Key points about scabies
- scabies is caused by a reaction to a tiny mite which digs under the skin and lays eggs
- small blisters grow on the skin and the skin gets very itchy
- the redness and small blisters look like a rash on the skin
- the scabies rash may start anywhere and can happen to anyone
- everyone in the house needs treatment at the same time to get rid of scabies
Causes of scabies
Scabies is caused by a reaction to tiny mites that are so small you can't see them. Mites are a type of insect. The mites burrow under the skin surface and lay eggs as they go. The skin rash is a reaction to the mites, the mite poo, and the mite eggs.
How scabies spreads
Anyone can get scabies. It is more common when lots of people are in close contact. Washing with soap doesn't stop it.
Scabies spread from one person to another by skin to skin contact, and by sharing bedding, clothing or towels used by a person with scabies.
Signs and symptoms of scabies
One of the first symptoms of scabies is a very itchy rash. This is usually worse when your child is warm, in bed, after a shower etc.
Symptoms usually start 3 to 6 weeks after getting the scabies mite. But, if you've had scabies before, the rash can start after only 1 to 3 days.
The scabies rash looks like lots of small blisters surrounded by red patches.
The most common places for the rash are between your child's fingers and toes, on their wrists, inside their elbows, around their waist, on their bottom or genitals.
Children often get a rash all over their body.
See a health professional if you think your child has scabies.
Not all people with scabies will be itchy. So people can spread scabies even if they don't have symptoms.
What to do if your child has scabies
See a health professional
A health professional will prescribe a scabies cream or lotion to kill the mites. If your child is under 2 years old, they may need a different treatment so check with your health professional.
The most common cream or lotion is called permethrin.
Treat everyone in the household
Get enough scabies cream or lotion to treat everyone in the household. Treat everyone even if they don't have a rash or itch.
Cream for everyone on the same day
Apply scabies cream or lotion to everyone in the family or household on the same day, just before going to bed.
Apply cream all over
The scabies cream or lotion has to go all over the body, from head to toe - including the soles of the feet. Be careful to cover between toes and fingers, armpits, tummy button, genitals and buttocks.
Leave overnight
The scabies cream must be left on overnight, for at least 8 hours. If you wash your hands overnight, put more cream or lotion on your hands.
Wash linen in hot water
On the morning after putting the scabies cream or lotion on everyone, you also need to wash all sheets, pillow cases, towels and clothes in hot water. Or, you need to put these things into a sealed plastic bag for 7 days to kill the mites. If you don't do these things, the mites will reinfect your family.
Hang blankets outside
Hang quilts, duvets and blankets outside for a day so the sun can kill any mites.
Check all family members
Check other family members for scabies.
What to do scabies gets worse
Once you have killed the scabies mites with the scabies cream or lotion, the sores or the rash will stop growing but it will still be itchy for up to 4 weeks.
You may also need to repeat the treatment of the whole family with the scabies cream or lotion.
Occasionally, scabies can be resistant to treatment with the cream or lotion. If you have done 2 treatments with the cream, ask your health professional if a different kind of treatment is needed.
The sores and rash can become infected. See a health professional if the sores or rash get redder, warm, start swelling or have pus. This could mean the sores are getting infected (cellulitis).
When to keep your child home from school or daycare
Keep your child at home until at least one day after treatment with the scabies cream.
Acknowledgements
Workbase and Ministry of Health printout (PDF, 189KB).
Images of scabies on this page have been reproduced from the website of the New Zealand Dermatological Society.