Scabies

Home care

• Machine wash in hot water all sheets, towels, pillowcases, underwear, pajamas, and other clothing you have worn lately. Use the hot cycle of a dryer. If an item can't be laundered, dry clean the item.

• Seal anything that is hard to wash in a plastic trash bag for at least a week. This includes coats, jackets, blankets, and bedspreads. (The insects die after 3 days off the human body.)

Medicines

Scabicides

Medicines used to treat scabies are called scabicides. These are creams that kill the scabies mites. Some also kill the eggs. A prescription is needed. When using these medicines:

• Always follow instructions provided by your health care provider and pharmacist. Also follow the printed instructions that come with the medicine.

• Talk with your provider about precautions to take when using these medicines.

• Use the cream on your body when your skin is clean, cool, and dry. Don’t use it after a hot shower or bath.

• Follow your provider's instructions for applying the medicine. Usually the cream is put on your whole body. This means from your chin all the way down to your toes. Scabies doesn't often affect an adult’s head. So cream isn't needed there. For children, discuss how to apply the medicine with your child’s provider.

• Leave the cream or lotion on for the advised amount of time. It is usually 8 to 12 hours before it can be washed off.

• Don’t leave cream or lotion on your skin longer than directed. Don’t use more than advised.

• Wear clean clothes after the treatment.

• If you wash your hands after using the cream, reapply the cream to your hands.

• If you're breastfeeding, wash off your nipples before feeding. Then reapply the cream after breastfeeding.

• For babies or infants, put mittens on their hands. This will stop them from licking the cream or lotion. It will also stop them from scratching themselves because of the itching.

Other medicines

• An oral medicine called ivermectin may be prescribed for severe cases that don't respond to topical creams. It may also be used if you can’t apply creams. Or it may be used if your child has crusted scabies because of a weak immune system, such as from cancer treatment or an organ transplant.

• Itching may cause the most discomfort. If large areas of your skin are affected, over-the-counter antihistamines may be used to reduce itching. Or you may be given a prescription antihistamine. Some of these medicines may make you sleepy. They are best used at bedtime. Don't drive or operate heavy machinery while taking medicines that make you sleepy. Antihistamines that don’t make you sleepy can be used during the day. Note: Don’t use medicine that has diphenhydramine if you have glaucoma. Or if you have trouble passing urine due to an enlarged prostate.

• If you were given antibiotics due to a bacterial infection, take them until they're finished. It's important to finish the antibiotics even if the wound looks better. This is to make sure the infection has cleared.

Follow-up care

Follow up with your health care provider as advised. Call your provider if your symptoms don’t improve after 1 week, or if new burrows or rashes appear.

When to get medical advice

Contact your health care provider if any of these occur:

• Yellow-brown crusts or drainage from the sores

• Other signs of infection, including increasing redness, swelling, pain, or pus

• Fever of 100.4°F (38ºC) or higher, or as advised by your provider (See Fever and children, below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the health care provider what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.

Below is when to call the health care provider if your child has a fever. Your child’s health care provider may give you different numbers. Follow their instructions.

When to call a health care provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s health care provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider