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What are scabies?

Scabies are little bugs (mites) that burrow under the skin and cause severe itching and little red bumps. They are so small that they can only be seen with a microscope. They rarely attack the skin above the neck, except in the case of infants. Usually more than one person in a family has scabies.

Scabies cannot be diagnosed over the telephone. Your child needs to be checked by your healthcare provider to confirm that he or she has scabies.

How can I take care of my child?

  • Anti-Scabies cream (prescription only)

    Your child needs the medicine prescribed by your healthcare provider. (Usually it’s a prescription product called Elimite.)

    Apply the cream to every square inch of the body from the chin down to the toes. Don't forget the navel, between the toes, or other creases. Leave some cream under the fingernails. Areas that don't seem infected should still be covered with the cream. (Infants less than 1 year old also need it carefully applied to the scalp, forehead, temples, and neck. Avoid putting it on the lower face from the eyes to the chin.)

    Eight to 12 hours later give your child a bath and remove the cream. One treatment is usually effective. For severe rashes, repeat the treatment once 1 week later.

  • Itching

    The itching and rash may last for 2 to 3 weeks after successful treatment with Elimite. The itch is caused by an allergic reaction to the dead fragments of lice and eggs. Continuing to have the rash does not mean that the treatment didn't work or that it needs to be repeated. This itch can be helped by frequent cool baths without use of soap, followed by 1% hydrocortisone cream, which you can buy without a prescription, applied only to the itchy spots up to 3 times per day.

  • Contagiousness

    Children can return to school 24 hours after one treatment with the scabies medicine.

  • Family contacts

    Scabies is highly contagious. The symptoms take an average of 30 days to develop after exposure. Therefore, everyone living in the house should be treated before they develop a rash with one application of the anti-scabies cream. Close contacts of the infected child (such as a friend who spent the night or a baby sitter) should also be treated.

  • Cleaning the house

    Machine wash all your child's sheets, pillowcases, underwear, pajamas, and recently worn clothing in hot water. Put items that can't be washed into plastic bags. You need to keep them in the bags for 4 days to kill the mites. Scabies cannot live outside the human body for more than 3 days.

When should I call my child's healthcare provider?

Call during office hours if:

  • It looks infected (sores that enlarge or drain pus).
  • New scabies occur after treatment is completed.
  • You have other concerns or questions.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2018.1 published by Change Healthcare.
Last modified: 2012-08-08
Last reviewed: 2017-06-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2018 Barton D. Schmitt, MD FAAP. All rights reserved.
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