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Scabies

child; scabies; mite; rashes; itch; eczema; skin; infectious; diseases ;

Scabies is an itchy rash caused by the scabies mite burrowing into the skin and causing intense itching. Scabies is not due to poor hygiene. Nor is it due to animal mites, which do not infest humans.

The first sign may be a very itchy skin, especially after getting warm in bed.

Scabies mites mostly live on hairless parts of the body, and in adults and children they are commonest on the wrists, hands, fingers, elbows, buttocks, feet, genital areas, nipples and around the waist. On children under 2 years old they can be on any part of the body.

Contents


What is scabies?

  • Scabies mites are about 0.5mm long, pearly white, with brownish legs and mouth parts.
  • The male mite stays on the surface of the skin, and the female burrows into the skin where it lays its eggs.
  • After 3 to 4 days the eggs hatch and the baby mites (larvae) come back out onto the skin where they feed and grow. They become adults within 14 days, and then they can start laying eggs.
  • Mites only live up to 2 days off the human body, and eggs can survive for no more than 5 days.
  • Animal mites (such as the ones that cause mange on dogs and horses) look like the human mites, and can live on the skin of humans, but they do not lay eggs on humans. They do not burrow into the skin and do not cause any itching.

How scabies is spread

  • Scabies is mainly spread by close skin to skin contact with a person who has scabies.
    • Scabies does not mean that people are unclean.
    • It is often spread among family members and sexual partners.
    • Spread from one person to another person can happen before the first person has any itching.
  • Occasionally it is spread by contaminated bedding, towels and clothes.
  • Scabies is not spread by pets or other animals.

Signs and symptoms of scabies

  • The first sign may be a very itchy skin, especially after getting warm in bed. This may be 3 to 4 weeks after contact, but for people who have had scabies before, the itch may start within 1 to 4 days.
  • Scabies mites mostly live on hairless parts of the body, and in adults and children they are commonest on the wrists, hands, fingers, elbows, buttocks, feet, genital areas, nipples and around the waist. On children under 2 years old they can be on any part of the body.

scabies

  • You can sometimes see the tiny burrows, but they are often hidden by scratches.
  • An allergic rash can occur on other parts of the body.
  • Both the place where the scabies mites are and the rash are very itchy.
  • It is almost impossible not to scratch because it is so itchy, and the scratching may make the rash look like other skin problems such as eczema.
  • Other skin infections often happen with scabies because germs get into the skin where it is scratched (eg impetigo).

Treating scabies

  • Because scabies can look like other skin problems, you should not try any treatment until a doctor has seen the child or other person and worked out what the problem is.
  • Several treatments are available from chemists, and the doctor will tell you which one is the best to use for your family and your child. The current treatments recommended in South Australia are permethrin or benzyl benzoate.
  • Do not treat pregnant or breastfeeding women, or babies under 12 months without first checking with a doctor.
  • Carefully follow the manufacturer's instructions for using the treatment including steps that you need to take before and after applying it. 
    • As the itch and rash can be on a different part of the body to where the scabies mites are, make sure that the whole body is treated, not just itchy spots.
    • The lotion or cream must be left on for the time stated on the package (between 8 and 14 hours), then washed off. If hands are washed during this time, the cream or lotion needs to be applied again.
    • Treatment should be repeated after 5 to 7 days.
  • All family members and other close contacts should be treated at the same time, even if they are not itching.
  • The common causes of treatment failure are:
    • failing to treat all contacts
    • failing to cover all the skin (below the neck) with the insecticide. This is important because the site of the mites may not be the itchiest place.
  • The treatment will kill the mites, but itching can go on for 1 to 2 weeks after they are dead. This does not mean the treatment did not work. Other treatment for the itching may be needed.

Other things to do to stop scabies spreading

  • Clothing, bedding and towels should be washed in hot water (at least 60ºC) before you remove the treatment. 10 minutes in a hot clothes drier will also kill the mites, and so will ironing.
  • Things that cannot be washed should be dry-cleaned or placed in a sealed plastic bag for 5 days to kill any mites or eggs.
  • Mattresses and upholstered furniture can be vacuumed or gently ironed to remove mites and eggs.
  • All chairs should be cleaned with hot soapy water or sprayed with an insect spray.
  • Pushers/strollers, prams and car seats can also be sprayed with an insect spray.

Keeping away from others

  • Children with scabies will not be allowed to go to child care, school etc until the scabies has been treated. They can return on the day after the treatment.

More information

The New Zealand Dermatological Society (DermNet NZ) has a fact sheet with many pictures of scabies mites and the rashes they can cause 
http://dermnetnz.org/arthropods/scabies.html 

References

Department of Health (South Australia) Public Health Fact Sheet
'Scabies:symptoms, treatment and prevention'

Sexually Transmitted Disease Servies (South Australia) 'Crab lice and scabies'

Women's and Children's Hospital Pharmacy (South Australia) 'Treating scabies' 2007

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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