Scabies: an overview and more

Scabies is a disease caused by the Sarcoptes scabiei mite. It is characterized by an itchy sensation that may or may not be accompanied by a rash. Scabies affects men and women equally, affects people of all ages, and spreads to people of all ethnic groups and geographic regions around the world.

In fact, it is estimated that at least 300 million cases of scabies occur worldwide each year.

Scabies can be treated and is not usually associated with harmful health problems, although skin infection or scarring can result from excessive scratching and, as a result, a bacterial infection .

Get Medical Information / Emily Roberts

The symptoms of scabies.

Topping the list of scabies signs and symptoms is intense itching, which begins within a few days of contact with a mite, but can begin after a few weeks. The incubation period, the time between exposure to the tick and the appearance of symptoms, will be shorter if you have already had an infection.

Most commonly, itching affects the armpits, belly button, elbows, wrists, fingers, chest, buttocks, or genitals, and usually does not affect the face. The itching is usually persistent, but is often more noticeable at night.

Itching with scabies may be accompanied by a visible rash that may appear as small red bumps, scars, or scaly lesions. You can get cuts and scrapes from frequently scratching your itchy skin.

Symptoms may be worse if you have an allergic reaction to a tick. Very young children may have more extensive injuries, such as the face, head, palms, and soles of the feet, while adults do not.

The most advanced form of scabies, Norwegian scabies, is characterized by areas of scabs with a high content of mites.

Causes

Scabies is caused by a mite that invades the skin, which occurs from direct skin-to-skin contact with someone with the condition. It can be, and often is, sexual contact, but other types of close and prolonged skin contact are also associated with the spread of scabies (as is often the case in crowded settings). Hugging someone or shaking hands quickly is usually not risky.

A tick does not live for more than a day or two on inanimate objects, so it is rare to get scabies from touching objects that have been in contact with someone who has had or has had scabies.

However, although this is not common, contaminated bedding or clothing can cause new infections.

The parasitic mite is tiny, usually too small to be seen with the naked eye. The female tick hides under the skin and lays 10 to 25 eggs before dying. The eggs hatch after three days and the larvae emerge on the surface of the skin. The larvae mature in 10-14 days .

Diagnostics

The doctor's decision is usually all that goes into diagnosing scabies , and he or she specifically considers the presence of severe itching and the appearance and location of the rash. Obviously, your rash is most likely related to scabies if you live or have been in contact with someone who has scabies. You can use the Provider Discussion Guide below to help you get started talking with your doctor about scabies and what treatment your diagnosis may require.

A Discussion Guide for Healthcare Professionals on Scabies Control

Get our printed guide to your next doctor's appointment to help you ask the right questions.

Rash

A rash caused by scabies can often be similar to other rashes. Again, the itchy rash usually occurs on the wrists, between the fingers, in the armpits, around the waist, and in the genital area. While a rash in these areas is not a direct confirmation of scabies, it certainly makes it more likely.

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The rash causes red papules with small attached lines called burrows that essentially follow the path of the tick. Since the tick does not usually travel very under the skin, the burrows may or may not be visible. The rash can also cause severe skin inflammation with blisters, redness, and itching. Photos of scabies can give you a good idea of what a scabies rash might look like.

Diagnostic tests

There are no good tests that can diagnose scabies, but a healthcare provider can scrape off a small portion of the rash and examine it under a microscope for mites or mite eggs; flaky skin are the best examples. However, mites and eggs are often not visible, even if the person is sick with scabies.

Several advanced microscopic techniques can improve diagnostic sensitivity.

Watch out

The following treatment options can help clear up the scabies rash.

  • Permethrin 5% cream: standard first-line therapy for most people, including pregnant or nursing women and children older than 2 months. Apply generously from the top of the neck to the soles of the feet before going to bed and wash off in the morning. It is important to know that permethrin is the safest treatment for pregnant women .
  • Ivermectin – An alternative therapy, but not recommended for children weighing less than 33 pounds. This oral medication is used to treat other parasites. The dose used is calculated based on your weight and the drug is taken in two doses, two weeks apart. It is not currently FDA approved for scabies, but there are studies that show it to be effective and the Centers for Disease Control (CDC) recommends it for people who are not receiving better scabies treatments that the FDA has developed. approved .
  • Sulfur ointment (precipitated sulfur) – Another safe second-line treatment for pregnant women. It is also used as a first-line treatment for newborns younger than 2 months.

The drugs kill the mites, but they remain on the skin until the body breaks them down and absorbs them. This process can take about four weeks, and scabies usually cause intense itching during this time. Topical steroids applied to particularly irritating blemishes and oral antihistamines like Benadryl (diphenhydramine Hcl) can help relieve itching.

Prophylaxis

As mentioned, the best way to prevent scabies is to avoid close contact with sick people. However, many cases of scabies are passed from one person to another even before the first person knows they have been affected.

If you have been in close contact with someone who has been diagnosed with scabies, you should also receive treatment, whether they show signs and symptoms of scabies or not. Whole households are often treated, even if only one person has scabies. If your PCP recommends treating your entire family, everyone should be treated at the same time.

All clothing, bedding, and towels used by a person with scabies should be washed in hot water and dried in a hot tumble dryer. The very high temperature destroys the tick, preventing it from spreading.

If you can't wash certain items, you can avoid contact and put them in a plastic bag for three days to decontaminate them. The mite can survive for several months on the human body, but only a few days on objects, making decontamination efforts effective when done correctly .

Get the word of drug information

If you have scabies, the itching and rashes can be very uncomfortable. You will be able to recover much faster and more comfortably if you seek medical attention as soon as you know you may have been exposed or as soon as signs or symptoms of the disease begin, whichever comes first.

Scabies can be stigmatized as many do not know exactly how it occurs. If this bothers you, it may help if you communicate in advance about your diagnosis and the people who may be affected by it, explain the steps you are taking to protect shared spaces, and talk about what you have learned about how easy it is. can be distributed.

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