Scabies is caused by infestation with small mites, which are not insects but more closely related to ticks and spiders. Scabies mites live only on humans, where they burrow into the skin to lay eggs.
The rash and itching that occur with scabies can be very severe. It may take several weeks for these symptoms to develop after exposure to the mites. In infants, the rash may occur on the scalp, body, arms, legs, palms, soles and diaper area and may appear as large red bumps. In older children and adults, the rash is most often seen on the hands (especially between the fingers), the underarms, the genital area and the waist, where small red bumps and blisters develop.
Treatment for scabies requires the use of topical (skin) medication to kill the mites and any eggs. In general, all close contacts such as household members should be treated, even if they have no symptoms since the onset of symptoms may be delayed. Scabies is highly contagious.
Older infants and children are treated with Permethrin 5% cream (Elimite). The treatment should be repeated in seven days. Young infants and pregnant women are treated with 5 percent precipitated sulfur in petrolatum. Treatment should be done once a night for three nights in a row.
For infants, apply the medicine to the scalp, forehead, body, arms, legs, hands, feet and diaper area. For older children and adults, apply the medicine from the neck down to the feet, covering all body areas. Also apply between the fingers and toes and in the genital area. Leave the medicine on overnight (eight to 14 hours). In the morning, wash it off completely with shampoo and soap.
Your doctor may also prescribe a topical steroid cream or an oral (by mouth) medicine to help with the itching.
When to Call the Doctor
Call your doctor if your child continues to have a rash or itching more than four weeks after treatment or he or she develops signs of a skin infection such as pain, swelling, increasing redness of the skin or pus.