors may use zoster immune globulin to help prevent serious illness after exposure.
Here’s a quick list:
| High-Risk Group | Possible Treatment Options |
|---|---|
| Pregnant women | Antivirals, immune globulin |
| Newborns | Immune globulin |
| Weak immune system | Antivirals, vaccine |
| Unvaccinated adults | Antivirals, vaccine |
What to Do If Problems Happen
Chickenpox can sometimes cause problems like skin infections, pneumonia, or swelling of the brain (encephalitis). Doctors choose treatments based on the specific problem.
For bacterial skin infections or pneumonia, doctors may prescribe antibiotics. If the brain gets swollen, doctors may use antiviral drugs and provide care in the hospital.
Getting medical help quickly is important if there are signs of serious issues like trouble breathing, confusion, or a high fever.
Everyday Tips and Home Care
Avoid Scratching the Rash
Itching is common with chickenpox, but scratching the blisters can slow healing or cause scars and infections. Keep fingernails trimmed short and clean.
| Tip | Why It Helps |
|---|---|
| Short nails | Lessens chance of infection |
| Gloves/mittens | Prevents scratching at night |
For young children, use soft gloves or mittens, especially at night, to prevent scratching.
Soothe Discomfort and Itching
Several home remedies can help ease itchiness and other symptoms:
- Cool Baths: Add oatmeal, baking soda, or aluminum acetate to a cool bath to calm the skin. Colloidal oatmeal can also help.
- Calamine Lotion: Apply calamine lotion to the rash to relieve itching.
- Gentle Foods: If blisters are in the mouth, serve soft, mild foods. Avoid salty or acidic foods.
- Itch Relief Medicine: In some cases, antihistamines may help with itching. Always ask a healthcare provider before giving any medicine.
- Fever reducers: Use acetaminophen for mild fevers. Never use aspirin for children or teens with chickenpox, as it can cause serious problems.
Important: If a fever goes above 102°F (38.9°C) or lasts longer than four days, contact a healthcare provider. Use caution with medicines like ibuprofen unless a doctor approves them, as some drugs may increase the risk of skin problems with chickenpox.
Getting Ready for Your Medical Visit
Details to Have Ready Beforehand
Before the visit, prepare a list of symptoms, including when they started and how they have changed. Note if there was recent contact with someone who had chickenpox, as it spreads easily.
Bring a list of all current medicines, vitamins, or treatments for other health conditions. Write down any questions about chickenpox you want to discuss, such as how long it lasts, recommended medications, and ways to reduce the risk of spreading the virus.
Consider asking about possible signs of dehydration or other problems, which can sometimes happen during childhood illness. If the doctor’s office asks for any special steps before the visit, such as staying away from crowded places, follow those instructions.
Sample Questions for Your Visit
| Question | Why It’s Important |
|---|---|
| Is this likely chickenpox? | Helps confirm the diagnosis |
| When will symptoms go away? | Sets expectations for recovery |
| How easily does chickenpox spread? | Understands risk to others |
| How can I prevent infecting others? | Reduces spread in schools/work |
| Could this cause herpes zoster (shingles)? | Informs about possible complications |
What the Doctor May Ask or Do
Healthcare providers often ask about the first symptoms noticed and contact with anyone who had chickenpox. They may ask if you or your child had the vaccine.
Doctors may also ask about recent treatments or ongoing health conditions. It is common for them to ask about school or daycare attendance, since chickenpox spreads quickly among children.
They might check for signs of dehydration or other complications from the infection. If the patient is pregnant, breastfeeding, or has other specific health concerns, doctors will likely ask about these as well.
Steps You Can Take While Waiting
While you wait for your appointment, try to rest. Drink plenty of fluids to avoid dehydration.
Stay away from others to lower the chance of spreading chickenpox. The infection spreads most easily until the blisters crust over.
Wear a face mask if you need to go out. This helps protect people at higher risk, such as pregnant people or those with weakened immune systems. Do not scratch your sores. This helps prevent skin infections and scarring.
