儿童疥疮：应了解哪些症状和治疗方法

在所有你想避免的令人讨厌的童年条件中，疥疮可能是最严重的。这种高度传染性和极度不舒服的情况经常在日托和学校环境中传播，让家长高度警惕。在任何特定时间，全世界有超过200,000个病例，疥疮被认为是一种常见的疾病。但这并没有让它变得不那么悲惨。

作为父母，你可能会有很多疑问：什么会导致疥疮？疥疮长什么样？怎么去疥疮？无论您是被告知可能爆发疥疮，还是只是希望避免，请查看我们的家长综合指南。

How Do You Get Scabies?

疥疮是一种由微小疥螨（学名疥螨)引起的皮肤病。根据疾病控制和预防中心的说法，它钻入皮肤的上层并产卵。

疥螨在长期的人与人接触中繁殖，因此最有可能在托儿所、医院、学校和疗养院等拥挤的地方传播。纽约市的皮肤科医生哈德利金博士说，疥疮感染对这种环境来说是个坏消息，因为螨虫可以在没有宿主的情况下轻松存活几天。这与许多其他类型的螨虫非常不同，比如虱子或臭虫。金博士警告说，如果只有一只螨虫存活下来，你可能会再次感染疥疮，因为它们的繁殖速度非常快。

接触被感染的物体（如被褥、毛巾或衣物)也会导致孩子身上结痂，但这不是最常见的传播方式。

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Scabies Symptoms in Kids

疥疮通常开始时是一种阴险的瘙痒，在晚上会变得更严重，随后是一种广泛的、丘疹样的红疹，可以遍布全身。对于年幼的孩子来说，疥疮会影响面部和颈部，而年龄较大的孩子和成年人通常不会在这些地方发痒。疥疮感染最常见的感染部位是手（尤其是手指之间

gers), wrists, midsection, groin, legs, and buttocks. Sores can develop after scratching the scabies rash, which can lead to infection.

If your child has been infested with scabies, you may notice a series of bumps in a straight line; this is a sign of the arthropods burrowing into the skin, and it's a hallmark of scabies in kids and adults alike. "Because mites are often few in number (only 10-15 mites per person), these burrows may be difficult to find," notes the CDC.

At first, though, you may not see any symptoms at all. "There may be no symptoms for the first two to six weeks," says Dr. King. This is especially true for first-time scabies infections; if you've been infected before, symptoms may appear within days. But remember that infected kids can still spread scabies without symptoms, says the CDC.

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Scabies Treatment

There isn't much good news when it comes to scabies in kids. And the treatment for scabies isn't exactly a walk in the park either. The best way to treat scabies is usually a 5% permethrin treatment, prescribed by a doctor. "This comes in the form of a topical cream, and can safely be used on kids two months of age and older, and women who are pregnant," Dr. King says.

Below, we've included step-by-step instructions for how to treat scabies in kids using permethrin cream. Always make sure to read manufacturer's directions, though, and talk to a doctor for any questions.

1. In the evening before bed, undress your child completely, including their diaper. Give them something to distract their attention.

2. Liberally apply the cream from the neck down. (Infants and young children often need treatment for their scalp and face, too, says Dr. King.) Be sure to hit every single inch of skin, including between the fingers, in the armpits and groin, behind the knees, and even the bottoms of their feet.

3. Let the lotion dry for at least 30 minutes. Then dress your child in pajamas that provide full coverage to avoid them rubbing the lotion off or putting it in their mouth (for younger children, footed pajamas work well for this).

4. First thing in the morning, remove all of your child's clothing, along with any and all bedding (blankets, comforters, stuffed animals, etc.) and place everything in a trash bag. Seal the bag tightly and store it near your washing machine for at least 24 to 48 hours.

5. Shower your child in very warm water, removing lotion completely.

6. Wash your child's belongings using the hottest water possible in a washing machine, and then use the hot setting in a dryer, Dr. King says. "If something cannot be washed, have it dry cleaned, or seal it in a plastic bag for at least one week. And vacuum all rugs and upholstered furniture on the day you start treatment." This step is essential and must be done thoroughly in order to prevent re-infestation.

7. Repeat the cleaning process as needed, and the permethrin treatment one week later if your doctor recommends it. 

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For stubborn cases of scabies that aren't resolved with the use of permethrin cream, oral ivermectin can be used safely, even in young children, Dr. King says. Talk to your child's pediatrician to determine the best course of treatment to bring quick relief to the miserable scabies rash. And remember that scabies treatment is also recommended for members of the infected person's household, as well as anyone who had close contact with them.

What To Do If Your Child is Exposed to Scabies

If you have a young child at daycare or school, you may one day get that dreaded note in their backpack indicating there's a scabies outbreak. If you receive this news, it's essential to act fast, Dr. King says. "Scabies is very contagious. Everyone who had close contact with the outbreak needs treatment. People do not have to have signs and symptoms of scabies to have mites on their skin—it can take two to six weeks before symptoms develop. It's prudent for everyone to be treated."