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Wednesday, October 3, 2012

A pox on all your houses


The house has been struck by chicken pox, after a winter of full on illnesses this seems like the last insult to injury. But unlike the last litany of mystery bugs and viruses, Chicken Pox is something I know how to deal with. It’s a familiar childhood illness, ubiquitous and predictable. However knowledge on how to minimise Chicken Pox effects is starting to wane and as such I am putting together a Chicken Pox guide to help parents deal with this virus in a proactive and effective manner.

Chicken Pox Painting by Annemarie Busschers

Typical medical practice for managing chicken pox (Varicella zoster virus) is to prescribe acyclovir as an antiviral in the early stages, paracetamol for fever, antihistamines for itch and pinetarsol baths for itch as well. My concern with the first three at least is the pressure they put on the liver and kidneys and the fact that some of the adverse effects seem as bad if not worse than the infection itself. I also worry that it is commonly children that are affected by Chicken Pox and very rarely are these drugs tested on small children, Acyclovir in particular is not recommended for under twos.

So if you want to take an alternative route here is my guide to managing Chicken pox at home.

First here is a little overview on how chicken pox manifests:

The Varicella zoster virus is extremely contagious and has an almost 90% hit rate in people with no prior immunity. The virus incubates for 10-21 days and you become contagious a couple of days before the spots appear (sneaky isn’t it, this virus knows how to get around). Chicken pox is usually spread by airborne droplets (coughing) and from the liquid in the blisters. While it is highly communicable it is considered mild and self limiting unless a complication arises. These complications usually occur in compromised individuals who do not manage the illness well.  Chicken pox is usually diagnosed by the distinctive vesicular rash which forms primarily on the face, torso and groin though it can appear anywhere including on the eye, in the ears and in the mouth and throat. The rash forms fluid filled blisters which will eventually burst and crust over. Once all the blisters have crusted there is no longer a chance of contagion though your child may not be accepted back into society until the marks have faded. (unclean unclean). Often people with Chicken pox will have a low grade fever and nausea, usually manifesting up to four days before the spots appear.

If you are pregnant, immune compromised or have had a course of steroids recently then you are at high risk of complications and seeing a doctor is advisable. If you are none of these and you feel confident to manage the disease then it might be best to keep your germs to yourself and stay out of the doctor’s waiting room.

Things to watch out for:
The rash does not start crusting after 5 days of infection and continues to worsen

The fever worsens after a few days of infection and does not let up

The blisters seem reddened or infected

Child seems listless and worsens instead of improving

So how do you treat Chicken Pox?

First stage: Exposure and Incubation

If your family have exposed and you feel you may be incubating chicken pox (fever, runny nose, tiredness) then don’t be a hero. Keep your kids at home and stay away from infants, pregnant women and the elderly.

The first thing to do is ensure anyone affected is well hydrated, keeping fluids up is very important.

The second thing to be aware of is nutrition, people who are low in the amino acid L-lysine are at risk of complications and increased severity of infection. Taking an additional supplement of lysine while Chicken pox is circulating and once infection is established is a good idea, these supplements are far more effective in the incubation stage than when the pox has erupted. Also ensuring a strong immunity by maintaining Vitamin D levels and maintaining good nutrition is a must. Poorly nourished children who are low in essential nutrients are at a much higher risk of complications.



So to summarise supplements

Vitamin D

Vitamin C
Vitamin B complex
L-Lysine



Recommended dosage is 1000iu daily for Vitamin D and 12mg of L-lysine per Kg of body weight in children over two.Taking Sodium ascorbate or Lipospheric Vitaman C in a bolus dose when contact with Chicken pox can bolster the immune system, up to 2000mg over the course of the day can be easily tolerated though exceeding this can cause an upset tummy, there is no hazardous upper limit with Vitamin C though large doses can cause your bowels to be a bit more hasty. These doses are a guide only. No upper limit has been established with Lysine, though higher doses have been associated with gallstones.

If you prefer not to supplement then you can stock up on lysine rich foods such as eggs, dairy, most nuts, red meat, beans, fruit and veg, brewers yeast, mung bean sprouts and spirulina. It may also be wise to avoid foods rich in L-arginine as arginine uses a similar pathway for uptake in the body as lysine, therefore food high in arginine may increase lysine requirements and reduce availability. Foods rich in arginine to be avoided are chocolate, fish, coconut, wheat flours, carob, peanuts chickpeas, raisins, brown rice and gelatine.

