- What is scabies and how is it caused?
- How does a baby catch scabies?
- What are the symptoms of scabies?
- How is scabies diagnosed?
- What are the complications of scabies in babies?
- How is scabies treated?
- How to manage infantile scabies at home?
- How to prevent scabies in infants?
When an infant has scabies, you notice several red, dot-like rashes on the body, and thin, white, thread-like lines around the rashes. The baby has an intense itch and just can’t keep his hands off the rashes. But what is scabies and why would babies get affected with it? MomJunction gives all the information you need to know about infantile scabies.
What Is Scabies And How Is It Caused?
Scabies in babies is also called pediatric scabies or infantile scabies, and is caused by the dust mite Sarcoptes scabiei. The bug is microscopic, about the size of the head of a pin. It belongs to the same family as ticks, another human parasite (1).
The scabies mite burrows into the human skin by making a tiny cut using its mouth while breaking apart the skin using its front legs. It enters the upper layers of the skin and then burrows through it while laying eggs in the tunnels. The eggs hatch into larvae that feed on the dead skin and hair follicles. The larvae become full grown mites and begin burrowing the skin thus marking the completion of the first life cycle.
A scabies mite is not naturally found on the human body. This means that the baby gets it from an external source.
How Does A Baby Catch Scabies?
A scabies mite can land on your baby’s skin through:
- Direct skin-to-skin contact with someone with scabies
- Sharing clothing or bedding with an infected person
- Skin contact with a scabies-infected animal including domesticated animals
Babies who spend a lot of time in daycare centers are at a higher risk as they often come in direct skin contact with other infants. Also, if your pet has scabies, then the baby may catch the mite while petting the animal. Once a mite lands on a baby’s skin, it immediately burrows within, but symptoms emerge at the end of the first life cycle.
What Are The Symptoms Of Scabies In Babies?
The symptoms of scabies appear two to four weeks after the first entry of the mite. The baby will have the below symptoms (2):
- Bumpy red rashes that look like small red dots often located in clusters. In infants, these rashes appear at folds such as the creases of elbow and knee, inner thighs, between toes and fingers, underarms, buttocks, and genitals. The rash makes an appearance around the diaper’s elastic at the waist. Newborns even display rashes on face, neck, scalp, palms, and soles.
- An intense itching especially during night time. The itching would be so severe that it would interfere with daily activities of the baby. Itching is a result of the body’s allergic reaction to the mites, their eggs, and excreta.
- Short, straight or wavy lines that appear in pink or white color. You will usually see them joining two clusters of rashes. These lines are burrows dug by the mites inside the skin, where they lay their eggs.
Rashes and unbearable itchiness are the two fundamental indicators of infantile scabies. The itch is quite likely to leave the baby vexed, and the parents perturbed. It is best to get a diagnosis done by a doctor.
How Is Scabies Diagnosed?
The diagnosis is a two-step process (3):
- Visual examination of the rashes: The doctor looks for the pattern, density of the rashes, and the presence of white or pinkish lines that indicate burrows.
- Microscopic inspection of skin scrapings: Rashes and burrows are gently scraped, and the scrapings are checked under a microscope for the presence of mites and their eggs. Scabies mites live in the external layers of dead skin that have no nerve endings. Therefore, scraping the rash will be painless.
Timely diagnosis is important as it may otherwise set off a range of complications in the baby.
What Are The Complications Of Scabies In Babies?
Untreated scabies can lead to the following complications (4):
- Secondary bacterial infection: The repeated scratching of the skin can cause tiny wounds that get invaded by bacteria such as staphylococcus and streptococcus. It can cause the formation of pus and infections such as impetigo that lead to the creation of bacteria-infested sores.
- Chronic skin inflammation: Since the baby is scratching all the time, the skin would mostly stay red and inflamed. It causes a lot of discomfort and irritation to the baby, which may interfere with daily activities such as feeding and playing.
- Norwegian scabies: In babies with compromised immunity caused by HIV or cancer, the population of scabies mites multiply at a rapid rate producing large scales or crusts on the skin. Such form of scabies is called Norwegian or crusted scabies. It is hard to treat it since the skin contains hundreds or even thousands of scabies mites compared to 15-20 usually found on the skin during normal scabies (5).
To avoid these complications, the sooner the treatment begins post diagnosis, the better it is for the baby.
How Is Scabies Treated?
The scabies infection in infants is treated in one of the below-mentioned ways.
