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.

Your child needs to be checked by your healthcare provider to confirm that he or she has scabies.

Scabies cream for all except pregnant women

Your child's medicine is ______________________________.

Apply the cream to every square inch of the body from the neck down. (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.) 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.

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.

Precautions for Kwell: If Kwell is used, babies under 1 year of age should have it washed off in 4 hours. Leaving Kwell on longer than this can cause side effects. Swallowing Kwell can be quite harmful, so cover the hands with gloves or socks if your child is a thumbsucker.

Pregnant women 
Pregnant women need special medicines for scabies. They cannot use Kwell. If you use Elimite cream, wash it off in 8 hours. If you use Eurax, leave the first coat on. Apply a second coat over it 24 hours later. Wash off all of the Eurax 24 hours after the second application. The Eurax 2-day treatment needs to be repeated once 1 week later.

Itching 
The itching and rash may last for 2 to 3 weeks after successful treatment with Elimite or Eurax. 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.

Contagiousness 
Children can return to school 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 scabies medicine. 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 3 days to kill the mites. Scabies cannot live outside the human body for more than 3 days.

If you feel that your child needs immediate medical care.

• It looks infected (sores that enlarge or drain pus). 
• You have other concerns or questions. 
• New scabies occur after treatment is completed.

Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
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.