Scabies

Scabies is a skin condition caused by a mite.  A mite is a spider-like insect so small that it can only be seen under a microscope. A female mite digs under the skin and lays eggs. This digging causes severe itching. The tunnel where the mite digs looks like a tiny scratch-like mark. A rash may also appear in this area.  If the skin is scratched open, it can become infected.

Scabies is "caught" by having close contact with a person who has it or by wearing clothes that have scabies mites living in them. Sometimes scabies can be caught from a family dog or cat that carries the mite, but this form of scabies is self-limited and does not require treatment.

Mites can stay alive on clothing and bedding for up to 3 days. Your child should not have close contact with anyone who has scabies until that person is treated with a prescribed medicine that kills mites. 

Family members have close contact with each other, so all family members, including infants, must be treated at the same time your child is treated. Check with your doctor or the pharmacist to be sure the medicine may be used on all family members, including children under 18 months and pregnant women.

Treatment

1. Your doctor will prescribe a cream or a lotion to get rid of the scabies. Remember, this is a medicine and must be kept high in a cupboard, out of the reach of children. It is important to follow the directions on the bottle carefully.
2. Before bedtime, give your child a warm soapy bath or shower. It’s very important to let the child's skin get very dry and cool before you put on the medicine.
3. It is best to put the medicine on the skin right before bedtime because it should be left on the skin for a certain number of hours (usually 8 to 14 hours). Ask your doctor how long the medicine should be left on the skin.
4. Put a thin layer of the prescribed lotion or cream over your child's whole body, from the head (including the scalp on infants) to the bottom of the feet. Ask your pharmacist if the medicine may be put on the face. Be careful not to get the medicine near your child's eyes, mouth or nose. The mites live in warm, moist areas such as between fingers and toes, under arms, in the skin around the waist and in the genital area. Be sure to put the medicine on these areas.
5. If you wash the child's hands or the baby's diaper area again before bed, put more medicine on.
6. In the morning, give your child another bath or shower and wash off all the medicine.
7. After the medicine is washed off, put clean clothes on your child and clean linen on the bed (Picture 1).

Other Tips and Advice

• Keep your child's fingernails cut short to stop him from scratching open the skin. Placing socks over the child's hands may help to keep him from scratching (Picture 2).
• If your child sucks his thumb or fingers, put 2 socks on each hand to stop the child from sucking off the medicine and getting it into his mouth.
• Itching may continue for a while after treatment, sometimes up to a few weeks. If itching bothers your child, ask your doctor to prescribe a medicine to help stop itching.
• Your child will probably need to be treated only once. Do not reapply the medicine unless your doctor says so.

Care of Clothing and Linens

• All clothes that had been worn within the week before your child was treated must be washed in very hot water. Very hot water kills the mites that may be living in your child's clothes or bed linens.
• In the morning, before the medicine is washed off, all bed linens, washcloths and towels must also be washed in very hot water.
• Clothing, blankets, toys and stuffed animals that cannot be washed should be placed in a plastic bag. Close the bag tightly and put it high up out of children's reach for at least 3 days. The mites cannot live away from the human body more than 3 days.
• Vacuum the furniture and carpeting well.

How to Keep Scabies from Spreading

• All family members should be treated at the same time as the child who has the scabies.
• If you know where your child got the scabies, have him avoid close contact until that person is treated and well.
• Notify your child’s school or child care center and anyone else that your child has had close contact with.

Safety Tips

• Keep the medicine high in a cupboard, out of the reach of children.
• If you think your child may have swallowed the medicine or has any of the medicine on his lips or in his mouth, call the Poison Control Center at 1-800-222-1222. They will tell you what to do.
• If any lotion or cream gets into the eyes, rinse the eyes with cool water. Let the water run from the area near the nose out to the side of the face for several minutes. Then call the Poison Control Center.
• If contact is necessary before treatment, be sure to wash your hands right away.

Scabies (PDF)

HH-I-59 4/78, Revised 11/16 Copyright 1978 Nationwide Children’s Hospital