Chickenpox Tips for Minimal Misery

Tips for Minimal Misery

A t first your child just doesn't feel well. ''Sorta tired,'' is all he can tell you. When you put him to bed, you notice one little bump on his tummy--maybe a bug bite, you think.

In the morning, that little bump has been joined by a flock of others, and some of them show tiny clear water blisters.

Say hello to the chickenpox.

It's a fairly harmless malady that can strike babies and children as well as adults. For a week or more, the discomfort is almost continual. First there may be mild fever, then blisters, itching and, finally, scabbing. In very rare cases, cases, chickenpox can lead to more serious ailments.

For parents, this uncomfortable malady offers just one consolation: After your child has had it, chickenpox are usually gone for good. ( Unless, that is, you have another susceptible child in the house who hasn't been through it before.)

Here's how the experts suggest you keep your child with chickenpox as comfortable as possible.

Supply pain relief. If the fever or itching is making your child unbearably uncomfortable, you can give her acetaminophen (Children's Tylenol), says William Howatt, M.D., professor of pediatrics in the Department of Pediatrics and Communicable Diseases at the University of Michigan Medical Center in Ann Arbor. Check the package directions for the correct dosage for your child's age and weight. If your child is under age two, consult a physician. If the fever isn't making your child uncomfortable, however, don't try to lower it: ''It's actually one of the body's disease-fighting mechanisms,'' explains Dr. Howatt.

And never give a child with chickenpox aspirin, because it has been linked with Reye's syndrome, a potentially life-threatening complication, says Dr. Howatt.

Dress your child lightly. ''The cooler you can keep your child's skin in the first 48 to 72 hours, the less discomfort he'll have,'' says F. T. Fitzpatrick, M.D., a pediatrician in private practice in Doylestown, Pennsylvania. Avoid bundling your child up, and dress him lightly in cotton clothing or pajamas. Cotton is the best choice because it's the least irritating to the skin, he says.

Supply cooling relief. Another way to help lower your child's temperature is to bathe her skin with a cool cloth or put her in a cool bath, says J. Owen Hendley, M.D., professor of pediatrics and head of pediatric infectious diseases at the University of Virginia School of Medicine at Charlottesville. Be sure the water isn't so cold your child shivers, however.

Try an itch-relieving bath. A bath in colloidal oatmeal--oatmeal that's been ground to a fine powder--can help soothe the itch, says Kenneth R. Keefner, Ph.D., a pharmacist and associate professor of pharmacy in the School of Pharmacy and Allied Health Professions at Creighton University in Omaha. You can find this product at most pharmacies under the brand name Aveeno, and directions for use are on the box. But take special care that your child doesn't try to stand in the bath, because this product can make the bathtub quite slippery, says Dr. Keefner.

Or soothe with soda. Baking soda is a perfectly good substitute for colloidal oatmeal, according to Dr. Keefner. Stir about a half-cup of baking soda into a shallow bath or a full cup in a deep bath. Use a washcloth to spread the bath water over all affected areas of skin.

Cool the itchy spots. If your child has one or two spots that are particularly itchy, wring out a washcloth in cool water, lay it on the area for five minutes and repeat as needed. ''Coolness on the site of the itch can counteract the itching,'' says Dr. Hendley. If the cloth is rough on one side, however, put the smooth side next to the skin to avoid irritation, he suggests.

Keep your child fresh and clean. Children with chickenpox should get a daily shower and shampoo to keep the sores clean and help prevent infection, says Dr. Fitzpatrick. Also, while it may be tempting to let your groggy child fall asleep in the same pajamas she's worn all day, she should have a clean pair for the night, he says. ( If your child is still in diapers, they should be changed frequently.) Not only is the clean clothing comforting, but the change can reduce the risk of the sores getting infected.

Try to control the scratching. If your child is old enough to understand, explain that he should try not to scratch, because scratching can cause infection or scarring. But chances are your child can't completely ignore the raging itch all the time, so supply a cool, wet washcloth he can scratch gently with, suggests Dr. Hendley. ''This will help keep him from ripping his skin open,'' he says.

Clip nails short. Trim your child's fingernails as soon as chickenpox strikes--and keep them trimmed short, says Dr. Fitzpatrick. Even after the worst is over, he recommends trimming the nails twice a week for several weeks afterward. Scratching with sharp nails can lead to a bacterial infection in the sores, and that can lead to permanent scarring.

Treat with an antibiotic. If a few of the pox show signs of infection such as redness around them or the presence of pus in open pox, apply an over-the-counter antibiotic ointment such as Neosporin or Polysporin, says Dr. Keefner. ''But if more than a few of the sores are infected, contact your pediatrician,'' he cautions.

Control the itch with an antihistamine. ''An oral over-the-counter antihistamine, like Benadryl Elixir, may help control the itching,'' says Dr. Hendley. ''But even if it doesn't, at least it will make your child sleepy so he can get some of the rest he needs.'' Be sure to read package directions to make certain the product is recommended for your child's age. For the correct dosage, follow package directions or consult your physician. Some doctors don't advise Benadryl cream or spray because it could cause a reaction.

Or try calamine lotion with phenol. This type of calamine lotion works as a topical anesthetic and can help with the itching, says Edward DeSimone, Ph.D., a pharmacist and associate professor of pharmacy administrative and social sciences in the School of Pharmacy and Allied Health Professions at Creighton University. Just dab it on particularly itchy pox. Because this product can be absorbed through the skin, you want to apply it just to the pox--not smear it all over, says Dr. DeSimone. ''Also, make sure that you don't exceed package directions, which specify that this lotion should not be used more than three or four times a day.''

Avoid OTC topical hydrocortisone. These kinds of steroid creams and ointments are available in pharmacies and are ordinarily used to fight inflammation and itch, says Dr. Keefner. They will, however, inhibit the child's own immune system from fighting the virus in the area where it is applied and may even allow the pox virus to generate further, he says.

Keep your kids out of the sun. Children who have recently had chickenpox--as well as those who may be just about to come down with it-should be extra careful about sun exposure, says Dr. Fitzpatrick.

''Children who become sunburned during the incubation period of chickenpox, especially if they're close to the breakout time, will have a much worse case,'' he says. So if you know chickenpox is going around, keep your child off any sun-drenched playing fields or apply sunscreen with an SPF (sun protection factor) of 15 or higher.

Once the chickenpox is over, the skin remains particularly vulnerable to sunburn for about a year, says Dr. Fitzpatrick. So be especially careful with the child who has recently recovered. Again, be sure to apply sunscreen whenever he's going to be outdoors in direct sun.