Scabies

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What is scabies?

Scabies is caused by a tiny mite that burrows into the skin causing a rash. Scabies is a nuisance, not an infection. It is common in children. Some people believe children get scabies because they have not been washed properly, but scabies has nothing to do with cleanliness. The female mite lays eggs under the surface of the skin. The eggs then hatch within 3 - 4 days and the mites move to the surface of the skin to mature. This life cycle is repeated and infection gradually spreads.

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What are the symptoms?

The mites that cause scabies dig deep into the skin and cause a very itchy rash. The rash looks like curvy white threads, tiny red bumps or scratches and can appear anywhere on the body. Four to six weeks after being exposed, the person will develop a feeling of intense itchiness which is often worse at night. A red rash will also develop. In severe cases, the scabies ‘burrows’ can sometimes be seen under the surface of the skin as wavy, raised threads. The most common rash sites include the front of wrists, between fingers, back of elbows, breasts, male genitals, abdomen, back, and buttocks. They are rarely found above the neck except in infants.

How are they spread?

Scabies are highly contagious and are typically spread from person to person by touch or by contact with the clothes or other personal items of someone who has it. It can be acquired through sexual contact or contact with clothing, undergarments, towels, and bedding. The mites can live on clothes, other objects and off of skin for four days. The mites will die after four days if the items are stored in a plastic bag.

How can scabies be treated?

Scabies can be treated with a cream (scabicide) from your doctor. Even after the cream gets rid of mites, a person may still be itchy for a few weeks, but it does not mean that the mites are still there. Apply the scabicide behind the ears and from the neck down, including the groin, belly button area and between the fingers and toes. Cut nails short and apply scabicide beneath them. Treat all sexual contacts and household members at the same time as the infected individual regardless of symptoms.

What else should be done?

Treatment is essential for all household members because signs of scabies may not appear for two to three weeks after contact. Studies show a cure rate of 98% when all contacts are treated as opposed to a 50% cure rate when only visibly infected individuals are treated.

The following control measures are recommended.

• To prevent re-infection, treat all household members at the same time as the patient is being treated.
• All bed linen (sheets, pillow cases, blankets) and clothing worn next to the skin (underwear, T-shirts, socks, pants) should be laundered in a hot wash cycle and hot drying cycle.
• If hot water is not available, place all linen and clothing into plastic bags and store it away from the family for five to seven days. The mite does not survive beyond four days without skin contact.
• Children may return to day care or school the day after treatment is completed.
• Health care workers who have close contact with scabies patients may require prophylactic treatment.

Note: it is not necessary to disinfect items like mattresses and furniture.

For more information please contact Public Health at 519-376-9420 or 1-800-263-3456.

Canadian Paediatric Society