Friday, 10 February 2012

Psoriasis


What Is Psoriasis?

Psoriasis (pronunciation: "sor-eye-sis") is a common long term (chronic) condition that causes thick red marks and flaky white patches that look like scales to form on the skin. Skin cells grow deep in the skin and slowly rise to the surface. This process is called cell turnover, and it takes about a month. With psoriasis, it can happen in just a few days because the cells rise too fast and pile up on the surface.
Most psoriasis causes patches of thick, red skin with silvery scales. These patches can itch or feel sore. They are often found on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. But they can show up other places such as fingernails, toenails, genitals, and inside the mouth.


Who Gets Psoriasis?
What Causes Psoriasis?
How Is Psoriasis Diagnosed?
How Is Psoriasis Treated?


Who Gets Psoriasis?

Anyone can get psoriasis, but it occurs more often in adults. In many cases, there is a family history of psoriasis. Certain genes have been linked to the disease. Men and women get psoriasis at about the same rate.

Is psoriasis contagious?

No, you cannot catch psoriasis from another person or give it to someone by touching them. You also cannot spread it to other parts of your body

Symptoms

What are the symptoms of psoriasis?

The symptoms of psoriasis may include:
  • Pink or red, raised patches of scaly skin
  • Dry, cracked or flaky skin (it may also bleed at times)
  • Skin that burns, is itchy or sore
  • Thick, pitted fingernails
  • Pus-filled blisters on the red patches of skin (in more severe cases)
The symptoms most often appear on the skin of the knees and elbows, although psoriasis may occur anywhere on the body (including the scalp, palms of the hands, soles of the feet, mouth and skin on the joints).

What Causes Psoriasis?

Psoriasis starts with the immune system. Your immune system usually protects the body against infection and disease by attacking bacteria and viruses. However, when you have psoriasis, your T cells, a kind of white blood cells that are part of the immune system, mistakenly attack your skin cells instead. Your body then produces other immune system responses, leading to swelling and fast turnover of skin cells. Psoriasis tends to run in families and it usually appears between 10 and 45 years of age.
People with psoriasis may notice that sometimes the skin gets better and sometimes gets worse. Certain things that can cause the psoriasis to get worse include:
  • Infections (such as sore throat and the common cold)
  • Diseases that weaken the immune system
  • Stress
  • Certain medicines (such as beta-blockers for high blood pressure and other mediciness used to prevent malaria)
  • Skin irritations
  • Cold weather
  • Smoking

How Is Psoriasis Diagnosed?

Psoriasis is diagnosed by looking on the rash, however sometimes it may be hard to diagnose because it can look like other skin diseases. 

How Is Psoriasis Treated?

Treatment depends on:
  • How serious the disease is
  • The size of the psoriasis patches
  • The type of psoriasis
  • How the patient reacts to certain treatments.
All treatments don't work the same for everyone. Doctors may switch treatments if one doesn't work, if there is a bad reaction, or if the treatment stops working. There are a number of treatments for psoriasis. Your doctor will help you decide which one is best for you. Keeping your skin moisturized with an over-the-counter product is a good first step. Body lotion can help keep skin from getting too dry and cracking. It can also help remove some of the scales. Bathing daily in Dead Sea salts, bath oil or oatmeal can calm redness and remove scales.
Prescription creams, ointments, lotions and gels (also called topical medicines) that you put on the affected areas are often used to treat psoriasis. To help the medicine stay on the skin, you might apply it and then cover the areas with plastic wrap. Options include corticosteroids, a type of vitamin D and pine tar. Special shampoos are used for psoriasis on the scalp. 
For more severe cases of psoriasis, your doctor may prescribe antibiotics or other medicines in pill form. Some of these medicines can cause side effects, so your doctor may prescribe these for only a short period of time before returning to another type of treatment.
Sunlight also can help psoriasis, but be careful not to stay in the sun too long. A sunburn can actually make your psoriasis worse. Talk to your doctor about how to safely try sunlight exposure as a psoriasis treatment. Light therapy may be another option for treatment of psoriasis. With this treatment, the affected skin is exposed to controlled forms of artificial sunlight, usually after using Psoralen, a light-sensitizing medicine. This is called "PUVA" treatment. Talk to your doctor about this option.

