Scabies is a very itchy, contagious skin infection caused by microscopic mites that burrow into the skin’s upper layers and cause a rash. It is an infection that occurs not only in children, but in people of all ages.
The most common symptoms of scabies are itching and a skin rash. The rash appears 2 to 4 weeks after the mites enter the skin. The rash is actually the body’s reaction to the proteins, eggs, and excretions of the mites. If your child has had a previous scabies infection, symptoms can occur 1 to 4 days after being exposed again to the mites.
The rash can be extremely itchy and become worse at night. Along with a rash, the burrowing mites can form threadlike gray or white lines on the skin that resemble irregular pencil marks.
In children younger than 2 years, the rash appears most commonly on the palms, soles of the feet, head, and neck. The head, face, neck, palms, and soles often are involved in infants and very young children, but usually not adults and older children. In older children, the rash is found between the fingers or in the folds and creases of the wrist and elbows, as well as at the waistline, thighs, buttocks, and genitals.
An infested person still can spread scabies during this time even though he/she does not have symptoms, until they are successfully treated and the mites and eggs are destroyed.
The intense itching of scabies leads to scratching that can lead to skin sores. The sores sometimes become infected with bacteria on the skin.
What you can do
If your child develops scabies, she will probably scratch the scabies rash, which will increase the likelihood of the skin developing a secondary bacterial infection. To lower this risk, keep your child’s fingernails trimmed during a scabies infection. If you notice that your child has an itchy rash, contact your pediatrician. The doctor will look at the rash, make the diagnosis, and recommend a treatment.
Pediatricians can often diagnose a scabies infection by examining the rash and asking relevant questions. Because children tend to scratch the rash repeatedly, the scratch marks and crusting of the rash sometimes make this infection hard to identify. Your pediatrician may decide to confirm the diagnosis of scabies by gently taking a scraping from the rash or a burrow and having it examined under a microscope to identify the mite or its eggs.
Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. Scabicides used to treat human scabies are available only with a doctor’s prescription. No “over-the-counter” (non-prescription). These products have been tested and approved to treat scabies. The instructions contained in the box or printed on the label always should be followed carefully. Always contact a doctor or pharmacist if unsure how to use a particular medicine.
Children with a scabies rash should be cared for with one of several lotions or creams used for treating this infection. It should be applied over the entire body from the neck to the toes. About 8 to 14 hours after applying permethrin, bathe your child to remove the cream.
Even after scabies has been treated effectively, the itching associated with it can continue for several weeks and even months. This persistent itching does not mean that your child is still infested with scabies. To soothe the itching, ask your pediatrician about giving your child an oral antihistamine.
Suggested General Guidelines
It is important to remember that the first time a person gets scabies they usually have no symptoms. Symptoms can typically take 4-8 weeks to develop after they are infested; however they can still spread scabies during this time.
In addition to the infested person, treatment also is recommended for household members, particularly those who have had prolonged direct skin-to-skin contact with the infested person. Close personal contacts who have had direct prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated. All persons should be treated at the same time to prevent re-infestation.
Bedding, clothing, and towels used by infested persons or their household, sexual, and close contacts (as defined above) anytime during the three days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours. Scabies mites generally do not survive more than 2 to 3 days away from human skin.
Use of insecticide sprays and fumigants is not recommended.
Despite the itchiness and discomfort of a scabies infection, it is a mild and highly treatable condition. You can send your child back to child care or school after completing the treatment for scabies
A scabies infestation is easily spread from person to person through close contact, particularly skin to skin or with items such as clothing or bedding used by an infested person. If someone in your family has scabies, ask your doctor whether others in the household such as family members or live-in help should be tested or treated for scabies