Scabies

What it is

Scabies is an infestation with tiny mites that burrow into the skin. It causes intense itching, often worse at night, and small bumps or tracks between fingers, on wrists, armpits, waist and genitals. Babies may have it on palms, soles and scalp.

How it works

Scabies is a tiny mite burrowing in the skin; itch is an allergic reaction to it.

Why it matters on darker skin

Scabies spreads through close skin contact and is common in crowded homes and schools. On darker skin bumps may look darker or skin-coloured, and itching can leave dark marks.

Causes and triggers

Close contact; whole households get it.

What helps — and why it works

See a doctor or pharmacist for a scabies treatment and use it exactly as directed. Everyone in the household and close contacts should be treated at the same time, even without symptoms. Wash bedding, towels and clothes in hot water or seal them in a bag for 3 days. Treat everyone at once, repeat in 7 days: kills mites and newly hatched ones. Expected timeline: itch may last 2–4 weeks after. Wash bedding hot: removes mites. Expected timeline: same day.

What to avoid and why

Avoid treating only the child with symptoms, using steroid creams alone and repeated harsh antiseptic washes.

Common mistakes

• Treating only one person.
• Expecting itch to stop immediately.

Caring for children's skin

Children's skin is thinner, loses water faster and absorbs more of what is applied to it relative to body size, so simpler is safer. For most children a short lukewarm bath, a fragrance-free soap substitute and a plain emollient are all that is needed, plus shade, clothing and sunscreen from six months of age. Avoid adult products, essential oils, antiseptics in bath water, bleaching or 'toning' creams, and cosmetic treatments such as relaxers and gel nails. Medicines and medicated creams should be used only as a doctor, nurse or pharmacist advises, and in children Melanin & Me does not offer photo checks: a clinician should see the child. Trust your instincts as a parent: a child who is unusually sleepy, floppy, not feeding, breathing fast or has a rash that does not fade when pressed with a glass needs urgent care. Keep a simple record — photos and dates — of rashes that come and go, as this helps the doctor.

Products, medicines and when to worry

When choosing products for children, look for fragrance-free formulas with short ingredient lists, and avoid adult acne, anti-ageing or lightening products, essential oils and talc. Medicated creams — including steroid creams, antifungals and antibiotics — are safe and helpful when prescribed for the right condition and used for the right length of time, but mixed creams sold over the counter can contain strong steroids that are unsafe for children. Sunscreen is suitable from six months of age; younger babies should be kept in the shade and covered. Do not give medicines intended for adults, and ask a pharmacist about the right medicine for a child's age and weight. Seek urgent care for any rash with fever and a very unwell child, a rash that does not fade under a glass, swelling of the face or lips, or blistering of the mouth or eyes.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.