Topical Treatment:

Treatments applied right on the skin (creams, ointments) may help. These treatments can:
  • Help reduce inflammation and skin cell turnover
  • Suppress the immune system
  • Help the skin peel and unclog pores
  • Soothe the skin.

Light Therapy:

Natural ultraviolet light from the sun and artificial ultraviolet light are used to treat psoriasis. One treatment, called PUVA, uses a combination of a medicine that makes skin more sensitive to light and ultraviolet A light.

Systemic Treatment:

If the psoriasis is severe, doctors might prescribe medicine through a shot. This is called systemic treatment. Antibiotics are not used to treat psoriasis unless bacteria make the psoriasis worse.

Combination Therapy:

When you combine topical (put on the skin), light, and systemic treatments, you can often use lower doses of each. Combination therapy can also lead to better results.

Will psoriasis go away with treatment?

While psoriasis will typically improve with treatment, it may not ever completely go away. The scales of psoriasis should improve after you begin treatment. It may take 2 to 6 weeks for the affected areas of your skin to return to a more normal thickness, and the redness may take several months to improve. Sometimes, certain scaly spots will get better at the same time that other spots get worse.
After you've been using a certain type of medicine for a while, your psoriasis may "get used to" the treatment. If this happens, your medicine may not be as effective as it once was. Your doctor may change your medicine. Sometimes you may need a stronger dose of medicine. Talk to your doctor if your psoriasis doesn't seem to be getting better with treatment.

What Are Some Promising Areas of Psoriasis Research?

Doctors are learning more about psoriasis by studying:
  • Genes
  • New treatments that help skin not react to the immune system
  • The association of psoriasis with other conditions such as obesity, high blood pressure, and diabetes.

Questions to Ask Your Doctor

  • What treatment is best for me?
  • Will I have to change medicines often?
  • Is there anything I can do at home to relieve the pain and itching?
  • If my symptoms get worse, when should I call my doctor?
  • Is there a special shampoo I should use?
  • Could you recommend a good lotion?
  • Will I have to be on medicine the rest of my life?
  • I have psoriasis. Will my children have it?
  • Should I make any changes to my skin care routine?
  • Are there any support groups in my area?

Thursday, 26 January 2012

FEVER


A fever is usually a sign that something out of the ordinary is going on in your body. For an adult, a fever may be uncomfortable, but fever usually isn't dangerous unless it reaches 103 F or higher. For very young children and infants, a slightly elevated temperature may indicate a serious infection.
But the degree of fever doesn't necessarily indicate the seriousness of the underlying condition. A minor illness may cause a high fever, and a more serious illness may cause a low fever.
Usually a fever goes away within a few days. A number of over-the-counter medications lower a fever, but sometimes it's better left untreated. Fever seems to play a key role in helping your body fight off a number of infections.

Symptoms

You have a fever when your temperature rises above its normal range. What's normal for you may be a little higher or lower than the average normal temperature of 98.6 F.
Depending on what's causing your fever, additional fever signs and symptoms may include:
  • Sweating
  • Shivering
  • Headache
  • Muscle aches
  • Loss of appetite
  • Dehydration
  • General weakness
High fevers between 103 F and 106 F may cause:
  • Hallucinations
  • Confusion
  • Irritability
  • Fits
  • Dehydration
 When to see a doctor
Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.
Taking a temperature
To check your or your child's temperature, you can choose from several types of thermometers, including oral, rectal and ear thermometers.
Although it's not the most accurate way to take a temperature, you can use an oral thermometer for an armpit reading:
  • Place the thermometer in the armpit and cross your arms or your child's arms over the chest.
  • Wait four to five minutes. The armpit temperature is slightly lower than an oral temperature.
  • If you call your doctor, report the actual number on the thermometer and where on the body you took the temperature.
Infants
An unexplained fever is greater cause for concern in infants and in children than in adults. Call your baby's doctor if your baby has a fever of 101 F or higher. Also call your baby's doctor if your baby:
  • Has a fever and is younger than 3 months of age.
  • Refuses to eat or drink.
  • Has a fever and unexplained irritability, such as marked crying during a diaper change or when moved.
  • Has a fever and seems lethargic and unresponsive. In infants and children younger than age 2, these may be signs of meningitis. If you're worried that your baby might have meningitis, take your baby to the doctor right away.
  • Is a newborn and has a lower than normal temperature — less than 97 F. Very young babies may not regulate their body temperature well when they are ill and may become cold rather than hot.
Children
There's probably no cause for alarm if your child has a fever but is responsive — making eye contact with you and responding to your facial expressions and to your voice — and is drinking fluids and playing.

