What to know about chickenpox in children

Chickenpox, also called varicella, often begins with fever, tiredness, reduced appetite or headache. The rash may start as itchy red spots, then become small fluid-filled blisters before drying into scabs. New spots can appear while older ones are healing, so the rash may look like a mixture of stages. It commonly affects the face, scalp and trunk but can spread widely, including inside the mouth.

A child can pass the virus to others before every spot is visible and remains contagious until the lesions have dried and crusted. Scratching can break the skin and allow a bacterial infection to develop.

Keep the child’s nails short and consider soft gloves at night if scratching is persistent. Cool baths, loose clothing and fragrance-free moisturiser around healing areas may ease irritation. A pharmacist or clinician can advise whether an age-appropriate antihistamine or fever medicine is suitable; do not give aspirin to a child, and check before using medicines containing ibuprofen.

Offer frequent fluids and rest. Keep the child away from pregnant people, newborns and anyone with weakened immunity until a clinician confirms that the contagious period has ended. Do not pop blisters or pick scabs.

Arrange prompt medical advice if the child is very young, has a weakened immune system, is taking immune-suppressing medicine, or has had close contact with someone at higher risk. Seek urgent help for trouble breathing, unusual sleepiness, confusion, severe headache, stiff neck, repeated vomiting, dehydration, or a rash involving the eyes.

Contact a clinician if the skin becomes increasingly red, hot, swollen, painful or produces pus, or if fever returns after improving. Call ahead before attending a clinic so the team can reduce exposure to other patients.

Ask whether the rash is consistent with chickenpox, which fever or itch treatments fit the child’s age, and how long the child should stay away from school or nursery. You can also ask what signs would suggest a skin infection and whether household contacts need specific advice.