Scabies is a contagious skin condition, in which the patient experiences severe itching. The cause of this is a very small burrowing mite known as Sarcoptes scabiei. The patient experiences intense itching in the areas where this mite burrows. The desire to scratch and the itching can be very severe at night.
Scabies can spread easily and rapidly from one person to another via close physical contact, such as seen among family members, day care centers, nursing homes, schools etc. Due to its contagious nature, it is recommended that the entire families/contact groups be treated for complete elimination of the mite and scabies.
Treatment comprises of topical medications to kill the mites and their eggs. The patient, however, may continue to experience itching for many weeks after the treatment.
Causes of Scabies
The cause of scabies is a minute, microscopic eight-legged mite named Sarcoptes scabiei. The female mite digs under the skin and creates a tunnel where it deposits its eggs. It takes 3 to 4 days for the eggs to hatch, after which the larvae migrate to the skin's surface, where they grow and spread to other regions of the skin, as well as to other individual's skin. The itching results from the allergic reaction the body has to the mites and their eggs. Scabies spreads through close physical contact, sharing bedding or clothes with an infected person etc.
Signs and Symptoms of Scabies
- Severe and intense itching, which is worse at night.
- Presence of narrow and irregular burrow tracks, which comprises of small bumps or blisters on the patient's skin.
These burrows or scabies is commonly found in folds of the skin such as: Between the fingers, armpits, around the breasts, around the waist, insides of wrists, inner elbows, around the male genital region, soles of the feet, shoulder blades, buttocks an knees.
In children, scabies commonly is found in the face, neck, scalp, palms of the hands and soles of the feet.
Investigations for Scabies
Due to the characteristic burrows present in the scabies, physical examination is usually sufficient for diagnosis. Scraping is taken from the burrows to examine them under the microscope to look for the presence of mites/ eggs.
Treatment of Scabies
Treatment comprises of eradicating the mites infestation with topical medications. These creams/ lotions are applied all over the body and kept for a minimum of 8 hours. If the condition persists or if there is recurrence of new rashes or burrows, then a second course of treatment is done. Due to the contagious nature of the scabies, it is strongly recommended to treat all the family members along with contact groups, even if they don't exhibit any symptoms of scabies.
Commonly prescribed medications for scabies include Permethrin 5 %, Lindane (not for children less than 2 years old, pregnant/ nursing women and individuals with weak immune system) and crotamiton. These medications destroy the mites immediately, but patient may still experience itching for many weeks after the treatment.
Sometimes oral medication, such as ivermectin, is also prescribed for those patients,
- Who do not benefit from prescription topical creams/lotions.
- Who have altered immune systems.
- Who have crusted scabies.
Home Remedies and Prevention of Scabies
- Application of cool compresses and soaking in cool water helps in relieving the itching.
- OTC soothing lotions, such as calamine lotion, help in alleviating the itching.
- Over-the-counter antihistamines are beneficial in relieving the allergic symptoms occurring as a result of scabies.
- Keep all your clothes and linen clean and wash them in hot, soapy water for at least three days before starting the treatment. Dry them on high heat.
- Items or clothing, which cannot be washed, should be kept in a sealed plastic bag, where no one can reach it, for at least a fortnight. This will kill the mites from lack of anything to eat.