Therapy of chickenpox

Synonyms in the broadest sense

Varicella infection

English:

Chicken pocks, varicella; shingles

therapy

Immunocompromised patients and newborns are particularly at risk from varicella infection and its possible consequences.
Antiviral therapy with acyclovir (e.g. Zovirax®) can be used for them and for patients with severe forms of the infectious disease with pneumonia or extremely painful courses of zoster (shingles).

Note: chickenpox

This article is a continuation of the article on chickenpox. Read about the development / cause, diagnosis and symptoms of chickenpox here:

• chickenpox

You might also be interested in this topic: Chickenpox in adults

Acyclovir

The drug must be administered for the first time within 48 hours, a maximum of 72 hours, after the onset of the illness in order to be able to show an effect.

Mild forms of chickenpox can be treated symptomatically, i.e. with itching-relieving measures and fingernail care (Fingernails cut briefly and wash your hands frequently) so that the blisters are not scratched open and become infected with bacteria.
Kick a bacterial superinfection the skin cells, antibiotic therapy may be necessary.

aspirin

Salicylates (e.g. Aspirin®) to lower the fever, as this active ingredient can cause liver damage in children with viral infections.

What can be done about chickenpox itching?

Towels soaked in green tea can be placed on the skin to prevent itching. In addition to relieving itching, these should also have an anti-inflammatory effect.
In general, cold helps against the itching, so that the skin can also be cooled with cool towels.
Also, poultices with synthetic tanning agents can help relieve itching. If the itching cannot be stopped, antihistamines can be used. These are taken orally and should lead to rapid symptom relief.
If the pustules that occur with chickenpox are scratched open, scarring can occur. Superinfection with bacteria can occur in open skin areas. To avoid this, care should be taken not to scratch the skin until it becomes bloody. In the case of a bacterial superinfection, antibiotic therapy should be used.
Instead of scratching the skin with your fingers, it is also possible to develop another mechanism that is gentle on the skin. Here you can try to stroke the affected areas of skin with your smooth hand.

Homeopathic treatment for chickenpox

Chickenpox usually does not require treatment and heals spontaneously after about five to seven days. Belladonna, lemon balm extract and the mother tincture of the stepmother are available as homeopathic remedies. Most often, however, skin remedies that alleviate the symptoms will help with chickenpox. These most important symptoms are primarily relieving severe itching and lowering high fever.

Complications

The blisters often become inflamed when they are scratched open because of the severe itching and bacteria (bacterial superinfection) can penetrate. The efflorescences (reddened skin) then heal with scarring. To provide relief to the children, tinctures can be applied to the affected areas to relieve itching.

In patients with weakened immune system the chickenpox infection can become one generalized inflammation which affects the entire body and can be fatal in up to 40% of cases.

It can be an accompanying in the context of the chickenpox disease lung infection (= pneumonia), there is also inflammation of the cerebellum and a drop in platelets (=Platelets) Amount in blood possible.

Note: complications

The rate of complications is highest in newborns and over 16 year olds.

During pregnancy, the mother transfers protective antibodies to the unborn child if she herself had chickenpox before pregnancy and is immune to it, or if she has been vaccinated against chickenpox and is therefore immune to the infectious disease.

Women who develop chickenpox in early pregnancy often lose their baby (= abortion).
If the pregnancy is already in the late phase and the child is still suffering from chickenpox in the mother's womb, it can be affected by the typical formation of blisters and scars, but one must also expect malformations (= congenital varicella syndrome).
The most common malformations in children are skin scars, skeletal and muscle malformations, changes in the eyes such as Cataract (= Cataract) or eye infections as well as abnormalities of the central nervous system.

If the mother develops varicella 7 days before or 2 days after birth, the children are also affected by the infectious disease in the first 10-12 days of life (= congenital varicella), as the mother was unable to transmit a (sufficient) amount of protective antibodies to her child. The severity of the disease is very different:

It is possible that the child will experience mild chickenpox with few skin cells, but it can also become severe with involvement of the lung come in the form of pneumonia.

If adolescents or adults get chickenpox, the infection is usually more severe and more complicated than in children:
The elderly patients often have higher fever than that skin rash is more pronounced and the disease lasts longer than in children.

