Bathing is NOT Contraindicated in Varicella
Bathing is actually recommended as a fundamental component of varicella management to prevent secondary bacterial skin infections, which are among the leading causes of varicella-related complications. 1
Why Bathing is Beneficial
Hygiene is the most important principle in the management of varicella, particularly bathing and use of astringent soaks to avoid secondary bacterial skin infection. 1
Regular bathing helps reduce the risk of bacterial superinfections, particularly invasive group A streptococcal infections, which are among the leading causes of varicella-related deaths and require immediate intervention. 2
The patient should be provided with regular changes of bed linen in a well-ventilated room as part of comprehensive supportive care. 1
Practical Bathing Recommendations
Use lukewarm water rather than hot water to avoid irritating the lesions. 1
Consider adding colloidal oatmeal or baking soda to bath water to help relieve itching (general medical practice).
Pat the skin dry gently rather than rubbing to avoid disrupting vesicles. 1
Bathing frequency can be increased if needed for comfort and hygiene, particularly in children who may scratch lesions. 1
Common Misconceptions to Avoid
Many clinicians and parents mistakenly believe that bathing will spread the rash or worsen the infection—this is false. The rash spreads through viremia (bloodstream dissemination), not through external contact with water. 1
The vesicular fluid contains infectious virus, but bathing does not increase viral spread within the patient or to others. 1, 3
Avoiding bathing actually increases the risk of secondary bacterial infections, which can lead to serious complications including cellulitis, abscess formation, and invasive streptococcal disease. 2, 1
Special Populations
For immunocompromised patients with varicella, maintaining good hygiene through regular bathing is equally important, as these patients face a 28% incidence of pneumonitis and 7% mortality rate without antiviral treatment, and bacterial superinfection compounds their risk. 3
Pregnant women, adults, and children with chronic conditions should also maintain regular bathing as part of supportive care while receiving appropriate antiviral therapy if indicated. 2, 4