Doctors’ Notes



Scabies is parasitic infection caused by the mite Sarcoptes scabiei. Scabies produces an intensely itchy rash that starts 4-6 weeks after initial exposure. Scabies is spread through close contact with other infected individuals.

The rash will appear as small red bumps with thread like grey or white lines. In adults and older children, the most common places to see scabies are in areas of skin folds: wrists, ankles, between toes and fingers, groin and underarms. Infants and young toddlers will often have the rash on the palms and soles, in the neck folds, and on the scalp.

Scabies is treated with a topical cream to kill the mite within the skin. The cream is usually applied neck-to-toe and washed off in the morning. Because it’s common for the scalp to be affected, the cream should also be applied to the scalp in infants and toddlers. Cream is left on the skin for 8-12 hours, then washed off. Once treated, the affected person is no longer considered contagious. Cloth items that would have come in contact with the skin can be put into a washing machine with soap and washed in hot water. If the fabric is unable to be washed, it can be sealed in a plastic bag for one week. Hard surfaces can be wiped clean with a bleach and water mixture.

Because scabies is highly contagious, the whole family residing in the home will usually be treated, even if there is no rash present in other family members.

Once the rash is treated, the itching can last weeks to months. The body is actually responding to the proteins, eggs and excretions of the mite. A topical steroid will sometimes be used to help decrease the itching — and possibly an oral antihistamine as well. It’s important to keep nails trimmed short during this period, because it will decrease the changes of secondary infection from scratching.

If you believe your child has scabies, please call the office and make an appointment to be seen.

Stacey Stratton, a Kids Plus provider, is a member of the American Academy of Physician Assistants and the Society for Physician Assistants in Pediatrics.