Treatment for Chicken Pox Spots and Scar Removal
There is no specific cream or treatment recommended for removing existing chicken pox spots, as most lesions heal naturally over time, but for permanent scars, chemical peeling with trichloroacetic acid has shown moderate to excellent results. 1
Understanding Chicken Pox Lesions
Varicella-zoster virus (VZV) infection typically presents as:
- A generalized, pruritic, vesicular rash with 250-500 lesions in different stages of development
- Lesions that progress through stages: erythematous macules → papules → vesicles → pustules → crusting
- Complete disease duration of approximately 2 weeks in healthy individuals 2
Management During Active Infection
Antiviral Treatment
Antiviral therapy may be beneficial if started early in the disease course:
- For healthy children: Routine antiviral treatment is not generally recommended 3
- For persons at increased risk for moderate to severe disease:
- Persons aged >12 years
- Those with chronic cutaneous or pulmonary disorders
- Persons on long-term salicylate therapy
- Persons on short, intermittent, or aerosolized corticosteroids 2
Symptomatic Relief for Itching
- Hydrocortisone cream: May be applied to affected areas not more than 3-4 times daily for adults and children over 2 years of age 4
- Caution: For children under 2 years, consult a doctor before using hydrocortisone 4
Management of Chicken Pox Scars
Chicken pox can leave permanent depressed scars in up to 18% of patients 1. Treatment options include:
Topical Treatments
- Tretinoin: Has been used for post-varicella scars, though evidence for effectiveness specifically for chicken pox scars is limited 1
Non-invasive Procedures
- Chemical peeling with trichloroacetic acid: Most frequently used method with moderate to excellent response 1
- Micro-needling: Has been used for depressed scars 1
- Laser therapy: Various laser modalities have been employed for scar treatment 1
Invasive Procedures
Combination Therapies
- Multiple modalities may be used together for enhanced results 1
Prevention of Chicken Pox
The most effective approach is prevention through vaccination:
- Varicella vaccination is recommended for all susceptible individuals 2
- During outbreaks, vaccination can be offered even if identified late 2
- Vaccination within 3-5 days of exposure may modify disease severity if infection occurred 2
Important Considerations
- Chicken pox spots naturally evolve and heal over time in most cases
- No specific "spot removal cream" has been proven effective for active lesions
- For permanent scars, treatment should be delayed until lesions have completely healed
- Chemical peeling appears to be the most studied intervention specifically for chicken pox scars 1
- Consult with a dermatologist for personalized scar treatment recommendations, especially for extensive or cosmetically concerning scars
Pitfalls to Avoid
- Do not attempt scar treatment during active infection
- Avoid picking at scabs, which can increase scarring risk
- Be aware that some treatments may cause hyperpigmentation or hypopigmentation, especially in darker skin types
- Realistic expectations are important—complete elimination of all scars may not be possible