Approx. 20% of the adult patients develop pneumonia as a complication.

Prognosis and course

The prognosis for varicella or zoster disease is generally good: the skin symptoms heal without scarring and the zoster pain subsides completely after the nerve inflammation.
After contracting varicella you are immune to the virus for life,
i.e. that despite renewed contact with the virus, you will not get chickenpox.

Patients with weakened immune systems, patients with zoster ophthalmicus or oticus, children with congenital varicella and premature babies who develop chickenpox after birth, however, have a serious prognosis because they can suffer severe permanent damage from the infectious disease.

Special case: shingles

The Shingles is therefore a second illness after a varicella infection (= chickenpox) in childhood or adolescence and occurs when the varicella-zoster virus is reactivated as a result of a weak immune system in the body. This immune deficiency can e.g. occur as part of an infection.

Shingles is one Nerve inflammation (= Neuritis), which is associated with pain and blistering of a certain skin region. The sharp delimitation of the pain and the grouped arranged vesicles on a certain skin region can be explained by anatomical factors:

The affected skin region becomes sensitive (= tactile, pressure and pain sensations are conveyed via sensitive nerves) from the nerve cells infected by the virus, which run to the skin in bundled form. Each nerve bundle supplies part of the skin; these areas innervated from a nerve bundle are called Dermatomes.

Shingles are one or more dermatomes or their associated Neurons affected. The inflammation mostly affects the nerve cells that supply the central part of the trunk with sensitive supplies: the vesicles appear in a belt-shaped arrangement in the lumbar area, which is why one of beltrose speaks.

If the immune system is extremely weakened by an existing disease, a Generalized zoster occur in which the herpes zoster and pain appear all over the body.

Patient with Shingles are contagious for people who have not yet developed chickenpox or who have not been vaccinated against chickenpox. Analogous to the vesicles of chickenpox, the vesicular rash in shingles contains the virus in high concentrations, which can be transmitted through direct contact or by air.

Shingles is announced by pain and a changed sensation in the affected skin area. After a few days, vesicles finally form in a sharply defined skin region.
The rash cannot be differentiated from that of chickenpox, but it can be separated from the varicella due to its limited area and severe pain.
Patients are often limited by the disease:
They are photophobic, have a fever and headache and show local swelling, i.e. of the nearby lymph nodes.

Shingles can have the following complications:
In older patients in particular, permanent pain can be observed in the region of the body affected by herpes zoster, even long after the healing process.

Is the coverage area of ​​the Ophthalmic nerve affected, which innervates the eye region sensitively, it can lead to complications eyes come.

In zoster oticus, here the nerve is responsible for the supply of the Ear Affected by the inflammatory process, courses are up to Deafness possible.

You can find out more about shingles here: Shingles

prophylaxis

Children with chickenpox should be isolated during a hospital stay. Chickenpox is no longer contagious 5 days after the last fresh skin vesicles appear. Children can again visit community facilities such as kindergarten or school without any risk of infection from them.

There is an effective one vaccination against the varicella zoster virus, which includes chickenpox and Zoster evokes.
Since 2004 the Standing Committee on Vaccination (STIKO) of
Robert Koch Institute vaccinated against the virus in children aged 9-17 who have not yet had chickenpox. The protection against chickenpox that the vaccination offers is almost 100% in children under the age of 14; in older adolescents and adults this rate is around 90%.
This vaccination is a so-called active immunization with one Live vaccine:

During vaccine production, viruses are weakened in their effect and their ability to multiply is switched off. When the body comes into contact with the weakened virus form, an immune response with antibody formation occurs. The vaccinated are immune, i.e. that if you come into contact with the virus again, the disease will not occur.

Live vaccination is also recommended for people who are not vaccinated but are at risk of infection, e.g. medical staff or patients with immunodeficiencies of any kind or for people who could transmit the virus to people at risk, such as Siblings of immunocompromised children or healthcare workers.
Women who want to have children should also be vaccinated in order to avert the danger to the baby of a varicella infection during pregnancy.

A so-called passive immunization is possible. It is useful for children whose mothers have developed chickenpox 7 days before to 2 days after birth or within 48 hours for pregnant women who have come into contact with the virus.