Most chickenpox is managed at home, which makes the medicine-cabinet question
the important one — and two of the obvious answers are wrong.
Not aspirin
**The use of aspirin in children with chickenpox is associated with Reye's
syndrome, a severe disease that affects the liver and brain and can cause
death.**
Not ibuprofen either
**The American Academy of Pediatrics recommends avoiding treatment with
ibuprofen if possible. Ibuprofen has been associated with life-threatening
bacterial skin infections.**
That is a different mechanism from the aspirin risk, and it matters here
specifically because chickenpox is a disease of broken skin — the blisters are
already an opening.
Use non-aspirin medications, such as acetaminophen, to ease fever.
When antivirals are worth it
**Antiviral medication works best given as early as possible, preferably
within the first 24 hours after the rash starts** — so the decision is made in
the first day, not after watching how it goes.
It is recommended for people more likely to develop dangerous illness:
- Otherwise healthy people older than 12 — chickenpox is milder in small
children than in teenagers and adults - People with chronic skin or lung disease
- People on long-term salicylate or steroid therapy
- Pregnant women
- People with a weakened immune system
Call a doctor before symptoms appear
After exposure to chickenpox or shingles — the same virus — call if you
have never had chickenpox and are not vaccinated, are pregnant, or
have a weakened immune system from disease or medication: HIV or cancer, a
transplant, chemotherapy, immunosuppressants, long-term steroids.
Symptoms that mean call now
- Fever lasting longer than 4 days, or above 102°F (38.9°C)
- **Rash or any part of the body that becomes very red, warm or tender, or
leaks pus** — this may indicate a bacterial infection - Difficulty waking, confused behaviour, difficulty walking, stiff neck
- **Frequent vomiting, difficulty breathing, severe cough, severe abdominal
pain** - Rash with bleeding or bruising (haemorrhagic rash)
At home
**Calamine lotion, and a cool bath with baking soda, uncooked oatmeal or
colloidal oatmeal**, help with itching. Keep fingernails trimmed short —
scratching both spreads the virus to others and causes the skin infections
above. **If you scratch a blister, wash your hands with soap and water for at
least 20 seconds.**
The best way to prevent chickenpox is the chickenpox vaccine.
Source: Centers for Disease Control and Prevention.
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