What it is
Scabies is an intensely itchy rash caused by tiny mites that burrow into the skin. It spreads through prolonged skin contact, so it moves through households and daycare rooms. The itch is often worst at night. Treatment works well, but everyone in the household needs to be treated on the same night, and the itch can linger for weeks after the mites are gone.
What you might notice
- Intense itching, especially at night
- Small red bumps and, sometimes, thin wavy lines where the mites have burrowed
- In babies: palms, soles, scalp and face
- In older children: between the fingers, wrists, waistline, armpits and groin
- Scratched areas that become infected
What we can do on video
- Assess the rash, its pattern and who else is itchy
- Prescribe a scabies cream (usually permethrin 5%, approved from two months of age) with instructions for the whole household
- Treat the itch, and any infected scratches
- Plan a second treatment about a week later
Caring for them at home
- Apply from the neck down (including the head and face for infants) and leave on 8 to 14 hours as directed
- Treat everyone in the household the same night, even if they aren't itching
- Wash bedding and clothing in hot water and dry on hot, or seal in bags for 72 hours
- Vacuum furniture and car seats
- Expect the itch to fade over two to four weeks after treatment
Be seen in person if…
- Pus, spreading redness or fever, which suggest a skin infection
- Thick, crusted, scaly plaques
- A baby under two months
- New bumps still appearing four weeks after treatment
This information is educational and doesn't replace an evaluation by a clinician. Hugs is not insurance. Treatment is at the discretion of the clinician and limited to what can be safely assessed over video. Reviewed by the clinicians of LPMD Medical Group. Updated 2026-09-17.