Scabies is a contagious skin disease caused by a mite that burrows under the skin and causes intense itching. Scabies is found in many countries, including the U.S. (we also see it often in Guatemalan, Chinese, and Russian adoptees), and can infect its victim regardless of age, sex or personal hygiene habits. Because children are in such close proximity to each other in care centers and orphanages, scabies is a common infestation. If your child has a diffuse (widespread), bumpy rash, chances are good that it is scabies. If your child brings scabies into your home, it is possible that you will get the infestation as well.
TREATMENT ABROAD
When you go to the orphanage to pick up your child, take along several tubes of the topical scabies treatment cream (insecticide) permethrin, 5%. Since it isn't available over the counter, you'll need to get a prescription for the cream from a travel clinic or from your primary care pediatrician. It should not be used by those with a known allergy to the medication, pregnant women or for children less than two months old. Scabies is a slow-moving bug and is unlikely to infect a contact as long as you are showering once a day and not sharing the same bed but we still recommend prophylactic (preventative) treatment for families. If you suspect that your child is infected, cover both them and you entirely--from your hairline on down to your toes--just before bed. Make sure to apply the cream in between the toes because scabies like to lay their eggs in the natural crooks and crannies of the human body. Leave the cream on the child’s skin for four hours (for kids two to six months old) and for 8-14 hours for older kids and adults, then shower or bathe. For babies or toddlers, it is also best to put mittens on their hands to prevent them from licking or ingesting the medication. You should also wash all clothing and linens in hot water and dry in a hot dryer. If hot water is not available, place all linen and clothing in plastic bags and store the bags away from the family for seven days. Hypothetically, the mite cannot survive for more than four days without skin contact.
Hopefully the permethrin will act as a preventative for you and as a treatment for the child, so you don’t bring the scabies infestation into your home. Sometimes, though, it is difficult to fully eradicate scabies.
TREATMENT WHEN YOU GET HOME
Additionally, it can take up to three months for scabies symptoms to show up. Therefore, it is possible to bring the infestation home with you and not know it for several months. If this is the case, use the permethrin cream as directed above. Treat everyone in your home, even if they don’t have any symptoms. Launder all of your clothes, bedding, towels and linens in hot water, and dry them in a hot dryer. If something can’t be laundered (stuffed quilts, shoes or slippers with fabric lining), either seal them in an airtight bag and put them in a cold place for two weeks, or seal them in an airtight bag and freeze them for 24 hours. Either method will kill the scabies eggs. Make sure to wash all of your child’s toys, as well.
You will probably itch for at least a few hours after treatment. Don’t worry, though, because you are no longer contagious as little as four hours after your first dose of treatment.
There is no need to treat the family pet, since the scabies species that infests humans is different from the species that infects pets.