How can I treat a scabies mite in a child? - briefly
Apply a prescription scabicidal cream—commonly 5 % permethrin—over the child’s entire body, leave it on for the recommended time, and repeat the application after seven days; wash all bedding, clothing, and towels in hot water and dry on high heat to eliminate remaining mites.
How can I treat a scabies mite in a child? - in detail
Treating a scabies infestation in a pediatric patient requires a systematic approach that addresses the parasite, alleviates symptoms, and prevents reinfestation.
First‑line medication is a topical scabicide applied to the entire body from the neck down, with special attention to interdigital spaces, wrists, elbows, knees, and the genital area. Permethrin 5 % cream is the preferred agent because it is safe for children older than two months, minimally irritating, and highly effective. Apply a thin layer, leave it on for eight to twelve hours (typically overnight), then wash off. A second application after seven days eliminates newly hatched mites.
For infants younger than two months, or when permethrin is contraindicated, sulfur ointment (5–10 %) may be used. Apply nightly for three consecutive nights, covering the whole skin surface. Sulfur can cause a mild odor but is safe for newborns.
Oral ivermectin is an alternative for older children (≥15 kg) when topical treatment fails or when extensive crusted scabies is present. The dose is 200 µg/kg as a single oral administration, repeated after one to two weeks. Ivermectin should be avoided in children under five years or weighing less than 15 kg unless under specialist supervision.
Symptom relief includes:
- Antihistamine tablets or syrup (e.g., cetirizine) for itching.
- Low‑potency topical corticosteroids (e.g., hydrocortisone 1 %) applied to irritated areas, not to the entire body.
- Cool compresses or colloidal oatmeal baths to soothe skin.
Environmental control is essential:
- Wash all clothing, bedding, and towels used in the preceding three days at 60 °C or dry‑clean them.
- Seal items that cannot be laundered in a sealed plastic bag for at least 72 hours.
- Vacuum carpets and upholstered furniture; discard vacuum bags promptly.
Family members and close contacts should receive simultaneous treatment, even if asymptomatic, to prevent cross‑contamination.
Follow‑up assessment after two weeks should confirm resolution of lesions and absence of new burrows. Persistent rash may indicate secondary infection; in such cases, a short course of oral antibiotics (e.g., amoxicillin) may be warranted.
Adhering to this protocol maximizes cure rates, minimizes complications, and reduces the risk of recurrence.