Getting sunshine will increase your D intake but ensure it is large areas of skin for periods of 10-15 minutes at a time, longer exposure will slowly reduce Vitamin D synthesis. Vitamin C can be obtained though fresh fruit and vegetables, kiwifruit in particular is a good source, but it must be fresh.Taking a  B complex is a good idea too, or eating vitamin B rich foods, such as avocados, oats, organ meats, legumes and brazil nuts.   

Its really important to understand that these supplementations or diet changes are a short term course of action to limit the severity of Chicken pox and not a long term lifestyle choice. 



Second Stage: Rash appears

Once the rash appears treatment of Chicken pox is more about ameliorating discomfort, preventing itching and reducing risk of complication.

The skin is performing an important role at this stage by maintaining an environment that prevents the spread of infection. Our skin is usually dry with a high salt concentration due to sweat. These conditions are not favorable for bacterial growth. Sweat and sebaceous skin secretions also contain substances that kill bacteria. The skin is also associated with the lymph system as aperipheral lymph organ and acts as part of the adaptive immune response. It’s important to let the skin do its job. The key to avoiding secondary infections and complications, is to assist this natural defence system. Things that prevent your skin from doing its job include over-bathing, poor nutrition, inappropriate care of sores, dirty fingernails and scratching. A lot of common chicken pox treatments actually increase risk of infection. Instead here is a list of treatments that will reduce risk and aid healing.



Skin Ph

Skin sweats salts and maintains a Ph that is hostile to bacteria. Destroying this balance can lead the way to infection. Avoid baking soda baths, as even though they reduce itch they will change the ph and make the skin vulnerable. Heavy soaping and drying is also a bad idea. If you are using baths to reduce itch then after each bath restoring the skin Ph is a must. Daubing your child gently with a saline and cider vinegar mix will help restore the right acidity and avoid bacteria from spreading. If your child will tolerate it you can put this mix into a spray bottle.



Saline Vinegar mix
1 cup water

1 teaspoon salt

1 tablespoon cider vinegar



Lavender oil, Lavendula officinalis:

Lavender is fabulous for skin healing, preventing infection and promoting healing. I source a local Pacific Blue genus of Lavender that is low in camphor from arbordale lavender farm. This is gentle enough to be applied neat but diluting it 1 part lavender oil to 9 parts carrier oil is a best to avoid evaporation. This mixture can be applied directly to the pox sores to take the itch out. I have used this on my boy and he hasn't scratched once. A note on lavender, a study was done which indicated that Lavender essential oil and tea tree oil were linked to breast tissue growth in boys. This study was very poorly conducted and included only 3 test subjects with absolutely no research done on what other products these children were putting on their skin and in one instance one of the lavender products cited as being an issue only negligible amounts of actual lavender in it. There is far more science to indicate that artificial fragrances are an issue. In any instance, the use of lavender oil for chicken pox is short term and for any danger to the endocrine system to be present it would have to be long term chronic use.



Chickweed, Stellaria media

Chickweed is a very cooling and soothing herb, many chicken pox creams and lotions include this as a primary ingredient as it will help stop the itching. Chickweed is a common weed (no surprises there) and you may find you have it in the garden. If you do then you can actually make your own chickweed itch salve. Here is the recipe.



Chickweed salve



1 litre of olive oil (extra virgin organic if possible)

100 grams of beeswax

2-3 cups of chickweed  (packed down)

Collect your chickweed after the morning dew has lifted when it is nice and dry. Avoid harvesting it after rainfall. Once picked shake excess dirt off of it and leave it to wilt somewhere cool and out of direct sunlight. It should be withered in a couple of hours but overnight is ideal. Once it has withered pack it into a clean glass jar and cover with olive oil. Be sure to get any air-bubbles out and to cover any plant material with at least an extra centimetre of oil. Put the jar somewhere warm and dark for a couple of weeks. 3 days will do at a pinch. You can gently warm the oil in a saucepan before pouring it over the chickweed which will make the process faster, but this degrades the oil. Better to be patient.

