Chickenpox

Varicella–zoster virus (VZV) is known to cause two diseases: chickenpox (varicella) and shingles (herpes zoster). Chickenpox is a common contagious disease of children that usually has a benign course. However chickenpox in adults or people with weakened immune systems can have serious complications. Second attacks of chickenpox are very rare. Shingles is caused by a reactivation of the latent VZV commonly seen over age 50.

Signs and Symptoms

The typical rash of chickenpox is made up of groups of small itchy blisters surrounded by inflamed skin on the trunk scalp face and extremities accompanied by low-grade fever fatigue headache and loss of appetite. The typical rash of shingles is made up of large blisters that cover a large area of the body especially the face trunk shoulders and neck and legs. These eruptions follow the path of an infected nerve. Usually only a single nerve is involved confining the rash to one side of the body. Pain after the rash has disappeared is common because the affected nerve is irritated.

What Causes It?

Exposure to an individual with chickenpox at home at school or in the hospital is the likely cause of this virus. Later in life weakening of the immune system from age or disease can make you susceptible to shingles.

What to Expect at Your Provider's Office

Your health care provider will easily be able to diagnose chickenpox because of its characteristic rash. If you have shingles your provider may order some blood tests. Pain medication antiviral medication and symptomatic treatments will likely be prescribed.

Treatment Options

Treatment Plan

Your health care provider will want to shorten the length of your disease as much as possible and give you symptom relief. Most childhood chicken pox is treated with over-the-counter lotions that help reduce symptoms. There is currently a vaccine available to healthy children. Exposure to chickenpox if you have a weakened immune system is more serious. Your provider will give you drugs to prevent or decrease the strength of the disease.

Drug Therapies

Prescription

• Acyclovir—for treatment of shingles for chickenpox in those with weakened immune systems for adults and adolescents with severe symptoms from chickenpox for women with chickenpox in the third trimester of pregnancy; various side effects
• Valacyclovir—speeds up the healing of shingles; various side effects
• Prednisone—relieves the pain of shingles (you will be given acyclovir at the same time); various side effects
• Capsaicin cream amitriptyline hydrochloride and fluphenazine hydrochloride—for symptom relief of shingles and for treatment of the lasting pain along nerves after a bout of shingles; various side effects

Over the Counter

• Acetaminophen (Tylenol)—for fever (Use in place of aspirin for children under 18 years.)
• Various creams to reduce itching

Complementary and Alternative Therapies

Nutritional and herbal support may be helpful.

Nutrition

• Avoid foods that inhibit immune activity and stimulate inflammation such as saturated fats refined foods sugars and juice.
• Beta-carotene (50 000 to 100 000 IU per day) zinc (30 to 50 mg per day) vitamin C (1 000 to 1 500 mg three to four times per day) and vitamin E (400 to 800 IU per day) promote healing of lesions.
• Calcium (1 000 to 1 500 mg per day) magnesium (200 mg two to three times per day) and B-complex (50 to 100 mg per day)
• Additional B₁₂ (500 to 1 000 mcg) for lingering pain
• Vitamin A (200 000 to 300 000 IU per day for 3 days then 100 000 to 150 000 IU per day for 3 days then 50 000 IU per day for three days) helps decrease severity and length of symptoms. Do not take high doses of vitamin A if you are pregnant or have liver disease.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots.

• Topical cream applications of concentrated extract of glycyrrhizic acid (from licorice root) can provide symptomatic relief. A poultice made from powdered slippery elm (Ulmus fulva) comfrey (Symphytum officinalis) and goldenseal root (Hydrastis canadensis) is soothing aids healing and reduces the likelihood of secondary infection.
• For acute infection combine equal parts of the following herbs in a tincture (30 to 60 drops three to four times per day) or a tea (3 to 4 cups per day)and drink. Coneflower (Echinacea purpura) licorice root (Glycyrrhiza glabra) burdock root (Arctium lappa) lemon balm (Melissa officinalis) chamomile (Matricaria recutita) and St. John's wort (Hypericum perforatum). Do not take licorice if you have high blood pressure.
• Combine equal parts tincture of Jamaican dogwood (Piscidia erythrina) wild lettuce (Lactuca virosa) valerian (Valeriana officinalis) marigold (Calendula officinalis) and St. John's wort (Hypericum perforatum) with 1/2 part yellow jasmine (Gelsemium sempiverens). Take 30 to 60 drops three to four times per day.

Homeopathy

Some of the most common remedies used for VZV are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms resolve.

• Lachesis for herpes zoster across left side of back with flushes of heat
• Mezereum for herpes zoster of the face with headaches and facial pain
• Petroleum for herpes zoster with intense itching that is worse at night

Physical Medicine

Tepid oatmeal baths may provide relief from itching and burning. Use Aveeno as commercially available or place 1 cup of oats in a sock and let soak in tub. Squeeze the sock to release the soothing oat milk.

Prepare a tea from peppermint leaf (Mentha piperita) cool and place in a spray bottle. Spray on lesions for temporary pain relief.

Acupuncture

Immune function may be stimulated with acupuncture treatments.

Following Up

Your health care provider may want to see you after shingles if you continue to have pain along the course of the affected nerve.

Special Considerations

While chickenpox usually goes away on its own severe and sometimes fatal infections may occur in newborn infants in adults and in people whose immune systems are weakened.

Supporting Research

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998:1086–1088.

Krugman S Katz SL Gershon AA et al. Infectious Diseases of Children. St. Louis Mo: Mosby-Year Book; 1992:587–609.

Mandell GL Douglas RG Jr Bennett JE. Principles and Practice of Infectious Diseases. 3rd ed. New York NY: Churchill Livingstone; 1995:1153–1158 2237–2240.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:218 249 289.

Copyright © 2000 Integrative Medicine Communications

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