Call your child's doctor if your child:
  • Is listless or irritable, vomits repeatedly, has a severe headache or stomach ache, or has any other symptoms causing significant discomfort.
  • Has a fever after being left in a hot car. Seek medical care immediately.
  • Has a fever that persists longer than a day (in children younger than age 2) or longer than three days (in children ages 2 and older).
Ask your child's doctor for guidance in special circumstances, such as a child with immune system problems or with a pre-existing illness. Your child's doctor also may recommend precautions if your child has just started taking a new prescription medicine.
Adults
Call your doctor if:
  • Your temperature is more than 103 F
  • You've had a fever for more than three days
In addition, seek immediate medical attention if any of these signs or symptoms accompanies a fever:
  • Severe headache
  • Severe throat swelling
  • Unusual skin rash, especially if the rash rapidly worsens
  • Unusual sensitivity to bright light
  • Stiff neck and pain when you bend your head forward
  • Mental confusion
  • Persistent vomiting
  • Difficulty breathing or chest pain
  • Extreme listlessness or irritability
  • Abdominal pain or pain when urinating
  • Any other unexplained signs or symptoms

Causes

Your normal body temperature varies throughout the day — it's lower in the morning and higher in the late afternoon and evening. In fact, your normal temperature can range from about 97 F  to 99 F. Although most people consider 98.6 F normal, your temperature may vary by a degree or more. Other factors, such as your menstrual cycle or heavy exercise, can affect your temperature.
A fever might be caused by:
  • A virus
  • A bacterial infection
  • Heat exhaustion
  • Extreme sunburn
  • Certain inflammatory conditions such as rheumatoid arthritis 
  • Overdressing
  • A malignant tumor
  • Some medications, such as antibiotics and drugs used to treat high blood pressure or seizures
  • Some immunizations, such as the diphtheria, tetanus
Sometimes it's not possible to identify the cause of a fever. If you have a temperature of 101 F  or higher for more than three weeks and your doctor isn't able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin.

Is it a Fever?
A gentle kiss on the forehead or a hand placed lightly on the skin is often enough to give you a hint that your child has a fever. However, this method of taking a temperature is dependent on the person feeling the temperature and doesn't give an accurate measure of temperature.
Use a reliable thermometer to confirm a fever (which is when a child's temperature is at or above one of these levels):
  • 100.4° F  measured rectally (in the bottom)
  • 99.5° F  measured orally (in the mouth)
  • 99° F  measured in an axillary position (under the arm)
But how high a fever is doesn't tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102°-104° F range), but this doesn't usually indicate a serious problem. And serious infections might cause no fever or even an abnormally low body temperature, especially in infants.
Because fevers can rise and fall, a child might have chills as the body tries to generate additional heat as its temperature begins to rise. The child may sweat as the body releases extra heat when the temperature starts to drop.
Sometimes kids with a fever breathe faster than usual and may have a higher heart rate. You should call the doctor if your child is having difficulty breathing, is breathing faster than normal, or continues to breathe fast after the fever comes down.

Complications

Complications of a fever may include:
  • Severe dehydration
  • Hallucinations
  • Fever-induced seizure, in a small number of children ages 6 months to 5 years
Fever induced seizures
Febrile seizures usually involve loss of consciousness and shaking of limbs on both sides of the body. Although alarming for parents, the vast majority of febrile seizures cause no lasting effects.
If a seizure occurs:
  • Lay your child on his or her side or stomach on the floor or ground
  • Remove any sharp objects that are near your child
  • Loosen tight clothing
  • Hold your child to prevent injury
  • Don't place anything in your child's mouth or try to stop the seizure
Most seizures stop on their own. Take your child to the doctor as soon as possible after the seizure to determine the cause of the fever.
Call for emergency medical assistance if a seizure lasts longer than 10 minutes.

