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Scabies


What is scabies?

Scabies is an allergic reaction to a microscopic mite that can barely be seen by the human eye. The mite, a tiny, eight-legged creature with a round body, burrows into the skin. The allergic reaction results in severe itching, often intense enough to keep sufferers awake all night.

Human scabies is almost always caught from another person, anyone who has come into close contact with the patient. This could be a child, a friend, or another family member.

The female mite is drawn to a new host by warmth and odor, makes a burrow and lays eggs. This causes an allergic reaction. Larvae hatch from the eggs and travel to the skin surface lying in shallow pockets where they will develop into adult mites. It may be up to a month before a newly infested person will notice the itching.

What are the symptoms?

The earliest and most common symptom of scabies is itching, particularly at night. An early scabies rash will show up as little red bumps or pimples. In more advanced cases, the skin may be crusty or scaly. Scabies will usually begin in the folds and crevices of the body particularly between the fingers, on the elbows or wrists, buttocks or belt line, around the nipples for women and on the penis for men. In children, there is usually a more generalized itching. Infestation may involve the entire body, including the palms, soles, and scalp.

What is crusted or "Norwegian" Scabies?

Crusted scabies is a form of the disease in which the symptoms are far more severe than usual. Large areas of the body, hands and feet may be scaly and crusted. This type of scabies occurs mostly among nursing home residents and in AIDS patients. This type of scabies is extremely contagious.

How are scabies diagnosed?

Many cases of scabies can be diagnosed by dermatologists through skin examination alone. If a dermatologist has any doubts, he or she can do a simple, painless test to diagnose scabies.

Who is most at risk?

Scabies is most common in those who have close physical contact with others, particularly children, mothers of infants, and elderly people in nursing homes. Studies of families have shown that children under two years of age are most at risk, followed by mothers and older females, siblings, and then by other family members who have frequent, close physical contact. Scabies among residents of nursing homes and extended care facilities has become a common problem.

How is scabies treated?

Scabies is easy and quick to treat with a prescription drug, 5 percent permethrin cream. This cream is applied to the skin from head-to-toe at bedtime and washed off the next morning. The only reported side effect of 5 percent permethrin cream is a mild, temporary burning and stinging, particularly in bad cases of scabies. All lesions should be healed within four weeks after the treatment. If a patient continues to have trouble he or she may be getting reinfected and requires further treatment by a dermatologist.

In a family, all members should be treated at the same time, as well as others who are in close contact with the patient. It is very important to wash clothing, bed linens and towels in hot water, and machine dry after treatment. Vacuum the entire house and discard the bag, just to be on the safe side. This treats a hidden infestation that may be present in the home.