Chickenpox (varicella) is an infectious disease caused by the varicella-zoster virus, primarily transmitted through airborne droplets or contact. The treatment aims to alleviate symptoms, shorten the disease course, and prevent serious complications such as skin infections or encephalitis. Treatment methods include antiviral medications, symptomatic relief drugs, and skin care measures, suitable for immunocompromised or high-risk patients.
Early treatment can reduce viral replication speed, with antiviral drugs being most effective when used within 48 hours of onset. Generally healthy children may only require symptomatic treatment, but immunodeficient patients or adults infected need active pharmacological control to prevent severe illness.
Main treatments are divided into two categories: antiviral drugs that directly inhibit viral replication, such as Acyclovir which works by inhibiting viral DNA polymerase; and symptomatic relief drugs targeting fever, itching, and other symptoms. Topical ointments containing oatmeal or similar ingredients can soothe skin irritation.
Immunoglobulin therapy is suitable for post-exposure prophylaxis, such as injection within 3-5 days after contact with an infected person, providing passive immunity to reduce disease severity. The choice of treatment depends on patient age, immune status, and timing of onset.
Antiviral drugs are mainly indicated for high-risk groups including patients over 12 years old, immunocompromised individuals (such as cancer patients), late pregnancy women, and those at risk of complications. Symptomatic relief treatments are suitable for all patients, especially for managing skin itching and fever.
Post-exposure prophylaxis applies to those who have been in contact with chickenpox patients but have not yet developed symptoms, especially immunodeficient or unvaccinated individuals. Vaccination is a preventive measure, effective when administered within 3-5 days after exposure.
Oral Acyclovir dosage is usually calculated based on body weight, with adults or adolescents taking three times daily for 7-10 days. Topical ointments should be applied 2-3 times daily to affected areas, avoiding broken blisters. Immunoglobulin therapy requires intravenous injection, with dosage adjusted according to age and weight.
Fever reducers like acetaminophen should be dosed according to body weight; aspirin must be avoided to prevent Reye's syndrome. All medications should be used strictly following medical instructions. Doses for patients under 12 years old should be adjusted accordingly, and self-adjustment is not allowed.
Vaccination provides long-term immunity, reducing the risk of disease by 70-90% after exposure. Combined treatment strategies can effectively control infection, especially benefiting high-risk populations with significant clinical outcomes.
Antiviral medications may cause gastrointestinal discomfort, headache, or dizziness; rare cases may show renal function abnormalities. Topical ointments may cause contact dermatitis; avoid contact with eyes or mucous membranes.
Severe side effects include allergic reactions or liver function abnormalities, requiring immediate discontinuation and medical attention. Immunoglobulin therapy may cause injection site pain, but severe allergic reactions are rare, occurring in less than 0.1% of cases.
Contraindications include allergy to drug components, severe renal or hepatic impairment, and interactions with nephrotoxic drugs. Use during pregnancy should be cautious, especially in early pregnancy where there may be an increased risk of congenital abnormalities.
Contraindicated groups include:
Combination with other nucleoside antiviral drugs may increase nephrotoxicity; renal function should be monitored. When used with immunosuppressants, dosage adjustments are necessary as they may reduce drug efficacy. Non-steroidal anti-inflammatory drugs (NSAIDs) may add gastrointestinal side effects.
Timing with vaccination is important: immunoglobulin should be spaced at least 5 months from vaccination to avoid neutralizing vaccine efficacy. Patients undergoing chemotherapy or organ transplantation should inform their physicians of all medications used.
Clinical trials show that starting Acyclovir within 24 hours of rash onset can shorten symptoms by an average of 2 days and reduce blister scabbing time by 30%. In immunodeficient patients, immunoglobulin can reduce encephalitis incidence by up to 80%.
Systematic reviews indicate that combined use of antipyretics and skin care can reduce secondary infection rates by 45%. Post-vaccination protection can reach 90%, with breakthrough infections usually presenting mild symptoms.
Non-pharmacological treatments include cold compresses to relieve itching, trimming nails to prevent scratching blisters, and oatmeal baths to soothe skin irritation. Traditional Chinese medicine may use heat-clearing and detoxifying formulas, but safety should be discussed with a healthcare provider.
Alternative medications include Valacyclovir as a substitute for Acyclovir, noting differences in hepatic metabolism. For severe infections, Famciclovir may be considered, with renal function assessment required.
How to properly care for skin rashes during chickenpox to prevent scarring?
Keep the skin clean and dry, avoid scratching blisters, and use cold compresses or zinc oxide ointments to relieve itching. Wear loose cotton clothing to reduce friction. If blisters rupture, apply antibiotic ointment and cover the wounds to lower infection and scar risks.
How to determine the timing and duration of antiviral medication (such as Acyclovir)?
Antiviral drugs should be started within 24 hours of rash appearance for effectiveness, typically for 5-7 days. The doctor will adjust the dosage based on age, immune status, and symptom severity. Patients must strictly follow prescribed instructions and not stop medication prematurely.
How to safely use antipyretics during fever? What precautions should be taken?
It is recommended to use paracetamol (acetaminophen) for fever reduction and avoid aspirin to prevent Reye's syndrome. If high fever persists or seizures occur, seek medical attention immediately and follow the physician’s instructions for medication adjustments.
What dietary considerations should be taken during treatment to promote recovery?
Consume high-protein, vitamin-rich foods such as fresh vegetables, fruits, and quality proteins. Avoid spicy or hot foods that may irritate oral ulcers. Drink plenty of water to promote metabolism, but avoid citrus fruits to prevent skin irritation.
How long can immunity be maintained after treatment? Is additional vaccination necessary?
Immunity acquired from natural infection usually lasts over 10 years, but protection from vaccination may be lower. For high-risk exposures or immunocompromised individuals, a second dose of the varicella vaccine may be recommended by a healthcare provider to enhance protection.
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