Scabies is caused by a tiny insect (mite) known as Sarcoptes scabiei. Female scabies mites lay their eggs in small tunnels that form as they burrow under the surface layer of the skin.
Scabies usually spreads through skin-to-skin contact. It often breaks out in kindergartens, schools and nursing homes (which parents of children might have visited).
Scabies doesn't happen because your child or home is dirty.
Scabies usually shows up as red lumps and threadlike 'tracks' on the skin.
The tracks appear especially between the fingers and toes, on the insides of wrists, on the backs of elbows, in the armpits, around the belly button and groin, and on the buttocks. In babies, the rash often appears on the palms of the hands and soles of the feet and might look like little blisters or pimples.
Scabies is extremely itchy, especially at night, or after a hot bath or shower. Scratching affected areas sometimes leads to secondary infection.
It can take up to a month after infection for the rash to appear, because it takes this long for the scabies eggs to mature.
When to see your doctor about scabies symptoms
Your child should see your GP if:
- itching goes on for more than a week, or initially stops and then comes back
- bleeding, scabs or pus-filled sores appear in the same area as the itching.
Tests for scabies
Your GP might take skin scrapings to confirm the diagnosis, but this isn't usually necessary.
Scabies spreads very easily, so your child must stay at home until treatment is completed.
Your GP will prescribe a lotion or cream (usually 5% permethrin cream) to put on your child's skin from the neck down.
Here are steps for putting on the cream:
- Give your child a lukewarm bath or shower and dry her skin gently before you apply the cream. You don't need to scrub her skin.
- Make sure you get the cream into all your child's body creases.
- After you've put the cream on your child, take care to cover his skin thoroughly, particularly his genital area.
- Don't wash the lotion or cream off for 8-12 hours. If your child washes her hands during the treatment period, put the cream on her hands again.
- Wash your child thoroughly 8-12 hours after applying the cream.
You'll usually have to give your child this treatment twice, with a week between each application of the cream.
If your child has scabies, treat your whole family at the same time.
You should also wash all clothing, linen, towels and soft toys, using the hottest setting possible. This will destroy the mites and their eggs. Vacuum all carpets and mattresses. If there are things you can't wash, spray them with insecticide and leave them closed in a plastic bag for around a week.
The itch can take up to six weeks to go away. This is usually because of an allergic response, not ongoing scabies. Treat the itch with calamine lotion or an antihistamine. If the itch doesn't go away with this treatment, your doctor will prescribe a corticosteroid cream.
Don't reapply the lotion or cream unless your doctor tells you to.
Complications of scabies
The itchy areas might get infected if your child scratches a lot. If this happens, he'll need antibiotics.
Prevention of scabies
You can't prevent an initial infection of scabies, but you can stop scabies from spreading through your family.
Prevent the spread of scabies by washing linen, towels, clothes and soft toys. Treat all family members at the same time, even if only one child is affected.
It's best to keep your child home from child care, kindergarten or school until she's finished two treatments. But ask the school or child care centre how long they'd prefer scabies-affected children to stay away, because this can vary from place to place.