Scabies is a very itchy rash caused by a small, eight-legged mite called Sarcoptes scabiei, which burrows into the skin. Scabies is usually spread by close, prolonged skin-to-skin contact (e.g. holding hands), and is common in school-aged children.

If left untreated, scabies can spread to all members of the family via linen, couches and towels. The mites and their eggs may live on clothes or bed linen for one to two days.

Signs and symptoms of scabies

It is often difficult to diagnose scabies, because the symptoms vary and the signs can be very subtle. The symptoms of scabies are caused by an allergic reaction to the mites, and commonly include:

• intense itch, usually worse at night and after a hot bath/shower
• bumps or blisters (raised, solid lesions) on the skin where the mites burrow in.

Scabies occurs when a number of mites (10 or more) burrow into the skin. This often happens between the fingers, in the armpits and belly button, and on the wrists, elbows, nipples, penis and scrotum. The burrows may be visible. In infants and young children, there are often fluid-filled bumps on the palms of the hands and the soles of the feet, and sometimes on the scalp in infants.

The bumps or lesions caused by scabies are generally small, and may be hard to see. Sometimes the only symptom is the itch, without a rash.

The symptoms of scabies usually appear two to four weeks after infection, although people who have previously been infected may develop symptoms within two days.

When to see a doctor

If you think your child has scabies, see your GP. The doctor may make a diagnosis by scraping a burrow and looking at that skin under a microscope.

Your doctor will recommend the appropriate treatment, which you can buy over the counter at the pharmacy.

Care at home

Anyone who has close contact with your child should be treated at the same time, because scabies is easily spread, particularly throughout a household. Treatment should be repeated one week after the first treatment because it's possible to be reinfected. It is OK for your child to go back to child care, kindergarten or school 24 hours after the first treatment.

• Do not apply the treatment more than twice. The itching caused by scabies may take up to three weeks to go away after treatment. Your doctor can prescribe a corticosteroid cream for the itch if needed.
• Sometimes the raised, solid lesions caused by scabies can last for months.
• Scabies above the neck is common in babies who live in central and northern Australia. This means treatment should also be applied to the face and hair, but be careful to avoid the eyes, nose and mouth.
• Bathe your child in warm water as hot water may make the itching worse.
• To kill the mites and their eggs, bedding and clothing should be washed in hot water and, if possible, dried in a clothes dryer on a hot setting.
• Items that cannot be washed and dried this way can be put in airtight containers or bags, or placed in the freezer. Leave them there for a couple of days to kill the mites.

Key points to remember

• Scabies is spread by close physical contact and is common in school-aged children.
• The mites and their eggs may live on clothes or bed linen for one to two days.
• If left untreated, scabies will usually spread to all members of the family, and anyone who has close contact with an infected person should be treated.
• Treatment should be repeated one week after the first treatment. Do not apply the treatment more than twice.

For more information

• Better Health Channel: Scabies
• See your GP or pharmacist.

Developed by The Royal Children's Hospital Dermatology and Emergency departments. We acknowledge the input of RCH consumers and carers.

Reviewed April 2018.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit  www.rchfoundation.org.au.