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Clinical Reference Systems: Pediatric Advisor 10.0
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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

  1. 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.

  2. 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.

  3. 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.

  4. Contagiousness

    Children can return to school after one treatment with the scabies medicine.

  5. 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.

  6. 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.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems