Chickenpox

---

Chickenpox

With its trademark red bumps that later turn crusty, chickenpox is not the prettiest disease around. And since its victims are usually kids-often not the easiest patients to deal with--you're likely to hear plenty of complaints.

But there's no need to let chickenpox ruffle your feathers. From a medical standpoint, your kids and you should fly through this sick time with a minimum of fuss.

"In an otherwise healthy child, chickenpox is such a mild disease that it's really hardest on parents who have to miss a week of work to stay home with the child," says George Sterne, M.D., clinical professor of pediatrics at Tulane University in New Orleans. "Sure, the child may be miserable, but he's usually not that sick. For a single parent or a dual-income family, chickenpox is usually hardest on the parents because of the financial problems resulting from missed work."

In contrast to measles and mumps, which can be avoided with vaccines, there's currently no prevention generally available for chickenpox, which is caused by a virus in the herpes family. (A new vaccine is being developed, however.) And since chickenpox gets passed around at school more frequently than stolen test answers, just about everyone gets it sometime in his life (although it's most common between ages five and nine).

"Generally, the older you are, the worse the case," says Dr. Sterne. It's hardest on adults who have never had it before; they are much more likely than kids to suffer rare complications such as pneumonia or encephalitis. It can also cause permanent skin damage in those of all ages who have ongoing skin problems, such as eczema or psoriasis. And anyone taking cancer drugs or cortisone must alert his doctor immediately at the first sign of chickenpox infection.

But for most of the kids who get it, there's more itching than health risk with this inevitable ailment. If your tot has the unquenchable urge to scratch, here's how to make the going a little easier

The Aspirin Danger Don't give children aspirin to treat the pain and fever that accompany chickenpox, because aspirin has been associated with Reye's syndrome, a life-threatening neurological disorder. While its cause is unknown, Reye's syndrome is associated with the use of aspirin by children who have viral infections, most often chickenpox or influenza. Better: Use Tylenol or another acetaminophen preparation for fever, says Edgar O. Ledbetter, M.D., former chairman of the Department of Pediatrics at Texas Tech University in Lubbock.

Head for the kitchen cabinet ... then the bath. "The best home remedy to relieve the itching from chickenpox is to mix 1 cup of white kitchen vinegar, 1/2 cup of baking soda and one to two capfuls of Alpha Keri body oil in a bath," says Marian H. Putnam, M.D., a pediatrician in Boston and clinical instructor of pediatrics at Boston University School of Medicine. "After a good soak of 15 to 20 minutes, leave the bathtub and then apply Dyprotex cream, an over-the-counter product that is sold as pads or in lotion form. This relieves itching better than some of the other anti-itch formulas, and since it doesn't crust like those other drying agents, there's less chance of scarring."

You can also soak a washcloth in the bath and just apply it to the face to soothe the itching, according to Dr. Putnam.

File nails daily. "Kids will tear themselves up trying to scratch themselves, so I recommend you get a few emery boards and file their nails down, literally on a daily basis," says Dr. Sterne. "Most people simply cut the nails, but doing that doesn't give you as smooth an edge."

Wash 'em, too. "It's a good idea to scrub a child's nails with soap and water or even a gentle brush once or twice a day in order to prevent secondary infection," says Edgar O. Ledbetter, M.D., former chairman of the Department of Pediatrics at Texas Tech University in Lubbock.

Nix the itch with oatmeal baths. Doctors recommend colloidal baths using preparations such as colloidal oatmeal to treat itchy skin. "I recommend twice-daily colloidal baths for patients with chickenpox, because colloidal oatmeal is nonirritating and soothing and has a slight anti-inflammatory effect," says Lawrence Charles Parish, M.D., a Philadelphia dermatologist. (Colloidal oatmeal, such as Aveeno, can be purchased in any drugstore. It is simply raw oatmeal that's been ground to a fine powder.)

The Chickenpox Treatment Chickenpox can be a severe medical problem for teenagers or adults-or for those of any age with compromised immune systems or skin conditions or those who take certain medications. Be sure to see the doctor if you have been exposed and see early signs that you may have the virus. Symptoms usually begin with a slight fever and malaise a day or so before the characteristic rash starts to appear. The prescription drug acyclovir may be recommended, but "the key with acyclovir is to start taking it at the earliest indication of the rash, as the drug is not effective after 24 hours from onset of the rash," says Henry M. Feder, Jr., M.D., a professor of family medicine and pediatrics at the University of Connecticut Health Center in Farmington who headed several studies on the drug. "The sooner you start taking the drug, the better it works."

Keep cool. English researchers speculated in the British Medical Journal that keeping patients cooler than usual might result in milder cases with fewer pockmarks. This is still in the theory stage, but Dr. Sterne has a possible explanation: "When people are warmer, they do tend to itch more, and the rushes are more prominent," he says. (And you'll note that more pockmarks appear on "warm" areas of the body, such as the armpits and groin.)

Forget steroid creams. Probably the biggest and most dangerous mistake people make in treating chickenpox is reaching for relief with an over-the-counter anti-itch cream. "Never put on a steroid cream like Cortaid, because using it may cause an additional bacterial infection," according to Henry M. Feder, Jr., M.D., professor of family medicine and pediatrics at the University of Connecticut Health Center in Farmington. "Besides that, it can make the pox a lot worse."

Try to limit exposure. While it's practically guaranteed that an infected family member will pass chickenpox to others who haven't previously been exposed, limiting contact with the "contagious" child can make for a milder case. "There's a trend that the more time you spend around the person who initially has it, the longer and worse your case will be," says Dr. Feder.