Scabies (Pediatric):
A parent's guide for infants and babies

The physician may be able to diagnose scabies simply by examining your child's skin for typical lesions, such as burrows. A skin scraping, called a scabies preparation, may be examined under the microscope for mites, eggs, or mite droppings (feces).

In most cases of scabies, the doctor may recommend a topical cream or lotion, such as:

• Permethrin cream – After application, wash the cream off after 8–14 hours. Use the permethrin cream again in 1 week.
• Crotamiton lotion or cream – Apply once daily for 5 consecutive days.
• Sulfur ointment – Apply nightly for 3 consecutive nights. This is often the best choice for babies and for pregnant and nursing women because it is very safe to use.
• Lindane lotion or cream – Wash the cream or lotion off after 8 hours. Lindane may be toxic to some people. Therefore, avoid using it for young children, pregnant or breast-feeding women, or people with diseases affecting the nerves (neurological diseases).

When using a topical cream, lotion, or ointment, be sure to follow these steps (unless the physician gives other instructions):

• Apply to the entire body from the neck down.
• Smear the product beneath your child's fingernails and toenails.
• Apply to body folds, including inside the navel, in the buttock crease, and between the toes.

For more severe scabies, your child's doctor may prescribe oral medications:

• Ivermectin pills – Take once and then repeat 1–2 weeks later
• Antihistamine pill
• Antibiotic pills – If any scratched areas appear to be infected with bacteria 

Itching may take up to 3 weeks to go away as your child's immune system continues to react to dead mites. However, new burrows and rashes should stop appearing 48 hours after effective treatment.

Your doctor will remind you to launder towels, bed linens, and clothes used by your child in the previous 72 hours and to vacuum carpets, rugs, and upholstered furniture.

Household members, sexual partners, and anyone else with prolonged skin-to-skin contact with an infested person should also seek treatment from their doctors. Since the initial development (incubation time) for scabies infestations can be from 6–8 weeks, people may be infected with scabies, but since they do not yet feel itchy, they are unaware that they have an infestation. If untreated, these close contacts could pass the mites back to your child. Ideally, everyone should be treated at the same time in order to prevent re-infestation.