Once the chickweed has infused into the oil you melt the beeswax in a saucepan and add 100mls of the oil. Once it is all liquid you can add the rest of the oil slowly, do not allow the oil to overheat for the reasons stated above, once all combined pour it into containers promptly before it sets. If you can’t be bothered with the balm step it’s fine to use it just as an oil.





Homeopathy

Not everyone’s cuppa but if you are that way inclined then the following remedies can be of use. Homeopathy can be used to manage all stages and manifestations of pox.
Rhus tox: This is the key homeopathic remedy for Chicken pox and should be offered in 30c or 200c potency when itching worsens

Mez: This is the top remedy for itch and relentless scratching.

Varicella nosode: This is a remedy made from the Varicella virus. You would take this to try and avoid catching Chicken pox but because in homeopathic literature Chicken pox is considered a beneficial virus to have had this is only suggested if you are a non immune adult who has been exposed to the virus or taken once the rash has erupted to bolster immune response.

Ant tart - Great remedy for restless children who fidget a lot and have intense itching that worsens when scratched.

Ant crud Sulky irritable children with a white coated tongue. The sores would be burn and itch and would be thick with a honey like discharge.

Merc sol – For any infection of sores, particularly sores that weep



Loose clothing

My son has spent the whole week in his pyjamas, loose but warm cotton clothing that absorb any excess moisture and breathe easily. It is also soft enough to not irritate any of the sores yet loose enough to breathe. If your child is still in nappies then give them as much bare bum time as possible and if they are not dry through the night instead of putting night nappies on I would put a waterproof layer on the bed and a couple of towels  to absorb any moisture as nappies can heat the area up and irritate any spots. If you use cloth then a temporary switch to disposable is advisable.



Colloidal oats, Avena sativa: 

Often Doctors will recommend colloidal oatmeal in the bath water to resolve itchiness. Rather than buying colloidal oatmeal it’s a simple matter to grind up some whole oats in your blender or spice grinder and putting it in the water. I avoid commercial oat, skin products as these often contain parabens and chemicals. Bog standard oats from the supermarket are cheap and effective. Don’t use soaps in the oatmeal bath, a few drops of oil will keep the skin from drying out too much. Remember to rebalance the Ph afterwards.



Hygiene

Trim the fingernails as soon as the first blisters appear, and keep the hands clean to prevent infection. For very severe itching you may want to gently bandage the hands at night and keep your children distracted during the day with gentle but engaging physical activity, puzzles, activity toys and art are ideal - things that keep the hands busy. My son found baths really helpful so I moved a plastic tub into the lounge for him to bathe in, it kept him in the family space so he wasn’t alone and allowed me to keep an eye on him. 



Stage three, crusting.

Once all of the blister have crusted your children are no longer contagious. This does not mean you can just leave them to it. This is the worst stage for scratching and scarring.

To help with itching you can continue to use the remedies above but if you notice any slow healing spots you can use Vitamin E or Calendula oil to help out, just dabbed on the spots.



Things to avoid:



Calamine -this is a mixture of zinc oxide and ferric oxide that can be purchased over the counter at most pharmacies. It is quite drying and can cause scarring. It has no active medical properties except as an antipruretic to relieve itching. I avoid this as it will not help the pox heal.

Gentian violet -also known as Methyl violet it is a triarylmethane dye that has antibacterial, antifungal and anthelmintic properties. As a topical application it can help prevent infection and heal up sores without the sting associated with other applications. But it is also messy and can stain skin or even tattoo open wounds. It has also been linked to cancer in lab animal testing.

Tight clothing and hair in the face - keep hair tied back and clothing loose, anything tight or constricting can irritate the sores. Vigorous hair brushing is also a bad idea as it can burst any blisters on the scalp..

Junk food - nutritionally void food and simple carbohydrates that are high in arginine will hinder recovery.

Over bathing - his will change the skin Ph, baking soda baths without redressing the balance are a big no no.

Vigorous towel drying - this can burst the blisters. Sun drying is the very best but the next best is wrapping gently in a towel and getting your children to lie or sit still until they are bone dry before dressing.

Febrifuges like paracetamol and nurofen, these will inhibit your immune response which is the opposite of what you want to happen. 

Recovery

Once the spots start to fade you may notice a boost in their demeanour and a development leap. This is normal and rather lovely.

Hopefully the threat of Pox isn't as intimidating as it was previously with this resource on hand.

1 comment:

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