Chickenpox
Chickenpox is very common. It is caused by a virus called varicella zoster. If your child has been in contact with someone who has chickenpox it can take 1 to 3 weeks for them to develop the rash. Children can pass the virus to others from the day before the rash appears until the last spot has scabbed over. Your child may also have a temperature, muscle aches, loss of appetite, a cough and a runny nose.
Chickenpox starts with red bumps that become small, yellowish blisters. The spots can affect the whole body including the mouth and genitals (which can be very painful). They then open before scabbing over.
Visit the NHS website for more pictures of how the rash develops.
Most children with chickenpox can be looked after at home and do not need to see a doctor. You do need to contact a doctor if your child is a baby under 3 months of has a weak immune system (for example due to cancer treatment, immunosuppressive treatment or generic immunodeficiency) If your newborn baby or child with a weak immune system (for example due to cancer treatment, immunosuppressive treatment or genetic immunodeficiency) catches chickenpox then you should contact a doctor.
When should you worry?
If your child has any of the following:
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Breathing very fast, too breathless to talk, eat or drink
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Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
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Breathing that stops or pauses
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Is pale, blue, mottled or feels unusually cold to touch
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Difficult to wake up, very sleepy or confused
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Weak, high-pitched cry or can’t be settled
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Has a fit (seizure)
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Has a rash that does not go away with pressure (the ‘Glass Test’)
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Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
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Increasing pain and redness between the spots:
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New blisters or spots appearing after 7 days
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Rash spreading to the eyes
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Baby less than 4 weeks old
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Breathing a bit faster than normal or working a bit harder to breathe
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Dry skin, lips or tongue
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Not had a wee or wet nappy in last 8 hours
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Poor feeding in babies (less than half of their usual amount)
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Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
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Is 3 to 6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
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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
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Temperature less than 36°C in those over 3 months
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Getting worse and I am still worried
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A parent is pregnant and has not previously had chickenpox
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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)
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features
If none of the above features are present:
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Watch them closely for any change and look out for any red or amber symptoms
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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.
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Additional advice is also available to young families for coping with crying of well babies – click here.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This content has been developed by healthcare professionals from across the UK in collaboration with the RCPCH.
What can you do to help your child?
It can be upsetting to see your child unwell with chickenpox. While treatment of the virus itself is not usually needed, there are simple things you can do to make your child more comfortable:
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Paracetamol for a high temperature or pain
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Antihistamines (for example piriton) can help with itching and sleep
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Do not give your child Aspirin if they are under 16 years of age
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Plenty to drink
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Try ice lollies or jelly if your child is not drinking much
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Try an oat bath. Put a handful of porridge oats in a small cloth bag or a sock. Tie it at the top and place this in their bath
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Pat dry after bath rather than rubbing
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Dress in loose clothes
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Avoid scratching. Keep nails short or apply hand mittens at night to reduce damage to the skin
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Don’t give ibuprofen unless advised to by a doctor
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Speak to your local community pharmacist for advice on what can help with itching
How long does it last?
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Usually the last spot has crusted over by 5-7 days after the rash first appears
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It is easily passed to other people until spots have dried and scabbed over
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Avoid nursery or school until all spots are fully scabbed over. This is usually by 5 days. for 5 days from the start of the rash or until all spots are fully scabbed over
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Avoid contact with newborn babies
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Avoid contact with pregnant women (unless they have already had chickenpox) and people with a weakened immune system
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Now that your child has had chickenpox, they will usually but not always be immune for life. The virus lives in the body forever (in the nerve roots) and may come back at some point in life as shingles. You cannot catch shingles from chickenpox.
The chickenpox vaccine
Children are now offered the MMRV vaccine, which protects against measles, mumps, rubella and chickenpox (varicella).
They are offered 2 doses of the vaccine when they are 12 months and 18 months old. Older children born on or after 1 January 2020 are also offered 1 or 2 doses of the vaccine.
You may also be offered the chickenpox vaccine on the NHS if there's a risk you could spread the virus to someone who has a weakened immune system.
For example, you can be vaccinated if you're living with someone who is having chemotherapy.
For those not eligible for vaccination on the NHS it is still possible to get vaccinated privately.
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.