The itch mite is Sarcoptes scabiei var hominis. It has an oval shaped body with four pairs of short legs. The female mite is larger than the male. In a usual patient of scabies, average number of mites is 10 to 12. However, in crusted scabies, it can be up to two million.

Mode of Transmission

Transmission is facilitated by overcrowding and poor hygiene. It also spreads by close physical contact including sex. As the mite does not survive for more than two days away from a moist environment, transmission through clothing is unlikely.

Clinical Features of Scabies

Extreme itching, which is more at night is usually considered as heralds of scabies.

The most common sites of involvement are webs of the fingers, wrists, elbows, anterior axillary folds, nipples, umbilical area and groins.

The primary lesion of scabies is a burrow. It appears as a wavy dark line with a papule or vesicle at the open end. The mite may be seen as a whitish dot at the closed end of the burrow.

The other lesions that may be seen are larval papules, nodules, pustules and vesicles.

Other members of the family are commonly affected.

Diagnosis

Scabies should be suspected in case of,

Itchy papules or nodules involving the classical sites.
History of itching at night.
History of similar complaints in other family members.

Diagnosis is confirmed by the demonstration of the mite, its eggs or fecal pellets.

Treatment Modalities

Permethrin 5% is the drug of choice, which can be used for all ages and on all body areas. It is used as a single application, washed off after 8 to 12 hours and may be repeated after one week.

GBHC 1% (Gamma benzene hexachloride) can be used once in 12 hours. But, it is not recommended for children, pregnant women, lactating women and those with neurological and extensive cutaneous diseases.

Benzyl benzoate lotion 25% (12.5% in case of children) can be used. It should be applied and left on the body for at least 48 hours or its application is repeated for three consecutive nights and is then washed off.

Sulfur (6% precipitated sulfur in petrolatum) is another option of treatment. It should be applied to the entire body below the neck daily for three days and the patient should take bath after 24 hours of each application. It is the drug of choice in pregnant women.

At the conclusion of therapy, clothes and bed linen used should be washed in warm water.

Itching may persist for up to four weeks and usually 7 to 10 days after treatment.

To know more about scabies and its treatment, consult a scabies specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/scabies

Frequently Asked Questions

1. What Can Be Done to Remove Scabies Mites in Humans?

Scabies is a dermatologic disease caused by the mite names Sarcoptes scabiei. Some of the methods to remove scabies mites from the human body are:
- Permethrin cream.
- Sulfur cream.
- Ivermectin.

2. How to Know the Presence of Scabies Mites?

The most common way of recognizing a scabies infestation is intense itching with pimple-like skin rashes. The scabies mite can spread by skin-to-skin contact with the infected person.

3. In What Region Do Scabies Usually Start?

Initially, scabies starts around the wrists, finger webs, elbows, armpits, waist, knees, ankles, or groin.

4. Who Is Prone to Scabies?

Scabies is most commonly seen in young individuals, people with developmental disabilities, weak immune systems, or with certain infections like HIV (human immunodeficiency virus) and lymphoma. In addition, it is commonly seen in people taking immunosuppressive drugs.

5. What Causes Scabies?

Scabies is caused by a tiny burrowing mite called Sarcoptes scabiei, which causes intense itching that exaggerates at night.

6. What Are the Symptoms of Scabies?

The symptoms of scabies are:
- Rash.
- Intense itching.
- Blisters.
- Bumps with a clear top filled with fluid.
- Read and scaly patches.

7. Is It Possible to Pull Scabies Out of the Skin?

It is not possible to pull scabies mites out of the skin. However, it can be cured with prescription medications. The doctor might try to scrape the skin with a thin needle to pull out the parasite from its burrow.

8. How Does Poor Hygiene Contribute to Scabies?

Poor hygiene does not contribute to developing scabies. Instead, it infests people living in close, crowded conditions.

9. Do Blood Tests Reveal Scabies?

Blood tests may reveal scabies infestation by a sensitive and specific test that detects the scabies-specific circulating antibodies. In addition, the doctor checks the patient’s skin for the symptoms of scabies.

10. Do Scabies Affect the Eyes?

As per medical literature, the involvement of the eye and adnexal structures in a scabies infection is a very rare occurrence, with just two such cases ever being reported.

11. How Does Scabies Present?

The most common presentation of scabies are:
- Night itching.
- Rashes.
- Sores.
- Skin crusting.
- Non-specific symptoms (fever, headache, and fatigue).

12. What Is the Duration of Scabies?

Scabies does not last 48 to 72 hours off a body, while they may survive beyond 1 to 2 months living on an individual's skin. Sometimes, it takes around six weeks for scabies infection to subside.

13. What Is the Homecare Routine After Scabies?

After a scabies infection, household items like bedding, clothing, and towels must be cleaned by machine-washing in hot water and drying with a hot cycle or by dry-cleaning.

14. How to Kill Scabies in Hair?

To kill the mites over the skin, not just the scalp, Permethrin cream and Malathion lotion are the most common treatment modalities. The lotion can be applied applied and left on the scalp for ten minutes to get rid of the infection

15. What Is the Effect of Scabies on the Face?

Scabies infests the entire skin, even the face, scalp, and neck. Therefore, the lotion must be applied all over the body to treat the infection. The patient usually has pimples on his face after getting infected with scabies.

Last reviewed at:
07 Sep 2018 - 2 min read

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