What you need to know about scabies

Scabies is one of a number of skin conditions which can trigger itching and rashes. It is a dermatological condition caused by eight-legged microscopic mite, the sarcoptes scabiei.

Scabies is contagious, and can easily spread by direct physical contact from person to person. This is likely to cause an outbreak in settings such as the family home, child care setting, school class, home nursing, or prison.

It can affect people of all ages, however, whatever their lifestyle and socioeconomic status. If an person has scabies, they must all be treated together, and anyone they have close contact with.

Fast facts on scabies

Here are a few key points about the scabies. The main article includes more specifics and supporting information.

• While the scabies mite needs skin to feed and survive, it can live without a human host for 48 to 72 hours.
• The rash and itching experienced by those with scabies is a result of the body’s allergic reaction to the mites, their eggs, and their waste.
• The average person infested with scabies will have 15 to 20 mites present.
• Those at highest risk of developing crusted scabies include the immunocompromised, the elderly, and those housed in institutional settings.

What is scabies?

Scabies affect millions of people every year, from all races, ages and socioeconomic status.

It is highly contagious, being quickly spread by close physical contact and sharing of mite-infested bedding, clothing and furniture.

It is estimated that Scabies infects more than 300 million people worldwide every year, including 1 million people in the US.

Scabies most commonly occurs in children and young adults, and outbreaks are common in child care facilities and schools.

Symptoms

The onset of scabies signs varies depending on whether a person has been previously exposed to the mites or not. It may take up to 2-6 weeks for symptoms to develop when a person is first exposed to the scabies mite.

In subsequent infestations, this timeframe is significantly shorter, as the body’s immune system responds quicker, usually within 1 to 4 days.

Symptoms and Scabies symptoms include:

• Itching: Often at night this is worse, and can be intense and painful. Itching constitutes one of the most common symptoms of scabies.
• Rash: When the mite burrows into the skin, it makes burrow tracks or lines that are most commonly found in skin folds and mimic scaly skin patches, hives, scratches, knots, pimples. There may also be Blisters.
• Sores: These occur in places that are infested where a person has scratched his skin. Open sores can lead to imppetigo, which is usually caused by Staphylococcus aureus secondary infection.
• Thick crusts: Crusted scabies, also known as Norwegian scabies, is a type of extreme scabies that harbors hundreds to thousands of mites and mite eggs in the skin crusts, causing severe symptoms of the skin.

Those afflicted with crusted scabies most often show widespread, dark, dense, cracking crusts.

Due to the food provided by the crusts themselves, mites living in the separated crusts can live up to a week without having human contact.

The most common site of adult and older infestation includes:

• in between the fingers
• around fingernails
• armpits
• waistline
• inner parts of the wrists
• inner elbow
• soles of the feet
• the breasts, particularly the areas around the nipples
• male genitalia
• buttocks
• knees
• shoulder blades

Infants and young children are infested in other areas of the body including:

• scalp
• face
• neck
• palms of the hands
• soles of the feet

Children may sometimes present with a widespread infestation that covers a majority of the body. Kids infested with scabies tend to show irritability signs, and problems in sleeping and eating.

Images

Treatment

Scabies is highly contagious, and anyone who has been diagnosed with the disease or who has had close contact with the patient will most likely be recommended to undergo scabies medication, even if they have no symptoms at all. It includes every person the patient has had an intimate contact with recently.

Scabies is usually treated with topical drugs such as permithrin cream, crotamiton cream, or lindane lotion 5 percent. A 25 per cent lotion of benzyl benzoate or 10 per cent ointment of sulfur may be used in some situations. Most of the topical preparations are applied in the morning and washed off at night.

Ivermectin, an oral drug, may be approved for those immunocompromised, those with crusted scabies or those who have not responded to topical therapy.

Ivermectin should not be used during pregnancy or breastfeeding, nor should it be used by children weighing under 33 pounds.

Other medications such as antihistamines, anti-itching lotions such as Pramoxine lotion, antibiotics, and steroid creams may be used to give symptom relief.

Treatment with recommended drugs usually quickly kills the mites. Initially the scratching and rash can get worse.

Skin healing should be seen after 4 weeks of treatment though. Some people require more than one treatment course to get rid of the mites altogether.

Tests and diagnosis

Scabies can be mistaken for dermatitis or eczema sometimes because these skin conditions often cause scratching and bumps on the skin. Anyone who is confused about the cause of a skin condition should consult their doctor as OTC treatments are not capable of eradicating scabies.

A doctor can diagnose scabies by examining the skin or looking under a microscope at scrapings of the skin.

Causes

Scabies is a sarcoptic scabiei mite infestation also known as the human itch mite.

The female mite lays its eggs in the tunnel it has formed, after burrowing under the skin. When hatched, the larvae migrate to the skin surface and spread by near physical contact throughout the body or to another host.

Human beings are not the only species which are affected by mites. It can also kill dogs and cats. Although humans that experience a mild, temporary skin reaction to contact with non-human animal mites, a full-blown human infection with animal mites is uncommon, however, each species hosts a different species of mites.

Scabies is highly contagious and transmitted by direct contact with the skin or through the use of a towel, bedding or furniture infested with the mites. As such, some of the people most likely to get infested with mites will include:

• children attending day care or school
• parents of young children
• sexually active young adults and people with multiple sexual partners
• residents of extended care facilities
• older adults
• people who are immunocompromised, including those with HIV/AIDS, transplant recipients, and others on immunosuppressant medications

Home remedies

Scabies home remedies often aren’t recommended.

Most infestations can cure without having to be treated. Nevertheless, it is mainly the preventive measures listed below that people with scabies can take without a doctor’s visit.

Herbal treatments, such as tea tree and neem oils, have not been consistently shown to cure scabies. And seeing a doctor and asking for a prescription is recommended.

Prevention

Take the following steps to prevent re-infestation and spread;

• Wash or dry-clean all clothes, towels, linens, etc. When washing, use hot soapy water and dry on high heat. Place items that cannot be washed in a sealed plastic bag for one to several weeks to starve the mites.
• Vacuum the entire home on the day treatment is initiated, including carpets, rugs, upholstery, etc., and discard the bag or thoroughly clean the vacuum’s canister.

If you have questions about contracting scabies that you may have or may be at risk for, talk to a doctor.