Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version
Scabies
DESCRIPTION (Diagnosis must be confirmed by a physician.)
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.
HOME CARE
- Scabies cream for all except pregnant women
Your child needs the medicine prescribed by your
physician.
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. 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 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. Put
contaminated blankets away for 3 days. Scabies cannot
live outside the human body for more than 3 days.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- It looks infected (sores that enlarge or drain pus).
- You have other concerns or questions.
- New scabies occur after treatment is completed.
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Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
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Copyright 1999 Clinical Reference Systems
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