Health Tip: Antiviral Treatment for Chickenpox

Who May Need The Treatment

Chickenpox is a viral infection that causes itchy, fluid-filled skin blisters. Usually affecting children, the infection typically runs its course and clears up without treatment.

Adults and teens, however, may be at risk of more severe symptoms and may benefit from an antiviral medication, the U.S. National Library of Medicine says. An antiviral is most beneficial if begun during the first 24 hours of the skin rash.

The agency mentions these additional facts about use of an antiviral medication in a person with chickenpox:

• Healthy children who don't have severe symptoms probably don't need an antiviral medication.
• Adolescents who take regular aspirin may need an antiviral.
• People with skin or lung conditions, or those who have recently taken a steroidal medication, may benefit from an antiviral.
• People who have been exposed to chickenpox -- but haven't contracted the infection -- may benefit from an antiviral.

Complications of Chickenpox

Bacterial infection and Scarring. A common complication of chickenpox is a bacterial infection of the skin. A secondary infection may develop at sites which the patient has scratched. The infection is usually caused by the bacteria Staphylococcus aureus or Streptococcus pyogenes. Permanent scarring may occur as a result.

Reactivation of the Virus as Shingles (Herpes Zoster). The major long-term complication of varicella is the later reactivation of the herpes zoster virus and the development of shingles. Shingles occurs in about 20% of people who have had chickenpox

Chickenpox and Pregnancy. Other complications of chickenpox affect pregnant women. Chickenpox early in pregnancy can result in a variety of problems in a newborn, including low birth weight and birth defects, such as limb abnormalities. A greater threat to a baby occurs when the mother develops chickenpox in the week before birth. Then it can cause a serious, life-threatening infection in a newborn.

If you're pregnant and not immune to chickenpox, talk to your doctor about the risks to you and your unborn child.

Chickenpox, Pneumonia, Encephalitis. Chickenpox may also lead to pneumonia or, rarely, an inflammation of the brain (encephalitis), both of which can be very serious.

Antiviral drugs such as aciclovir tablet (Acylete, Avorax, Dravyr, Hepirax, Herpevex, Virless, Zoral, Zovirax) can limit the severity of chickenpox. These drugs do not kill the virus, but stop the virus from multiplying.

However, treatment should be started within 24 hours of the rash first developing. If it is started after this time it is not likely to have much of an effect.

Dose for Adults: 800 mg 4 times daily for 5 days.

Chickenpox vaccine. It is possible that varicella vaccine may be useful in helping prevent zoster if it is administered to elderly persons who have had chickenpox. However, wider surveillance is need to confirm this (1).

1. Marietta Vázquez M, Shapiro ED. Varicella Vaccine and Infection with Varicella–Zoster Virus. N Engl J Med 2005; 352:439-440

Declovir in the background is the topical dosage form of acyclovir. Declovir Cream is indicated for the treatment of herpes simplex or cold sores.