Scabies

This intensely itchy skin condition is caused by infestation with tiny, burrowing mites that lay their eggs within the outermost layer of the skin. Scabies infestations often look like brownish-gray, threadlike lines ending in black dots. These lines mark the path of the mite as it burrows under the skin. Itching usually develops a month or longer after the mite enters the skin. Small, red bumps erupt. Continued scratching can lead to a severe rash resembling eczema.

HOW DOES SCABIES DEVELOP?
Children can get scabies from skin-to-skin contact with someone who is already infested. Once the mite enters the skin, it deposits eggs and fecal material. As the eggs hatch and the mite population increases, itching develops gradually. This process may take four to six weeks. The picture may be complicated by a secondary infection, which occurs when bacteria enter skin broken by excessive scratching.

The symptoms of scabies infestation are often prompted by an allergic reaction, which develops when the immune system directs antibodies at the mites or their by-products. The fact that symptoms develop more quickly in second than in first infestations suggests that an allergic reaction is at work.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS SCABIES?
Before age two, scabies infestation is most likely to affect the armpits, feet and ankles. Older children more often develop lesions around the hands and wrists. Any time a child has an extremely itchy rash in these areas, scabies is a possible explanation, particularly in a child who rarely develops skin irritations. If several members of a household develop similar symptoms, scabies or some similar skin infestation is a likely explanation.

IS MEDICAL ATTENTION NECESSARY?
Yes. Scabies mimics many other skin irritations, particularly after being scratched for a few days, so the doctor should examine the rash and make a definite diagnosis. The doctor also will recognize the signs of a secondary bacterial infection, a common complication of scabies.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS SCABIES?
Scabies is diagnosed by microscopic examination of cells from a suspicious-looking lesion. If a scabies infestation is present, mites, eggs or feces will be visible.

WHAT TREATMENTS ARE AVAILABLE?
Several creams and lotions are available to eliminate scabies mites. These preparations are typically applied to the entire skin surface from the neck down and left on for six to eight hours. In most cases, one treatment is sufficient to get rid of the infestation, but a second treatment is sometimes needed about two weeks after the first.

PREVENTING SCABIES

• Avoid close physical contact with anyone known to have scabies.

• Discourage children from sharing towels and clothing.

• Consider treatment for the whole household if one member has scabies.

• Use hot water to wash all clothes, towels and bedding used by a child or adult with scabies.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.