Preparing for your appointment

After you make an appointment with your family doctor, general practitioner or pediatrician, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from the doctor.
 
What you can do
  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down information about the fever, such as when it started, how and where you measured it (orally for example) and any other symptoms. Note whether you or your child has been around anyone who's been ill.
  • Write down key personal information, including any major stresses, recent life changes or recent travel out of the country.
  • Make a list of all medications, vitamins and supplements that you or your child is taking.
  • Write down questions to ask the doctor.

Preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important. For fever, some basic questions to ask include:
  • What is causing the fever?
  • What else could be causing it?
  • What kinds of tests are needed?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • Is medicine necessary to lower the fever?
  • Are there any restrictions that I need to follow?
  • Is there a alternative to the medicine you're prescribing?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend?
In addition to the questions that you've prepared, don't hesitate to ask questions during your appointment anytime that you don't understand something.
What to expect from your doctor
Be prepared to answer questions your doctor is likely to ask you, including:
  • When did the symptoms first occur?
  • What method did you use to take your or your child's temperature?
  • Have you or your child taken any fever-lowering medication?
  • What other symptoms are you or your child experiencing? How severe are they?
  • Do you or your child have any chronic health conditions?
  • What medications do you or your child regularly take?
  • Have you or your child been around anyone who's ill?
  • Have you or your child recently undergone surgery?
  • Have you or your child recently traveled outside the country?
  • What, if anything, seems to improve the symptoms?
  • What, if anything, appears to worsen the symptoms?

Tests and diagnosis

Your doctor will look for an infection or noninfectious cause of your fever based on your other symptoms and a physical exam. You may need tests, such as blood tests, to confirm a diagnosis.
If you have a low-grade fever that persists for three weeks or more, but have no other symptoms, your doctor may recommend a variety of tests to help find the cause. These may include blood tests and X-rays.

Treatments and drugs

With low-grade fever, doctors don't always recommend trying to lower the body temperature. Doing so may prolong the illness or mask symptoms and make it harder to determine the cause.
Some experts believe that aggressively treating a fever interferes with the body's immune response. Viruses that cause colds and other respiratory infections thrive at normal body temperature. By producing a low-grade fever, your body may be helping to eliminate a virus.
Over-the-counter medications
In the case of a high fever, your doctor may recommend an over-the-counter medication, such as:
  • Paracetamol (Crocin) or ibuprofen (Brufen). Use these medications according to the label instructions or as recommended by your doctor. Be careful to avoid taking too much. High doses or long-term use of paracetamol may cause liver or kidney damage, and acute overdoses can be fatal. If your child's fever remains high after a dose, don't give more medication; call your doctor instead. For temperatures below 102 F, don't use fever-lowering drugs unless advised by your doctor.
  • Aspirin, for adults only. Don't give aspirin to children, because it may trigger a rare, but potentially fatal.
Prescription medications
Depending on the cause of your fever, your doctor may prescribe an antibiotic, especially if he or she suspects a bacterial infection, such as pneumonia or throat infection.
Antibiotics don't treat viral infections. There are a few antiviral drugs used to treat some specific viral infections. However, the best treatment for most viruses is often rest and plenty of fluids.

Lifestyle and home remedies

You can try a number of things to make yourself or your child more comfortable during a fever:
  • Drink plenty of fluids. Fever can cause fluid loss and dehydration, so drink water, juices or broth. For a child under age 1, use an oral rehydration solution. These solutions contain water and salts proportioned to replenish fluids and electrolytes.
  • Rest. It's necessary for recovery, and activity can raise your body temperature.
  • Stay cool. Dress in light clothing, keep the room temperature cool and sleep with only a sheet or light blanket.
  • Soak in lukewarm water. Especially for high temperatures, a lukewarm five- to 10-minute soak or a sponge bath can be cooling. If the bath causes shivering, stop the bath and dry off. Shivering raises the body's internal temperature — shaking muscles generate heat.

