For the first one to two days, there will be a fever, abdominal pain, or a general feeling of ill health.  Skin eruptions will then appear almost anywhere on the body.  Do not be alarmed if they appear on the mouth, throat, nose, scalp, vagina or penis.

Within 24 hours, the blisters collapse and scab over.  New crops erupt over a three to four day period, spreading to face and scalp, and
tending to spare the arms and legs.  The mouth, throat, and conjunctiva (white of the eyes) are sometimes affected.  The scabs may last for one or two weeks before detaching.  Fine scars may remain for several months following the detachment of scabs.  Permanent scarring may occur at the site of large eruptions or ones that develop bacterial infection.

Anyone who has chicken pox is infectious to others who have not had the disease.  The infectious period begins during the one or two days before the skin eruptions appear, continuing until new eruptions stop appearing and lesions are scabbed over.  Symptoms of infection appear 10 to 21 days after exposure.  There is no way to protect a person who has never been infected with chicken pox after exposure to the virus.

Signs and symptoms of more serious complications include:

1. Cough and trouble breathing or chest pain (pneumonia).
2. Severe headache, dizziness, disorientation or changes in personality or alertness (meningitis).
3. Persistent fever >101° F more than two days into the eruption.
4. Lesions on the inside of the eye.
5. Redness, heat and swelling spreading outward from an infected lesion (bacterial infection).

Items 1, 2, and 4 can be very serious and require emergency care.  Items 3 and 5 require an urgent care visit.

Pregnant women and those who are immunosuppressed are at greater risk of complications.
 
Self-Care

1. Stay home until all the lesions are scabbed over and no new ones are coming up.

2. Avoid scratching and picking.  Cut nails short if necessary.  Staying cool will decrease itchiness.  Cool cornstarch baths (4 tbsp. to a tub of water) or over the counter Aveeno® oatmeal baths may help.  Pramegel® lotion (over the counter) will provide temporary relief.

3. For severe itching, oral Benadryl® (diphenhydramine) is an over the counter antihistamine that can be taken up to every 6 hours.  It causes drowsiness and should not be combined with alcohol or used when driving.

4. There is a prescription medicine that may decrease the severity and slightly decrease the length of infection.  It is expensive and is generally reserved for those with serious concurrent health problems.
 
Prevention