Your child is scratching intensely, especially at night. You notice small red dots and maybe some tiny lines in the skin. Could it be scabies?

Scabies is a common skin condition that spreads easily among children, particularly in daycare settings. It's harmless but very uncomfortable — and it's important to treat it properly so the whole family gets rid of the mite.

What Is Scabies?

Scabies is caused by a tiny mite called Sarcoptes scabiei that burrows into the outermost layer of skin. There, the female mite lays eggs, and it's the body's reaction to the mite and its waste that causes the intense itching.

Scabies has nothing to do with poor hygiene. The mite thrives just as well on clean skin as on dirty skin. Anyone can get it, and it spreads easily in daycare settings and families.

According to the CDC, scabies is common worldwide and outbreaks occur regularly in daycares and institutional settings.

Symptoms of Scabies in Children

It can take 3–6 weeks from the time a child is infected before symptoms appear for the first time. With a new infection (if the child has had scabies before), symptoms appear within just 1–3 days.

Itching

The most typical symptom is intense itching that worsens at night and in warmth. The itching can be so disruptive that the child has difficulty sleeping.

Rash and Burrow Marks

Small red dots and itchy rash — often in clusters
Scabies burrows — thin, irregular lines in the skin (1–10 mm long) where the mite has tunneled in
Blisters and crusts — from scratching and secondary skin irritation
Eczema-like changes — can resemble ordinary eczema, making diagnosis difficult

Where on the Body?

In babies and young children, scabies can affect the entire body, including:

Palms and soles of the feet — common in babies, unusual in adults
Scalp and face — especially in children under 2 years
Between the fingers and on the wrists
Around the navel, in the diaper area, and in skin folds

In babies, scabies can produce a more widespread rash than in older children and adults. The rash can look like eczema, and it's not uncommon for the diagnosis to be delayed because eczema treatment is tried first.

How Does Scabies Spread?

Scabies spreads mainly through close and prolonged skin contact — not through brief contact like a handshake.

Common ways it spreads:

Direct skin contact — close cuddling, being carried, sleeping in the same bed
Family members — parents, siblings, and grandparents who have close physical contact
Daycare — particularly during nap time when children sleep close together

Transmission via bedding, clothing, and towels is possible but less common. The mite survives only 2–3 days outside the body.

If one household member has scabies, the entire household should be treated at the same time — even if not everyone has symptoms yet. Otherwise the infection will keep passing back and forth.

Treating Scabies

Scabies is treated with over-the-counter or prescription cream applied to the entire body. There is no effective home remedy — you need medical treatment to get rid of the mite.

Permethrin 5% Cream (First-Line Treatment)

Permethrin is the recommended first-line treatment according to the CDC and AAP:

Apply cream to the entire body from the neck down to the soles of the feet — including between fingers, under nails, behind ears, and in skin folds
In children under 2 years: Also apply to the head and face (avoid eyes and mouth)
Leave the cream on for 8–12 hours — easiest to apply in the evening and wash off the next morning
Repeat treatment after 1 week — to kill newly hatched mites from eggs that survived

Important Treatment Notes

Treat the entire household at the same time — everyone living together is treated on the same day
Clean bedding and clothing — change bedding, towels, and clothing after treatment. Wash on at least 60°C (140°F)
Clothing and textiles that can't be washed — seal in a plastic bag for 3–4 days. The mite dies without skin contact
Itching can persist for 2–4 weeks after successful treatment. This is an allergic reaction and does not mean treatment has failed

For itching after treatment: Moisturizer and if needed an antihistamine (ask your pharmacist about age-appropriate dosing) can provide relief while the skin settles down. Your doctor can also consider a mild hydrocortisone cream.

When Treatment Doesn't Seem to Work

If itching persists beyond 4 weeks or new burrow marks appear, it may be because:

Not enough cream was applied (the entire body must be covered)
Treatment was not repeated after 1 week
Not everyone in the household was treated
Re-infection from an untreated contact

See your doctor if treatment doesn't appear to be working.

Scabies and Daycare

According to the CDC, a child can return to daycare after the first treatment has been completed (usually the day after application). The child does not need to be symptom-free — itching can persist for weeks after successful treatment.

The daycare should be notified so other parents can watch for symptoms in their children. During an outbreak, all affected families should treat at the same time.

Parent applying cream to child's skin

When Should You See a Doctor?

See your pediatrician or an urgent care clinic if:

You're unsure whether it's scabies (a skin scraping can confirm the diagnosis)
The child is under 3 months old
Treatment with permethrin doesn't work after two rounds
The skin shows signs of bacterial infection (redness, swelling, pus, fever)
Your child has eczema or other skin conditions that may complicate treatment
Someone in the household is pregnant or has a compromised immune system

Can You Prevent Scabies?

It's difficult to prevent scabies entirely, but you can reduce the risk:

Treat promptly — the sooner you treat, the less chance it has to spread
Notify close contacts — so they can monitor for symptoms and treat early if needed
Avoid sharing a bed with an infected household member until treatment is complete

Happy family with healthy child

Frequently Asked Questions

Is scabies dangerous?

No, scabies is harmless but very uncomfortable. The only real risk is a secondary bacterial infection if the child scratches a lot. Treatment with cream normally eliminates the mite.

How long is my child contagious?

Your child is considered contagious until the first treatment is completed. After the cream has worked for 8–12 hours, the risk of transmission is very low.

Can babies under 6 months get scabies?

Yes, babies of all ages can get scabies. In the youngest babies, the rash is often more widespread and may affect the head and face. See your doctor for guidance on treating very young infants.

Can scabies come back?

Yes — you don't become immune to scabies. You can be re-infected if you come into contact with someone who has untreated scabies. With a new infection, symptoms appear faster (1–3 days).

Can you see the scabies mite?

The mite is extremely small (0.3–0.4 mm) and barely visible to the naked eye. It's easier to see the burrow marks — thin, irregular lines in the skin.

Want to keep track of your child's health history? Log health events in My Baby to have everything in one place. Also check our first aid kit checklist so you're prepared.

Scabies in Children: Symptoms, Treatment, and Transmission