Chickenpox medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Chickenpox Microchapters


Patient Information


Historical Perspective




Differentiating Chickenpox from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings

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Medical Therapy


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Case #1

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There is no definitive treatment for chickenpox, only supportive treatment exists, to minimize discomfort and pruritus. Antiviral therapy with acyclovir and valacyclovir is beneficial if given within the first 24 hours of appearance of the rash.

Medical Therapy

Symptomatic treatment

Antiviral Therapy

  • Indications for antiviral therapy: [4]
  • The decision whether to initiate antiviral therapy in a patient with chickenpox will depend on the patient's age, underlying medical conditions, and the risk of complications.
  • In general, young children (under age 12 years) are at lower risk for complications than are adolescents or adults. An exception may be secondary pediatric cases in a household, who tend to have more severe disease than the index case.
  • Benefits of antiviral therapy are minimal for healthy children presenting after 24 hours of illness. Because of the greater risk of complications, antiviral therapy is appropriate for adolescents and adults with chickenpox, probably even for those presenting 48–72 hours into the course of illness.
  • Immunocompromised patients with varicella are at significant risk for viral dissemination and visceral involvement and should always receive antiviral therapy.
Medications to avoid


  1. US Centers for Disease Control and Prevention. "Varicella Treatment Questions & Answers". CDC Guidelines. CDC. Retrieved 2007-8-23. Check date values in: |accessdate= (help)
  2. Somekh E, Dalal I, Shohat T, Ginsberg GM, Romano O (2002). "The burden of uncomplicated cases of chickenpox in Israel". J. Infect. 45 (1): 54–7. PMID 12217733.
  3. Evans, E.B.; Pollock, T.M.; Cradock-Watson, J.E.; Ridehalgh, M.K.S. (1980). "HUMAN ANTI-CHICKENPOX IMMUNOGLOBULIN IN THE PREVENTION OF CHICKENPOX". The Lancet. 315 (8164): 354–356. doi:10.1016/S0140-6736(80)90897-1. ISSN 0140-6736.
  4. Arvin AM (2002). "Antiviral therapy for varicella and herpes zoster". Semin Pediatr Infect Dis. 13 (1): 12–21. PMID 12118839.
  5. "A Controlled Trial of Acyclovir for Chickenpox in Normal Children — NEJM".
  6. Wallace MR, Bowler WA, Murray NB, Brodine SK, Oldfield EC (1992). "Treatment of adult varicella with oral acyclovir. A randomized, placebo-controlled trial". Ann. Intern. Med. 117 (5): 358–63. PMID 1323943.
  7. 7.0 7.1 Kechagia IA, Kalantzi L, Dokoumetzidis A (2015). "Extrapolation of Valacyclovir Posology to Children Based on Pharmacokinetic Modeling". Pediatr. Infect. Dis. J. 34 (12): 1342–8. doi:10.1097/INF.0000000000000910. PMID 26379165.

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