Chickenpox

NICE CKS Chickenpox. Last revised Nov 2023.

Guidelines

Clinical diagnosis is sufficient for most cases based on the characteristic chickenpox rash:
  • Small erythematous macules → papules, vesicles, pustules (intensely itchy

Laboratory tests can be used to confirm the diagnosis but not recommended in primary care.

For chickenpox in pregnancy, see a separate article.
 

NICE CKS recommends the following:
  • Paracetamol 
  • Itch alleviation
    • Calamine lotion
    • Chlorphenamine (if >1 y/o)

NICE CKS says to consider in:
  • Immunocompetent >14 y/o that is not pregnant, and
  • Presents <24 hours of rash onset, and
  • Particularly for severe chickenpox or those at risk of complications (e.g. smokers)

Choice of antiviral therapy: aciclovir 800mg 5 times a day for 7 days

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Antiviral therapy is not recommended for otherwise healthy children with uncomplicated chickenpox.

References

Author: Adams Lau
Reviewer:
Last Edited: 16/04/25