Scabies and Post Scabies Information

Scabies

By Linda Forde

One health problem that newly adopted children may have is scabies. They're nasty little (microscopic) mites that burrow under the skin, causing allergic itching. I am not a doctor, "just" an adoptive mom.  But since my second child had scabies when we met, I've had to learn much more than I ever wanted to know about this issue!  She was successfully treated with "Ascabiol" (a French product that the AEA International Clinic prescribed for us while we were in Vietnam), but about a month after we got home, she broke out with what looked like water blisters on her feet, wrists, and fingers which itched terribly.  Thanks to the postings on the APV list, I knew it probably wasn't a reinfestation of scabies, especially since no one else in the family was itching.  Scabies are highly contageous - if she still had them, so would we!

Even though a doctor at an International Adoption Clinic told me that she still had active scabies (after only a quick glance at her feet!), our doctor confirmed that this is a "post-scabies irritation condition" which is common after someone has had scabies.  This condition consisting of itching, redness, and blisters may be caused by  the "remnants" left under the skin after the mites are dead.  It takes some time (possibly months or years) for this "debris" to work its way out.  Hopefully,  you'll never have to deal with scabies - good luck!

Diagnosis:

Scabies occurs most often in folds of skin - between fingers, toes, wrists, heels, elbows, waist. Scabies cannot be seen with the naked eye, only under a microscope. The burrows of the mites may show up as small lines on the skin if a washable marker is used to color over the suspected area, then wiped off.

Post scabies irritation is characterized by reddening of the skin on affected areas, followed by  fluid-filled blisters.  These dry up and flatten out in a day or two, then the dead skin may peel off.  Itching seems most intense when the skin is beginning to turn red and when the blisters first appear, especially at night.  The outbreaks occur in 3-4 week cycles, lessening in severity over time.

Prevention:

Scabies are spread by close personal skin-to-skin contact such as that found in orphanages.  Anyone suspected of having scabies should not share clothing, towels, or sheets with any other family member.  Routine bathing in warm water with borax added; saunas; and frequent washing of towels, clothing, sheets, etc. in hot water and borax all seem to help prevent the spread of scabies. 

Treatment:

Most U.S. cases are treated with a 5% permethrin product.  DO NOT USE any product containing LINDANE, as this has caused severe reactions in some people.  Frequent warm baths or saunas are recommended as part of the treatment.

Control of itching:

Moisturizing lotions, hydrocortisone creams, olive oil, Benadryl, oatmeal baths, baking soda baths, and gently popping the blisters and applying Eucalyptus oil have all been suggested as ways to help stop or lessen the itching associated with scabies or post-scabies.

Scabies & Infant Acropustulosis

by Mary King Wilson

A reoccurrence of itchy pustules can be a post scabies condition that is not a result of still having the live mite.  If your child/infant really still had Scabies, you would too -- it is highly contagious.  One condition that many post-scabies children exhibit is infant acropustulosis.  This skin condition can persist for YEARS after having scabies.  Retreating with Elimite is useless if you do not have the live parasitic mite in your system.

Please read the resource link articles for clarification--show it to your physician.  The one point of difference I have with this article is that infers most kids grow out of this by age 3.  Unfortunately, my 4.5 yo daughter still experiences  bouts with the papules with frustrating reoccurrence. 

Relief comes through 1) topical application of 1% cortisone and 2) oral dose of Atarax (prescription antihistamine) if given early it can actually thwart an outbreak.

This skin condition also seems to pop up more in international adoptees than what a typical US physical would see (as does scabies).  Do print and show this article to your Doctor.