Pediatric Scabies

Scabies is an infestation of tiny mites on the skin. It causes a small red rash and intense itching. This infection is very contagious. It often spreads from child to child while children are sleeping together in the same bed or have close personal contact.

Scabies is caused by very tiny mites that burrow into the upper layers of the skin. The mites live there and lay eggs that hatch a few days later.

Anyone can get scabies, but it happens mostly in children and young adults. The greatest risk factor for getting scabies is coming in close contact with a person who has it. Other risk factors are overcrowded living conditions and poor hygiene.

It may take between 4 to 6 weeks for a child to get symptoms of scabies after coming in contact with an infected person.

In children younger than age 2, the rash caused by the mites tends to show up on the head, neck, palms, and soles of the feet. In older children, the rash is usually located on any of the following places:

• Hands
• Between the fingers
• Wrists
• Belt line
• Thighs
• Belly button
• Groin area
• Chest area
• Armpits

These are the most common symptoms of scabies. But each child may experience symptoms differently. Symptoms may include:

• Severe itching
• Rash with small pimples or red bumps. Sometimes burrows can be seen.
• Scaly or crusty skin in the worst cases

Your child's healthcare provider will look at your child’s skin and skin cracks to diagnose scabies. The provider may take a sample by scraping the skin. They will examine the skin under a microscope to check for mites.

Scabies is treatable, and usually all members in a family are treated at the same time. Overnight visitors, frequent visitors, and babysitters should also be treated. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

• Using prescription creams and lotions, such as permethrin
• Taking medicines by mouth to kill the mites
• Taking antihistamine medicine by mouth to help relieve itching
• Using other medicines on the skin as needed

Cut your child's fingernails to help prevent infection. In addition, it is important to wash all clothes and bedding in hot water and dry them in a hot dryer. Clothing and other objects that can’t be washed should be placed in a plastic bag for at least 1 week. These items can include things like pillows and stuffed animals. People with crusted scabies are considered very infectious. Careful vacuuming of furniture and carpets is recommended.

The itching may go on for many weeks after the initial treatment of the scabies. If scabies is still present after this time, or if new burrows appear, call your child’s healthcare provider. Your child may need to be retreated.

The intense itching caused by scabies can lead to bacterial infections such as impetigo. It can also cause thickening and scaling of the skin.

Scabies needs treatment. It is important that your child be examined for scabies. If your child has intense itching with a red rash, call their healthcare provider.