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Itchy Skin Without Rash - Types, Causes, Treatment, and Contraindications

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Itchy Skin Without Rash - Types, Causes, Treatment, and Contraindications

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Itching and scabies are unpleasant sensations where individual desires to scratch their body. Read this article to know about it in detail.

Written by

Dr. Rabia Anjum

Medically reviewed by

Dr. Sneha Kannan

Published At March 18, 2019
Reviewed AtJanuary 30, 2024

Introduction:

Itching is an uncomfortable sensation that makes a person scratch their body until they feel relieved. On the other hand, scabies is an infection or itchy rash caused by mites. Both these conditions are linked with itching, which will be discussed in this article.

What Is Itching?

Itching is an unpleasant sensation where an individual desires to scratch their body. Itching can be caused due to many reasons. It can affect any area of the body, and it can either be

  • Generalized (itching occurs all over the body).

  • Localized (itching only occurs in a particular area).

The itching is primarily mild, gets severe occasionally, and is tough to live with.

What Are the Causes of Itching?

Some of the common causes of itching include -

  • Skin conditions such as eczema (a condition that causes dry, itchy, and inflamed skin).

  • Allergic reactions to food products, pollen, insect bites, and some medicines.

  • Insect bites and stings.

  • Irritating chemicals, cosmetics, and other substances.

  • Parasitic infestations such as scabies.

  • Fungal infections.

  • Hormonal changes during pregnancy or menopause.

  • Systemic conditions include liver or kidney problems or an overactive thyroid gland.

  • Diseases affecting the brain or nervous systems, such as diabetes and shingles.

What Are the Complications of Itching?

Itchy skin that lasts for more than six weeks can cause discomfort and affect the quality of life.

Prolonged itching can damage the skin and lead to infection or scarring.

What Is the Treatment for Itching?

Itching is a normal condition that goes on its own, and to get relief from it faster, a person can try -

  • Applying cold compresses.

  • Taking lukewarm or oatmeal baths.

  • Using moisturizing lotions.

  • Using over-the-counter Hydrocortisone cream or antihistamines.

  • Patients should also avoid excessive scratching, wearing uncomfortable fabrics, and exposure to heat or humidity.

The patient should contact the healthcare provider if the itching does not go away after a few weeks.

What Is Scabies?

Scabies is a skin condition caused by an infestation of mites that spread by contact, which is why members of the same family rapidly spread infection and are caused by Sarcoptes scabiei var hominis mite. These mites or bugs get under the skin and cause red bumps or rashes and severe itching. Scabies is characterized by severe itching on the body, especially at night. Itching is associated with small red papules on the body and can get secondarily infected by bacteria leading to pustule formation. Secondary eczematous changes can also occur over it.

What Are the Causes of Scabies?

As already mentioned, scabies is caused by a tiny eight-legged mite. This bug burrows beneath the skin and creates a tunnel where it lays eggs. When the eggs hatch, the larvae travel to the surface of the skin and stay there until maturation. Later, it can travel to other areas and spread to other people through direct contact. Itching is caused by the allergic reaction of the body to the mites and their eggs and wastes.

Having close contact with the patient affected with scabies can spread the mites and even on sharing clothing with the infected person.

What Are the Most Affected Areas of the Body?

The mites can be found anywhere on the body, but the most commonly affected areas are the folds and narrow skin cracks. In adults, the commonly affected areas include -

  • Skin folds between the fingers and toes.

  • Folds in thighs and genital area.

  • Bends at wrists and knees.

  • In armpits.

  • On the buttocks.

  • Around the belly button.

  • The area around your waist.

  • Under fingernails.

  • Under rings, watch bands, and bracelets.

  • The area around the nipples.

In infants and young children, common sites include -

  • Fingers.

  • Face, scalp, and neck.

  • Palms of the hands.

  • Soles of the feet.

What Are the Different Types of Scabies?

Scabies can be differentiated into multiple types, which include -

  • Crusted (Norwegian)- This type is most commonly seen in people with weak immune systems and affects a large area of the skin.

  • Nodular- This is more common in children and causes brown-red nodules.

  • Bullous- It is more common in adults and causes blisters on the skin.

  • Scalp- This has the same symptoms as basic scabies but primarily occurs on the scalp.

What Are the Symptoms of Scabies?

A person infected with scabies may feel itchy for weeks, even before skin rashes or bumps appear. The rashes might look like pimples or bumps and spread slowly over weeks or months. Other than that, some of the common signs and symptoms include the following -

  • Intense itching more at night.

  • Bumps can become infected because of scratching.

  • Children can experience itching all over their bodies.

What Are the Complications of Scabies?

Scabies includes intense itching, leading to scratching, and can break the skin and cause an infection such as impetigo. It is a skin infection caused by the bacteria staphylococci or sometimes by streptococci.

How to Prevent Scabies?

Scabies can be prevented by following some of the following steps, which include -

  • Washing all the clothes and lines properly before wearing them. Hot soapy water should be used to wash the clothes as heat kills the mites and their eggs.

  • Limiting close contact with the people affected with scabies and keeping the surroundings clean.

How Is Scabies Diagnosed?

