What Happens After a Telemedicine Visit for Scabies - Triage

Audience: pediatric

Scabies is a skin condition caused by tiny mites that burrow into the skin, causing intense itching and rash. After a telemedicine visit for scabies, your healthcare provider will usually recommend treatment to kill the mites and relieve symptoms. This often includes special creams or lotions applied to the whole body. It is important to follow all treatment instructions carefully and to clean bedding, clothes, and towels to prevent spreading the mites to others. Your provider may also suggest ways to ease itching and monitor for any signs of worsening infection. Sometimes, close contacts like family members may need treatment too. If symptoms do not improve or if new symptoms develop, a follow-up visit may be needed. Telemedicine can help with education, treatment advice, and follow-up, but some situations require in-person care. Always watch for red flags like high fever, spreading redness, or severe pain, and seek urgent care if these occur. This guide helps families understand what to expect after a telemedicine visit for scabies and how to take good care of their child.

Red flags — go in person / ER

• High fever (above 38°C or 100.4°F) accompanying the rash — seek urgent medical care.
• Spreading redness, warmth, swelling, or pain around the rash indicating possible skin infection — get prompt evaluation.
• Severe difficulty breathing, swelling of the face or lips, or signs of an allergic reaction after treatment — call emergency services immediately.

What telemedicine can do

• Initial evaluation of typical scabies symptoms.
• Providing instructions for treatment application and household cleaning.
• Monitoring treatment response via follow-up visits.
• Answering questions about scabies and prevention.

What telemedicine cannot do

• Diagnosing unclear or unusual skin rashes requiring physical examination.
• Treating severe skin infections or complications.
• Managing allergic reactions or emergencies.
• Performing skin scrapings or laboratory tests.

Understanding Scabies and Its Treatment

Scabies is caused by tiny mites that dig into the skin, leading to itching and a rash. Treatment usually involves applying prescribed creams or lotions to the entire body, from the neck down, to kill the mites. It is important to apply the medication exactly as your healthcare provider instructs, often leaving it on for several hours before washing it off. This helps ensure all the mites and their eggs are eliminated.

Cleaning and Preventing Spread

Because scabies mites can live on clothing, bedding, and towels, it is important to wash these items in hot water and dry them on high heat. Items that cannot be washed may be sealed in a plastic bag for several days to kill mites. This helps prevent the mites from spreading to others in your household or community.

Managing Itching and Skin Care

Itching may continue for several weeks even after treatment, as the skin heals. Your provider may recommend soothing lotions or antihistamines to help ease itching. Avoid scratching to reduce the risk of skin infections. Keep your child's nails trimmed and clean.

When to Seek Follow-Up Care

If symptoms do not improve within 1 to 2 weeks after treatment, or if new rashes or sores develop, contact your healthcare provider. Sometimes a second treatment is needed. Also, if other family members develop symptoms, they may need evaluation and treatment.

Limitations of Telemedicine for Scabies

Telemedicine is useful for initial evaluation, treatment advice, and follow-up for scabies. However, if your child has signs of a severe skin infection, allergic reaction, or if the diagnosis is unclear, an in-person visit may be necessary. Your provider can guide you on when to seek face-to-face care.

How to prepare for your tele-visit

• Ensure good lighting and a quiet space for the telemedicine visit.
• Have a device ready with a camera to show affected skin areas clearly.
• Prepare a list of your child's symptoms, including when they started and any treatments tried.
• Have a list of current medications and allergies available.
• Be ready to describe any other household members with similar symptoms.
• Prepare questions or concerns to discuss with the healthcare provider.

After your tele-visit

• Apply the prescribed scabies treatment exactly as instructed, covering the entire body from neck down.
• Wash all bedding, clothing, and towels used in the past 3 days in hot water and dry on high heat.
• Seal items that cannot be washed in plastic bags for at least 72 hours.
• Avoid close skin contact with others until treatment is complete.
• Manage itching with recommended lotions or medications; avoid scratching.
• Monitor your child’s skin and symptoms for improvement or worsening.
• Schedule a follow-up telemedicine visit if symptoms persist or worsen.

FAQs

How long does it take for scabies treatment to work?

Treatment usually kills the mites quickly, but itching and rash may take 2 to 4 weeks to fully go away as the skin heals.

Can other family members get scabies too?

Yes, scabies spreads easily through close skin contact. Family members and close contacts often need treatment even if they have no symptoms yet.

Is it safe to use scabies creams on young children?

Yes, but always follow your healthcare provider’s instructions carefully. Some medications may have age limits or special directions for children.

What should I do if the rash gets worse after treatment?

Contact your healthcare provider. The rash might be due to an allergic reaction, a skin infection, or the need for a second treatment.

Can scabies come back after treatment?

Re-infestation can happen if you come into contact with someone who has scabies or if treatment is not done properly. Follow all care steps to prevent this.

Sources

1. Scabies — Centers for Disease Control and Prevention (CDC).
2. Scabies - Patient Information — Mayo Clinic.
3. Scabies — MedlinePlus, U.S. National Library of Medicine.
4. Scabies: Diagnosis and Treatment — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child’s condition worsens or you have concerns, seek evaluation by a healthcare professional in person.