Chickenpox parent advice sheet

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 (for example due to 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

If your child has any of the following:

  • Breathing very fast, too breathless to talk, eat or drink
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')
  • A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Increasing pain and redness between the spots:

  • New blisters/spots appearing after 7 days Rash spreading to the eyes

  • Baby less than 4 weeks old

  • Breathing a bit faster than normal or working a bit harder to breathe

  • Dry skin, lips or tongue

  • Not had a wee or wet nappy in last 8 hours

  • Poor feeding in babies (less than half of their usual amount)

  • Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)

  • Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

  • Temperature of 38°C or above for more than 3 days, shivering with fever
    (rigors) or if the temperature comes back after a few days

  • Temperature less than 36°C in those over 3 months

  • Getting worse or you are worried about them

  • A parent is pregnant and has not previously had chickenpox
    Contact with a pregnant woman who has not previously had chickenpox, person with a weakened immune system who has not previously had chickenpox or a newborn baby (the contact should seek advice from a healthcare professional)

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 are present:
  • Watch them closely for any change and look out for any red or amber
    symptoms
  • If your child has any other symptoms associated with their fever, you may
    want to look at the information on sore throat, cough, earache, diarrhoea
    and vomiting or tummy ache or our other pathways.
  • Additional advice is also available to young families for coping with crying of
    well babies.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.  

  • 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 has recently been recommended but is not yet part of the standard vaccine programme but is offered to children who 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 at Chickenpox vaccine overview - NHS (www.nhs.uk)

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

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