Scabies can be detected by performing a physical examination of the patient. The healthcare provider may try to remove a mite with a needle from the skin to confirm the diagnosis. But in most cases, the healthcare provider may scrape off a small section of skin to obtain a tissue sample. After that, the tissue sample should be examined under a microscope to confirm the presence of scabies mites.

Another test can also be performed as the scabies ink test or burrow ink test. This test helps spot the burrowed paths in the skin created by the mites. It can be simply done by dropping a fountain pen ink on the area of the skin that appears to be infested. The ink that falls into the path created by the mites can be easily visible to the naked eye.

What Is the Treatment for Scabies?

The treatment for scabies includes -

  • Treatment should be given to all family members, whether they have itching or not.

  • Lotions should be applied from the neck to the toe, leaving the face and scalp area.

  • Treatment should be repeated after one week to eradicate the infestation.

  • Clothes and bed linings should be washed in hot boiling water.

The medications available for its treatment are:

  • Permethrin.

  • Lindane.

  • Crotamiton.

  • Sulfur.

  • Benzyl benzoate.

  • Oral Ivermectin.

Conclusion:

Itching can be a very annoying and uncomfortable experience. If a person has a severe itch and cannot sleep, he or she might be infected with scabies. In that case, the patient should seek medical assistance as soon as possible. This infection can be easily managed, but the patient has to be very cautious.

Frequently Asked Questions

1.

What Type of Itch Occurs in Scabies?

 
Scabies causes intense itching in the areas where the mite shelters. Patients might feel a need to scratch stronger during the night. This leads to pimple-like rashes and can be treated with certain ointments or medicines.

2.

What Are the Commonly Affected Areas of Scabies?

Scabies usually occurs in areas where mite burrows. The commonly affected areas include wrists, elbows, between the fingers, armpits, waist, ankles, knees, or groin.

3.

What Are the Signs of Scabies?

Given below are the signs which indicate that the person is infected with scabies, such as:
- Intense itching, mostly at night.
- Pimple-like rashes that look like small bumps.
- Sores on scratching the rashes.
- Formation of thick crust on the skin.

4.

For How Long Does Itching Last in Scabies?

The symptoms of scabies usually take four to eight weeks to develop. If a person has a history of scabies, the symptoms can appear sooner, within one to four days. The itching can last for two weeks, even after the death of scabies mites. Itching occurs due to an allergic reaction, and it continues until all the dead mites are shed from the skin.

5.

What Is the Choice of Drug for Scabies?

Permethrin cream five percent is the choice for instant relief from scabies. This is an FDA (Food and Drug Administration) approved drug. Two or more applications of this cream can kill the scabies mites and eggs.

6.

Where Can the Scabies Be Seen Initially?

Scabies is most commonly found in the skin folds. However, it can also be found in other parts of the body. The most commonly affected areas include the fingers and toes in adults and children.

7.

Does Shower Help With Scabies?

Scabies can occur even in the cleanest person. Bathing with soap or water or swimming will not prevent or cure scabies. The mites get burrowed under the skin and cannot be eliminated with showering.

8.

Is Poor Hygiene the Cause of Scabies?

Anyone can get scabies, and it is not caused by poor hygiene. This disease is contagious and can affect even a person with good hygiene. It is commonly seen in people who live in closed and crowded places, elders who live in nursing homes, healthcare workers, and children and infants who have close physical contact with their parents and other people.

9.

What Other Disease Resembles Scabies?

Some skin-related conditions can be mistaken with scabies which include:
- Psoriasis (a skin disease causing a rash with itchy and scaly patches, most commonly on the knees, trunk, elbows, and scalp).
- Eczema (a condition with dry and inflamed skin).
- Contact dermatitis (an itchy rash caused by contact with a particular substance).

10.

What Is the Primary Cause of Scabies?

The infestation of the skin by the mite Sarcoptes scabiei var hominis causes scabies. This mite burrows in the upper layer of the skin and lays its eggs there. This leads to an allergic reaction in the body, causing intense itching.

11.

What Does Scabies Rash Look Like?

The scabies rash looks like a pimple or blisters. They appear as pink and raised bumps filled with fluid. The skin may appear red with scaly patches.

12.

What Happens if Scabies Is Left Untreated?

If scabies is left untreated, they can cause some severe complications. For example, untreated scabies has a high mortality rate and causes secondary sepsis (extreme response of the body to an infection). In addition, the mites directly affect the body's immunity and can lead to other conditions, such as impetigo (skin sores).

13.

How Do Scabies Spread?

Scabies can spread to other people through prolonged skin-to-skin contact. It can even spread from the infected items of the patients, such as clothing, towels, and bedding. However, the spread is uncommon unless the patient is infected with crusted scabies.

14.

Can a Person Feel the Scabies Mites Crawling?

The scabies mites are present under the skin. However, they are tiny and can only be seen using a microscope. Therefore a person cannot feel crawling under the skin.

15.

What Are the Home Remedies for Scabies?

Home remedies can also treat scabies, but their effects can vary among people. Home remedies such as neem oil, tea tree oil, aloe vera, and clove oil can be used. These have anti-inflammatory, antibacterial, and analgesic properties that can help in relieving the symptoms of scabies.
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Dr. Rabia Anjum
Dr. Rabia Anjum

Dermatology

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