Chickenpox

What it is

A common viral infection with itchy blisters.

How it works

The varicella-zoster virus spreads by air and contact.

Why it matters on darker skin

Spots may leave dark marks; avoid scratching.

Causes and triggers

Contact with infected people.

What helps — and why it works

Keep cool and nails short: reduce scratching. Expected timeline: 7–10 days. Paracetamol for fever (pharmacist advice): comfort.

More detail

Chickenpox usually begins with a mild fever and feeling unwell, followed by crops of itchy red or dark spots that turn into fluid-filled blisters, then crust over within about a week. New crops appear for several days, so spots at different stages are typical. A child is infectious from a day or two before the spots appear until all the blisters have crusted. Keep them away from school, pregnant women, newborn babies and anyone with a weak immune system during this time. Calamine lotion, cool baths, loose cotton clothes and short nails reduce scratching, which is the main cause of scarring and of dark marks on darker skin. Vaccination is available in many countries and prevents most severe cases. Adults, teenagers and babies tend to be more unwell than young children, and pregnant women who are exposed should contact a doctor promptly.

What to avoid and why

Avoid ibuprofen in chickenpox unless a doctor advises.

Common mistakes

• Sending to school while spots are wet.

Caring for children's skin

Children's skin is thinner, loses water faster and absorbs more of what is applied to it relative to body size, so simpler is safer. For most children a short lukewarm bath, a fragrance-free soap substitute and a plain emollient are all that is needed, plus shade, clothing and sunscreen from six months of age. Avoid adult products, essential oils, antiseptics in bath water, bleaching or 'toning' creams, and cosmetic treatments such as relaxers and gel nails. Medicines and medicated creams should be used only as a doctor, nurse or pharmacist advises, and in children Melanin & Me does not offer photo checks: a clinician should see the child. Trust your instincts as a parent: a child who is unusually sleepy, floppy, not feeding, breathing fast or has a rash that does not fade when pressed with a glass needs urgent care. Keep a simple record — photos and dates — of rashes that come and go, as this helps the doctor.

Products, medicines and when to worry

When choosing products for children, look for fragrance-free formulas with short ingredient lists, and avoid adult acne, anti-ageing or lightening products, essential oils and talc. Medicated creams — including steroid creams, antifungals and antibiotics — are safe and helpful when prescribed for the right condition and used for the right length of time, but mixed creams sold over the counter can contain strong steroids that are unsafe for children. Sunscreen is suitable from six months of age; younger babies should be kept in the shade and covered. Do not give medicines intended for adults, and ask a pharmacist about the right medicine for a child's age and weight. Seek urgent care for any rash with fever and a very unwell child, a rash that does not fade under a glass, swelling of the face or lips, or blistering of the mouth or eyes.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.