What is Scabies?

by Maria Diaz, MD FAAP

Scabies is a common, very itchy and contagious skin infection. It is caused by microscopic mites that burrow into the top layers of skin to lay their eggs, causing small bumps and blisters. It occurs not only in children, but in people of all ages.

Scabies usually spreads through skin to skin contact with someone who is already infected. Mites can live for about 2-3 days in clothing, bedding, or dust, making it possible to get scabies from people who share the same infected bed, lines or towels.

Scabies causes a rash that appears 2 to 6 weeks after the mites enter the skin, but if your child had a previous scabies infection, symptoms can occur 1-4 days after the exposure. The most common symptom is severe itching, which can be worse at night or after a hot bath. The rash is actually the body’s reaction to proteins, eggs and excretions of the mites.

In children less than 2 years, the rash appears most commonly on the palms, soles of the feet, head and neck. In older kids, the rash is found between the fingers or in the folds and creases of wrist and elbows, the waistline, thighs, and buttocks.

Pediatricians can often diagnose scabies by examining the rash and asking relevant questions. Scabies should be treated. Most often pediatricians choose a cream called Permethrin 5%. It should be applied over the entire body from neck to toes, not just the area with the rash. This cream must stay on the skin for 8-12 hours before it can be washed off. In infants and young children, it should also be placed on the head, scalp and neck. Sometimes your pediatrician may ask you to reapply the cream a week later.

Even after scabies has been treated well, the itching can continue for several weeks and even months. This doesn’t mean that your child is still infested with scabies. To soothe the itching, your doctor may prescribe an oral antihistamine or topical steroid.

You can send your kid back to school or daycare after completing the treatment for scabies. If you have any questions or concerns, always ask your provider.