Scabies

Scabies is an infestation of mites (tiny insects) in the skin, characterized by small red bumps and intense itching. This highly contagious condition often spreads from person to person while they are sleeping together in the same bed or have close personal contact. The itching is caused by the mites burrowing into the skin where they lay eggs that hatch a few days later. Scabies can affect people of all ages but mostly occurs in children and young adults.

What are the symptoms of scabies?

It may take between four to six weeks for a child to develop symptoms of scabies after coming in contact with an affected person.

In children younger than 2 years of age, the lesions caused by the mites tend to occur on the head, neck, palms, and soles. In older children, the lesions usually are on the hands, between the fingers, wrists, belt line, thighs, belly button, in the groin area, around the breasts, and in the armpits.

The following are the most common symptoms of scabies. However, each child may experience symptoms differently. Symptoms may include:

• Itching, usually severe
• Rash, with small pimples or red bumps; sometimes burrows can be seen
• Scaly or crusty skin (with advanced conditions)

How is scabies diagnosed?

In diagnosing scabies, the skin and skin crevices are examined by your child's doctor. A sample of skin, obtained by scraping the skin, may be examined under a microscope to confirm the presence of mites.

What is the treatment for scabies?

Scabies is treatable, and members in a family/home should be treated at the same time. Treatment should be repeated in 1-2 weeks to eliminate any newly hatched eggs following the initial treatment. Specific treatment will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history
• Extent of the infestation
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the infestation
• Your opinion or preference

Treatment may include:

• Applications of prescription creams and lotions, such as permethrin, topical sulfur and lindane solutions
• Oral antihistamine medication (to help relieve itching)
• In some cases, additional topical ointments are recommended (like topical steroids for management of post-scabies rash)

In addition, it is important to wash all clothes and bedding in hot water and dry in a hot dryer. Clothing and other objects that cannot be washed (for example, pillows, stuffed animals) should be placed in a plastic bag for at least one week.

The itching may continue for many weeks after the initial treatment of the scabies. If it is still present after this time, or if new burrows (which look like tiny wavy lines, often seen between the fingers) appear, retreatment may be needed and your doctor should be consulted.