- Permethrin 5% cream (for babies older than two months): It is the first choice of treatment to eradicate scabies mites and their eggs. Permethrin is an insecticide that is safe for babies older than two months. It has a 95% cure rate but carries some toxicity that only seems to affect babies younger than two months (6). The cream is applied throughout the body from the scalp to the toe, including the inside of the navel and earlobes, to ensure all the mites and their eggs are killed. The cream is left on the body for 8-14 hours depending on the doctor’s recommendation. After the period, the baby is given a bath. The application is repeated a week later.
- Sulfur 7% cream (for babies younger than two months): Infants under two months are administered a sulfur 7% cream. The method of application is the same as the permethrin cream. The ointment is less potent than permethrin and may have to be applied more frequently. On the bright side, it has no side effects and is safe even for very young infants, and pregnant and lactating women (7).
- Oral antihistamine: These medicines control the intense itching. The medicine does not affect the scabies mites and is only prescribed if the baby is unable to sleep and eat properly due to itching.
The itching and rashes subside significantly within a couple of days of first application of medicines (8). However, you need to continue the medicine for the complete period as recommended by the doctor. A slight itch may persist for two weeks after the mites are eliminated, but that is normal. Overall, the baby would be cured in about four weeks after the initiation of the treatment (9). Home management is essential to get maximum benefit from the treatment.
How To Manage Infantile Scabies At Home?
The following steps let you manage a baby’s scabies at home while also helping you protect other family members from the condition (10):
- Dress the baby in loose clothing, as the baby feels itchy all the time. Loose clothes ensure less friction and irritation to the skin.
- Wash the baby’s clothes separately from those of siblings and other family members. Soak them in hot water before washing them with a baby-safe detergent. Dry the clothes in direct sunlight. These steps help neutralize the eggs and scabies mites that found their way on the clothes from the baby’s skin.
- Trim the baby’s nails to discourage and prevent itching. Long nails can also trap scabies mites that may get transferred to healthy skin when scratched.
- Disinfect and store baby’s beddings in bags for three days. The scabies mites cannot survive outside human skin for more than three days. For a better rate of disinfection, you can place the bag in direct sunlight for a couple of hours every day.
- Keep the house clean to prevent the spread of infection from the baby. Use a vacuum to clean sofa, carpets, and places where the mites can hide, readily waiting to come in contact with skin. Keep hard surfaces clear of dust and use a disinfectant floor cleaner.
Besides the above, you could also follow a few steps to ensure that the baby does not itch and bruise his skin.
Ways To Reduce Itching
A baby requires prescription medicines to kill the scabies mite, which cannot be done through home remedies. However, the itching can be brought down with the use of some over-the-counter medicines (11):
- Antihistamine medicines: Babies older than 12 months can be administered over-the-counter antihistamine medicines such as Benadryl. Remember to follow the instructions given on the bottle. Antihistamine medicines reduce the intensity of the allergic reaction making itching less annoying and more tolerable.
- Calamine lotion: Apply a baby-safe calamine lotion on infants older than six months. Calamine helps reduce skin irritation and inflammation caused by repeated scratching of the skin.
- Disinfectant baby bathing soap: A baby-safe disinfectant bathing soap may kill the scabies eggs and also affect the egg-laying efficiency of the scabies mite. It will help slow down the spread of scabies to the healthier skin.
It is best to consult a doctor before using a home remedy for a baby younger than six months. The immune system does not develop any resistance against the scabies mite. It means that re-infection is possible even once cured and even when the baby is otherwise healthy. Prevention is thus vital.
How To Prevent Scabies In Infants?
Prevention of scabies is simple and requires you to observe a couple of precautions. Here is what you must do to prevent your baby catching scabies:
- Keep distance from those with scabies: Direct skin-to-skin contact is the principal mode of scabies transmission. If someone in the family has scabies, then the baby must be kept away from the person and their personal items. Do not let the baby play with other infants that have scabies.
If the mother develops scabies, then she must avoid skin-to-skin contact as well. Breastfeeding can be a challenge during such moments. Therefore, express milk for feeding and let the baby be handled by a healthy family member. Babies can catch scabies by coming in contact with clothing and bedding of an infected person, but according to the American Academy of Paediatrics (AAP), this is very rare (12). Nevertheless, keep an infant from all contaminated items.
- Maintain cleanliness and general hygiene: Scabies mites are microscopic and drift in the air. They can land on surfaces waiting to make contact with healthy skin. Therefore, maintain general cleanliness and hygiene around the baby. Keep dust at bay by cleaning surfaces, vacuuming, and placing beddings under direct sunlight periodically.
The irritation and itch from scabies are excruciating. But treatment provides a definite cure. Managing the disease at home is also easy while prevention is simple. Staying clear of those around with scabies and some simple daily personal hygiene is all the baby needs to live a life free of itchy scabies.
If you have any more tips on preventing scabies, then tell us in the comments section below.