What is Scabies?

Scabies is a common human skin infestation caused by the penetration of the mite sarcoptes scabiei. The intense itch and rash experienced in scabies is due to the allergic reaction to the mite or faeces of the mite.

How do You Get Scabies?

Scabies affects every individual regardless of their age, race, gender or social status and personal hygiene. You may get scabies with close skin to skin contact with the person harboring scabies mites. It’s the mite that gets transmitted not the rash itself. It is impossible to catch scabies just by sacking hands with the infected person, however repetitive prolonged contact like hugging, cuddling or sexual contact are sufficient to spread the mites.

Symptoms of Scabies

After initial infestation of scabies you may not experience itching until 4-6 weeks, but thereafter itching may be severe especially during night. The itching may be accompanied by the appearance of small red, scaly, sometimes crusted papules that are generally seen on finger web-spaces, sides of finger, lateral palm, elbows, underarms, legs, buttocks, scrotum,, penis, labia and areolae of female. In infants younger than 2 years, the face and scalp can also be infested, whereas it’s rare in the adults. The rash is due to the allergic reaction to the scabies mites and faeces so; distribution of rash is not necessarily related to distribution of mites. The rash may be complicated with scratching that may cause secondary bacterial infection.

What does Scabies Look Like?

How to Treat Scabies

There are several treatment options available for scabies and the level of effectiveness depends on the person age, cost, severity of lesion, and previous treatments. Depending on which country you live, several scabicides are available on the markets, which are given below.

Permethrin 5% cream: Applied for 8-14 hours then wash off. This application is often repeated in 7 days.

Lindane 1% lotion: Applied for 8 h then washed off. Second application is recommended after 1 wk. This is not recommended for children below 2, pregnant or lactating women.

Crotamiton 10% cream: This cream is usually applied on 2 consecutive days, then repeated once within 5 days of initial application. This topical cream may not be as effective as other topicals creams and lotions.

Sulfur ointments 5%-10%: Applied for 3 days and then washed off. Safe in children under 2 mo and during pregnancy, but messy to apply and limited efficacy data

Benzyl benzoate 10% lotion: Applied for 24 h then washed off.

Ivermectin, 200 µg/kg: The only oral but highly effective and safe scabicide known to date is ivermectin. It is usually given as a single oral dose and can be repeated in 10-14 days. It may also be used along with topical agents.

To get the most out of the topical scabicide treatment, topical scabicide should be applied to the entire body below the neck with special attention to the skin folds, genitalia, periungal region, soles of the feet and behind the ear. One should remember that even after the sufficient scabicidal therapy, the rash and itching may persist for days or even weeks (3-4 weeks), so over treatment should be avoided.

How to Prevent Scabies

Every household members or family who are in close contact with the infected person should be treated with a topical scabicide. This is very important to prevent spread of the scabies as family members already might have been infested with scabies but they may be in asymptomatic periods. Moreover, bed sheets, clothes, towels or any other clothes that may have been in contact with the person should be washed with hot water and dried and left untouched for atleast a week. Because the mite can live up to 3-5 days off the skin. Pets do not need to be treated as they do not harbor the human mite.