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Scabies (Latin name)

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Scabies is caused by a mite that digs into the child’s skin. The illness appears by a strongly itching rash, especially on the child’s feet, scalp and face. Since scabies is contagious, often, several cases appear in the family or in the day care. The whole family needs treatment and the course of treatment should be repeated after 1 week. Even though the child has recovered and all the mites are dead, the itching can continue for up to 3 weeks after finished treatment.

Scabies is seen in all ages and often with children. At schools, in kindergartens and in day cares, scabies can spread very quickly.

Scabies is caused by a mite that lives in the skin. The pregnant female mite – just below ½ mm long, which is why you can barely see it with the naked eye – digs down under the skin in a few minutes. Here it drills a tunnel (burrow) where it leaves excrements and lays its eggs. The eggs are hatched during a few days and develop – over the next 3 to 4 weeks – into grown mites. The grown mites can live on the child’s skin for 4 to 5 weeks and during that time many female mites become impregnated. This continues until treatment is commenced.

The scabies mite is usually transmitted when children plays and romp about. Since the scabies mite can survive up to 24 hours on clothing, furniture and floors, scabies can also transmit from the surroundings.

2 to 4 weeks after the child has been transmitted with a scabies mite, it starts to itch. The itch, which is worst during the night, worsens every day. The itch can become so strong that the child will scratch so violently that it draws its own blood. With children the scabies mite is typically found on feet, scalp and face but also hands and the navel can come under attack. Where the scabies mite lives, the skin is red with small blisters. Since it itches, small wounds may appear where the child scratches itself.

It can be difficult to see whether a child has scabies. You can (with a magnifying glass and strong light) see the superficial burrows, where the female mite has dug into the skin. It looks like someone has drawn fine winding lines with a pencil on the child’s skin. It is usually not possible to see the scabies mite itself, since it resides in the very bottom of the burrows.

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The perception of former times that transmission only took place if you lay under the same comforter is false. Usually, the scabies mite is transmitted when children plays and romps about. Since the scabies mite can survive for up to 24 hours on clothing, furniture and floors, scabies can also be transmitted through clothes and furniture.

It is therefore recommended to wash the child’s clothes at temperatures above 50 degrees Celsius for ten minutes and thoroughly clean floors and furniture. Consider who has visited you for the last three weeks and notify them that they might be infected. Also, notify the school, kindergarten or the day care.


There are several different remedies against scabies. You can get a mite killing crème or lotion containing 5 % permethrin on prescription from your doctor. There are no known side-effects to the crème and can therefore be used on the very small children. First you bathe and dry the child. With children more than 3 years old, the crème is applied to the entire body (from the jaw and downwards) in a thin layer. With children less than 3 years, the scalp and face are also covered (however, not around the eyes and mouth). The crème is washed off with hot water and soap after 8-14 hours, and then the child is given clean clothes to wear. It is a good idea to start the treatment in the evening so that the child sleeps while the remedy takes effect. The treatment must be repeated after 5 to 8 days to be sure that all the mites are dead.

Even though the treatment kills all the mites, the itching can continue for 2 to 3 weeks. This is not a sign that the treatment is ineffective. Such an itching should be treated with corticosteroid crème that can be bought at a pharmacy over the counter.

Everyone in the family should be treated at the same time. Even though one member of the family has not got the itch, he or she can still have the scabies mite and thereby risk that the child is infected with scabies again.

What can you do?

If you are sure that the child has scabies, you can treat it yourself.

Get a prescription on the 5 % permethrin crème from your doctor and remember to treat every member of the family twice.

The child’s clothes and bed sheets should be washed at temperatures over 50 degrees Celsius for at least 10 minutes – this way, all the mites are killed.

Contact the doctor tomorrow

If you suspect scabies but is not entirely sure. The doctor can lead a pin down into the bottom of the burrow. The mite will then attach to the pin and then the doctor can examine the mite in his or her microscope. Then you know what causes the itch.

If it still itches 3 weeks after finished treatment.

Contact the doctor immediately

This is never necessary.