Prevention

The best way to prevent fevers is to reduce your exposure to infectious diseases. One of the most effective ways to do that is also one of the simplest — frequent hand-washing.
Teach your children to wash their hands often, especially before they eat, after using the toilet, after spending time in a crowd or around someone who's sick, and after petting animals. Show them how to wash their hands vigorously, covering both the front and back of each hand with soap, and rinsing thoroughly under running water. Carry moist towelettes or hand sanitizer with you for times when you don't have access to soap and water. When possible, teach your kids not to touch their noses, mouths or eyes — the main way viral infections are transmitted.
In addition, teach your children to turn away from others and to cover their mouths when coughing and their noses when sneezing.
You've probably experienced waking in the middle of the night to find your child flushed, hot, and sweaty. Your little one's forehead feels warm. You immediately suspect a fever, but are unsure of what to do next. Should you get out the thermometer? Call the doctor?
In healthy kids, fevers usually don't indicate anything serious. Although it can be frightening when your child's temperature rises, fever itself causes no harm and can actually be a good thing — it's often the body's way of fighting infections. And not all fevers need to be treated. High fever, however, can make a child uncomfortable and worsen problems such as dehydration.

  Types of Thermometers
Whatever thermometer you choose, be sure you know how to use it correctly to get an accurate reading. Keep and follow the manufacturer's recommendations for any thermometer.
Digital thermometers usually provide the quickest, most accurate readings. They come in many sizes and shapes and are available at most pharmacies. You should read the manufacturer's instructions to determine what the thermometer is designed for and how it signals that the reading is complete. Overall, digital thermometers usually can be used for these temperature-taking methods:
  • oral (in the mouth)
  • rectal (in the bottom)
  • axillary (under the arm)
Turn on the thermometer and make sure the screen is clear of any old readings. Digital thermometers usually have a plastic, flexible probe with a temperature sensor at the tip and an easy-to-read digital display on the opposite end. If your thermometer uses disposable plastic sleeves or covers, put one on according to the manufacturer's instructions. Remember to discard the sleeve after each use and to clean the thermometer according to the manufacturer's instructions before putting it back in its case.
Electronic ear thermometers measure the tympanic temperature — the temperature inside the ear canal.
Plastic strip thermometers (small plastic strips that you press against the forehead) may be able to tell you whether your child has a fever, but aren't reliable for taking an exact measurement, especially in infants and very young children.
Forehead thermometers also may be able to tell you if your child has a fever, but are not as accurate as oral or rectal digital thermometers.
Pacifier thermometers may seem convenient, but again, their readings are less reliable than rectal temperatures and shouldn't be used in infants younger than 3 months. They also require kids to keep the pacifier in their mouth for several minutes without moving, which is a nearly impossible task for most babies and toddlers.
Glass mercury thermometers were once common, but now they should not be used because of concerns about possible exposure to mercury, which is an environmental toxin.

