What is Scabies?

Scabies is a contagious disorder of the skin caused by very small, wingless insects or mites called the Human Itch mite or Scabies itch mite - Sarcoptes scabiei var. hominis. This insect causes infection by getting under the skin and causing itching and a rash. A very small, hard to see, zigzag red spot usually marks the trail of the insect as the female mite lays her eggs. Other more obvious symptoms are an intense itching (especially at night) and a red rash that can occur at the area that has been scratched. The most common locations for scabies are on the sides of fingers, between the fingers, on the backs of the hands, on the wrists, heels, elbows, armpits, inner thighs and around the waist. 

Scabies is spread by personal contact, e.g., by shaking hands or sleeping together or by close contact with infected articles such as clothing, bedding or towels. It is usually found where people are crowded together or have frequent contact, and is most common among school children, families, roommates, and sexual partners. Scabies can be spread by the insect itself or by the egg.  

What to do when a child has scabies? 

Infected children and adults should apply lotion or cream containing a scabicide (a chemical that kills the mites) over their entire body below their head. Elimite (5% Permethrin) is the most commonly used cream. Alternative medicines are Kwell (Lindane) and Eurax (10% Crotamiton). Elimite should be removed by bathing after 8 to 14 hours, and Kwell after 8 to 12 hours. Young children suspected of having scabies should see a physician.

Wash all clothes, bedding, and towels used by the infected person in hot water and dry them in a hot dryer. Monitor the infected person. A second treatment may be needed a week later.  
 

How to prevent scabies? 

Regularly change and wash all clothing, bedding, towels and underwear. Children should not share clothing or other personal articles such as hair brushes, combs or towels with one another.  

Notify the parents of children who may have had direct contact with the infected person. Other providers and children and their families may have been infected and may need treatment.  

The rash may take 2 to 6 weeks to develop in persons who have not had scabies previously. If a person has had scabies previously, it will take only days for the rash to develop.  
 

When can children with scabies return to child care? 

Children with scabies can return to daycare 24 hours after treatment has been completed 
 

When should children with scabies be excluded? 

Exclude the child until 24 hours after treatment has been completed.  

What to do if child care staff are pregnant or possibly pregnant? 

Child care personnel should be screened for Scabies. Scabies does not spread to unborn children. Medical treatments for scabies can causes problems with an unborn child. Pregnant staff should talk to their doctor about appropriate medications.