Most of the time there are no symptoms before the rash appears. Some children, though, may be tired, have a fever and complain of a stomach ache a day or two before a flat, red rash appears. The rash generally begins on the scalp, face and back, but can spread to any body surface. It is rarely seen, though, on the palms of hands or soles of feet. Sores smaller than a pencil eraser, that are sometimes encrusted, can also be found in the mouth, on the eyelids and in the genital area.

Within hours, these flat, red spots turn into tiny clear blisters that itch a lot. As your child scratches the blisters, serum spills out, dries and forms hard crusts that loosen and drop off about two weeks later. Since the rash continues to break out for the first two to six days, new red spots are often seen alongside old dried scabs. Some children have very few spots while others are covered.

Most children recover from chicken pox uneventfully in less than two weeks. Complications are rare, although chicken pox can occasionally lead to encephalitis (an inflammation of the brain), meningitis or pneumonia. Children who have cancer and those who take medications that affect the immune system are at a higher risk of complications from chicken pox. The biggest problem parents face with chicken pox, though, is infected blisters.

There is prescription medication available that can decrease the length and severity of chicken pox. It is not recommended for routine cases. Also, it is only effective if started within 24 hours of the onset of the infection. It does not interfere with the child's developing immunity to chicken pox. Ask your doctor for more information.

One attack of chicken pox usually gives your child lifelong immunity. Children rarely have a second round of chicken pox, but if it does occur, the attacks are usually very mild.

• Encourage your child not to scratch the scabs. Keep him or her busy with other activities.
• Give your child a cool bath without soap every 3-4 hours for the first couple of days (15-20 minutes at a time). Add one-half cup of baking soda or colloidal oatmeal bath packet such as Aveeno to the bath water. Pat, do not rub, your child dry.
• Dip a washcloth in cool water and place it on the itchy areas.
• Apply calamine (not caladryl) lotion for temporary relief.
• Trim your child's fingernails to prevent infection caused by opened blisters. Scratching off the crusty scabs may leave permanent scars.
• Cover the hands of infants with cotton socks if they are scratching their sores.
• Wash your child's hands three times a day with an antibacterial soap such as Safeguard or Dial to avoid infecting the open blisters.
• Keep your child cool and calm. Heat and sweating makes the itching worse. Also, keep your child out of the sun. Extra chicken pox will occur on parts of the skin exposed to the sun.
• Give your child Benadryl, an over-the counter antihistamine, if the itching is severe or stops your child from sleeping. (See label for proper dosage).
• Give your child acetaminophen (children's versions of the following: Tylenol, Tempra, Liquiprin, Datril, Anacin 3 or Panadol) for the fever. [Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger, unless directed by a physician, due to its association with Reye's Syndrome, a potentially fatal condition.]
• Give your child soft foods and cold fluids if he or she has sores in the mouth. Do not offer salty foods or citrus fruits that may irritate the sores.
• Have your child gargle with salt water (1/4 teaspoon to 4 ounces of water) to help ease itching in the mouth, if necessary.
• Reassure your child that the "bumps" are not serious and will go away in a week or so.

Does your child have a severe headache, stiff neck, convulsions, abnormal behavior and/or continuous vomiting?
Is your child hard to wake, confused or having trouble breathing?
Does your child have cancer, or is your child taking medications that affect the immune system and have a fever higher than 102oF?
Does your child have cancer, or is your child taking medications that affect the immune system but not have a fever higher than 102oF?
Does your child have a fever higher than 103oF or had a fever higher than 102oF for more than two days?
Does your child have any scabs that are red, oozing pus, or bleeding or has he or she developed a red rash with tiny pink dots?