Tips for Taking Temperatures
As any parent knows, taking a squirming child's temperature can be challenging. But it's one of the most important tools doctors have to determine if a child has an illness or infection. The best method will depend on a child's age and temperament.
For kids younger than 3 months, you'll get the most reliable reading by using a digital thermometer to take a rectal temperature. Electronic ear thermometers aren't recommended for infants younger than 3 months because their ear canals are usually too small.
For kids between 3 months to 4 years old, you can use a digital thermometer to take a rectal temperature or an electronic ear thermometer to take the temperature inside the ear canal. You could also use a digital thermometer to take an axillary temperature, although this is a less accurate method.
For kids 4 years or older, you can usually use a digital thermometer to take an oral temperature if your child will cooperate. However, kids who have frequent coughs or are breathing through their mouths because of stuffy noses might not be able to keep their mouths closed long enough for an accurate oral reading. In these cases, you can use the tympanic method (with an electronic ear thermometer) or axillary method (with a digital thermometer).
To take a rectal temperature: Before becoming parents, most people cringe at the thought of taking a rectal temperature. But don't worry — it's a simple process:
1.    Lubricate the tip of the thermometer with a lubricant, such as petroleum jelly.
2.    Place your child:
- belly-down across your lap or on a firm, flat surface and keep your palm along the lower back
- or face-up with legs bent toward the chest with your hand against the back of the thighs
3.    With your other hand, insert the lubricated thermometer into the anal opening about ½ inch to 1 inch (about 1.25 to 2.5 centimeters). Stop if you feel any resistance.
4.    Steady the thermometer between your second and third fingers as you cup your hand against your baby's bottom. Soothe your child and speak quietly as you hold the thermometer in place.
5.    Wait until you hear the appropriate number of beeps or other signal that the temperature is ready to be read. Write down the number on the screen, noting the time of day that you took the reading.
To take an oral temperature: This process is easy in an older, cooperative child.
1.    Wait 20 to 30 minutes after your child finishes eating or drinking to take an oral temperature, and make sure there's no candy in your child's mouth.
2.    Place the tip of the thermometer under the tongue and ask your child to close his or her lips around it. Remind your child not to bite down or talk, and to relax and breathe normally through the nose.
3.    Wait until you hear the appropriate number of beeps or other signal that the temperature is ready to be read. Write down the number on the screen, noting the time of day that you took the reading.
To take an axillary temperature: This is a convenient way to take a child's temperature. Although not as accurate as a rectal or oral temperature in a cooperative child, some parents prefer to take an axillary temperature, especially for kids who can't hold a thermometer in their mouths.
1.    Remove your child's shirt and undershirt, and place the thermometer under an armpit (it must be touching skin only, not clothing).
2.    Fold your child's arm across the chest to hold the thermometer in place.
3.    Wait until you hear the appropriate number of beeps or other signal that the temperature is ready to be read. Write down the number on the screen, noting the time of day that you took the reading.
Whatever method you choose, keep these additional tips in mind:
  • Never take a child's temperature right after a bath or if he or she has been bundled tightly for a while — this can affect the temperature reading.
  • Never leave a child unattended while taking a temperature.

CHICKEN POX


Chickenpox is a common illness among kids, particularly those under age 12. An itchy rash of spots that look like blisters can appear all over the body and be accompanied by flu-like symptoms. Symptoms usually go away without treatment, but because it is very contagious, an infected child should stay home and rest until the symptoms are gone.
Chickenpox is caused by the varicella-zoster virus (VZV). Kids can be protected from VZV by getting the chickenpox (varicella) vaccine, usually between the ages of 12 to 15 months. Medical bodies recommend a booster shot at 4 to 6 years old for further protection. It is also recommended that people 13 years of age and older who have never had chickenpox or received the chickenpox vaccine get two doses of the vaccine at least 28 days apart.
A person usually has only one episode of chickenpox, but VZV can lie dormant within the body and cause a different type of skin eruption later in life called shingles or herpes zoster. Getting the chickenpox vaccine significantly lowers kids' chances of getting chickenpox, but they might still develop shingles later in life.
Symptoms
Chickenpox causes a red, itchy skin rash that usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body, including the scalp, mouth, nose, ears, and genitals.
The rash begins as multiple small red bumps that look like pimples or insect bites. They develop into thin-walled blisters filled with clear fluid, which becomes cloudy. The blister wall breaks, leaving open sores, which finally become dry, brown scabs.
Chickenpox blisters are usually less than a quarter of an inch wide, have a reddish base, and appear in crops over 2 to 4 days. The rash may be more extensive or severe in kids who have skin disorders such as eczema.
Some kids have a fever, abdominal pain, sore throat, headache, or a vague sick feeling a day or 2 before the rash appears. These symptoms may last for a few days, and fever stays in the range of 100°-102° F, though in rare cases may be higher. Younger kids often have milder symptoms and fewer blisters than older children or adults.
Chickenpox is usually a mild illness, but can affect some infants, teens, adults, and people with weak immune systems more severely. Some people can develop serious bacterial infections involving the skin, lungs, bones, joints, and the brain. Even kids with normal immune systems can occasionally develop complications, most commonly a skin infection near the blisters.
Anyone who has had chickenpox (or the chickenpox vaccine) as a child is at risk for developing zoster later in life, and up to 20% do develop. After an infection, VZV can remain inactive in nerve cells near the spinal cord and reactivate later as zoster, which can cause tingling, itching, or pain followed by a rash with red bumps and blisters. Zoster is sometimes treated with antiviral drugs, steroids, and pain medications, and there's now a shingles vaccine for people 60 and older.
Contagiousness
Chickenpox is contagious from about 2 days before the rash appears until all the blisters develop scabs. A child with chickenpox should be kept out of school until all blisters have dried, usually about 1 week. If you're unsure about whether your child is ready to return to school, ask your doctor.
Chickenpox is very contagious — most kids with a sibling who's been infected will get it as well (if they haven't already had the disease or the vaccine), showing symptoms about 2 weeks after the first child does. To help keep the virus from spreading, make sure your kids wash their hands frequently, particularly before eating and after using the bathroom. And keep a child with chickenpox away from unvaccinated siblings as much as possible.
People who haven't had chickenpox or the vaccine also can catch it from someone with zoster, but they cannot catch zoster itself. That's because zoster can only develop from a reactivation of VZV in someone who has previously had chickenpox.
Chickenpox and Pregnancy
Pregnant women and anyone with immune system problems should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects and she is at risk for more health complications than if she'd been infected when she wasn't pregnant. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications. There is no risk to the developing baby if the woman develops zoster during the pregnancy.
If a pregnant woman has had chickenpox before the pregnancy, the baby will be protected from infection for the first few months of life, since the mother's immunity gets passed on to the baby through the placenta and breast milk.
Those at risk for severe disease or serious complications — such as newborns whose mothers had chickenpox at the time of delivery, patients with blood cancer or immune deficiencies — may be given varicella zoster immune globulin after exposure to chickenpox to reduce its severity.

 
Prevention
Doctors recommend that kids receive the chickenpox vaccine when they're 12 to 15 months old and a booster shot at 4 to 6 years old. The vaccine is about 70% to 85% effective at preventing mild infection, and more than 95% effective in preventing moderate to severe forms of the infection. Therefore, although some kids who are immunized still will get chickenpox, the symptoms are usually much milder than those of kids who haven't had the vaccine and become infected.
Healthy kids who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness.
Treatment
A virus causes chickenpox, so the doctor won't prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria. This is pretty common among kids because they often scratch and pick at the blisters.
The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears. Acyclovir can have significant side effects, so it is only given when necessary. Your doctor can tell you if the medication is right for your child.
Dealing With Discomfort
To help relieve the itchiness, fever, and discomfort of chickenpox:
  • Use cool wet compresses or give baths in cool or lukewarm water every 3 to 4 hours for the first few days. Baths do not spread the rash, in fact they help removing bacteria from the body hence it reduces the chances of bacterial infection and subsequent complications and scarring.
  • Pat (don't rub) the body dry.
  • Serve foods that are cold, soft, and bland because blisters in the mouth may make drinking or eating difficult. Avoid feeding your child anything highly acidic or especially salty, like orange juice.
  • Give your child paracetamol regularly to help relieve pain if your child has mouth blisters.
  • Ask the doctor about using over-the-counter medication for itching.
Never use aspirin to reduce pain or fever in kids with chickenpox because aspirin has been associated with the serious disease Reye syndrome, which can lead to liver failure and even death.
As much as possible, discourage kids from scratching. This can be difficult for them, so consider putting gloves or socks on your child's hands to prevent scratching during sleep. In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.
Most chickenpox infections require no special medical treatment. But sometimes, there are problems. Call the doctor if your child:
  • has fever that lasts for more than 4 days or rises above 102° F (38.8° C)
  • has a severe cough or trouble breathing
  • has an area of rash that leaks pus (thick, discolored fluid) or becomes red, warm, swollen, or sore
  • has a severe headache
  • is unusually drowsy or has trouble waking up
  • has trouble looking at bright lights
  • has difficulty walking
  • seems confused
  • seems very ill or is vomiting
  • has a stiff neck
Call your doctor if you think your child has chickenpox and you have a question or are concerned about a possible complication. The doctor can guide you in watching for complications and in choosing medication to relieve itching.
If taking your child to the doctor, let the office know in advance that your child might have chickenpox. It's important to try to avoid exposing others in the office — for some of them, a chickenpox infection could cause severe complications.