Comments from Expert Advisory Group
Seek secondary care advice in patients who are:
- Pregnant
- Immunocompromised
- Neonates
- Displaying systemic symptoms of chickenpox
Look for signs of complications such as secondary bacterial infection of skin lesions, pneumonia, and encephalitis.
HPSC update on group A Streptococcus
Non-immune women significantly exposed to varicella at any stage of pregnancy should be offered post exposure prophylaxis (PEP). See NIAC guidance on varicella zoster for more information.
Prescribing Considerations
- In immunocompetent patients the value of antivirals is minimal
- Consider prescribing oral aciclovir within 24 hours of onset of rash in patients with one or more of the following:
- ≥14 years of age
- severe rash
- severe pain
- smoker
- secondary household cases
- immunocompromised (start oral aciclovir while seeking secondary care advice about need for IV aciclovir)
Chickenpox Treatment
General Advice for Self-Care with Chickenpox
- Patients should be advised they are contagious until all the vesicles have scabbed over (usually 5-7 days after onset of rash)
- Pregnant women, who have not had chickenpox, should avoid patients with chickenpox/shingles
- Use simple emollients, antihistamines & antipyretics for symptom relief – seek advice from pharmacist
- Avoid NSAIDs due to increased risk of severe skin and soft-tissue infection
- Advise to keep nails short and clean to minimise scratching and secondary bacterial infection. Socks over hands at night may help prevent scratching.
- Bathe in lukewarm, not hot water.
- Keep hydrated – ice lollies may be helpful if mouth is sore.
Patient Information
Reviewed November 2022
