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Topical medications will treat daughter’s scabies

Copyright 2002 President Fellows Harvard College behalf HMS MediServices Phoby LizGreen HMS MediServices Anthony Leader Komaroff MD Harvard Health Publications

Copyright 2002 President and Fellows of Harvard College on behalf of HMS Media Services, Photo by Liza Green, HMS Media Services, Anthony Leader Komaroff, MD, Harvard Health Publications

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Updated: November 14, 2012 6:04AM

Dear Doctor K: My daughter picked up scabies at her day care center. How should I treat it? And what can I do to make sure she doesn’t get infected again?

Dear Reader: Scabies is a skin infestation by tiny, parasitic insects called mites. It causes intense itching. When a person catches scabies, female mites lay eggs in the person’s skin. The eggs hatch, mate and lay more eggs, continuing the cycle. Scabies is very contagious.

Scabies mites can be spread by direct skin-to-skin contact with an infected person. They can also be transmitted through clothing, blankets, sheets, towels or furniture that has touched an infected person’s skin. It’s common for kids to catch scabies in day care centers or schools, where they are in close contact with other kids.

Your daughter’s doctor can perform various diagnostic tests. Usually, though, the visual appearance of the skin and the severe itching are the circumstantial evidence that leads to treatment.

The doctor can prescribe various topical medications to apply to treat your daughter’s scabies. These include permethrin (Nix, Elimite), lindane (Kwell, Scabene) and crotamiton (Eurax). If your daughter is an infant or otherwise sensitive to these medications, her doctor may recommend sulfur in petroleum.

Topical scabies medications should be applied from neck to toes after bathing, left on the skin for 8 to 14 hours, and then washed off. In some cases, a second application may be necessary.

Your daughter should stop being contagious within 24 hours, and her symptoms should improve noticeably within two days.

In the meantime, to help control her itching, apply calamine lotion. If itching keeps her awake, ask her pediatrician about giving her diphenhydramine (Benadryl) by mouth. This medicine can help her sleep and reduce the itching.

You and other family members must be treated for scabies as well, even if you don’t have any symptoms. That’s because some of the mothers may already have jumped to your skin and are in the process of laying the eggs that will make you itch in the future.

In addition, you should wash all of your daughter’s clothing, bedding and towels in hot water and dry these items in a hot dryer. This should kill all scabies mites and eggs. Clothing that cannot be washed should be sealed and stored for one week.

To help prevent your daughter from catching scabies again do not allow your daughter to share clothing or towels at her day care center, provide a pillow and blanket from home that your daughter can use at the day care center.

Write to Dr. Komaroff at

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