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Scabies, a Very Common Skin Infestation (Itchy Condition Of The Skin)

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Scabies, a Very Common Skin Infestation (Itchy Condition Of The Skin)

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This article educates patients and others about the symptoms, types, prevention, home remedies, and treatment of scabies.

Written by

Dr. Vinay Kumar

Medically reviewed by

Dr. Preetha. J

Published At October 1, 2015
Reviewed AtOctober 10, 2022

What Are Scabies?

Scabies is an itchy condition of the skin seen in human beings caused by a tiny organism, with itching of various grades getting more intense in the late evenings and night. It is infectious and close contact is the most typical mode by which it spreads from one person to another.

What Are the Types of Scabies?

Scabies is caused by a mite called Sarcoptes scabiei. Only this mite is responsible for the scabies infection, but it causes three different types of scabies infection.

The following are the types of scabies infection:

  • Typical scabies.

  • Nodular scabies.

  • Norwegian scabies.

Typical Scabies:

It is characterized by itching and rashes on the skin of the hands, legs, wrist, and other usual places. Scalp and face are not affected in this type.

Nodular Scabies:

In the genital areas, groin, and armpits, there is the formation of bumps or lumps in this type of scabies.

Norwegian Scabies:

Also called crusted scabies, it is manifested by crusted lesions on the skin. These crusted lesions harbor many mites and their eggs and, therefore, are a severe and the most-infectious form of scabies. It appears thick and gray and crumbles when touched. Immunocompromised individuals share an increased risk of contracting this type of scabies infection.

What Are the Causes of Scabies?

The eight-legged mite causes scabies in humans, and it can be diagnosed under the microscope. The female mite makes burrows under the skin and creates a tunnel where it lays the eggs. When the eggs hatch and the mite larvae reach the skin's surface, they start to mature and spread to other areas of the skin or can reach the skin of other people.

When the mite reaches the skin, it starts to itch, and this is because of the body's allergic reaction to the mites, their eggs, and their waste.

The mite starts to spread when the infected person shares the clothes, bed, and other personal things and has close physical contact.

Animals and humans are all affected by their distinct species of mites. Each species prefers one specific type of host and does not live long away from that preferred host.

Humans may have a temporary skin reaction from contact with the animal scabies mite. But people generally cannot develop full-blown scabies from this source, as they might from contact with the human scabies mite.

What Are the Clinical Manifestations of Scabies?

The signs and symptoms of scabies include:

  • Itching - Severe and gets worse at night.

  • Thin and irregular burrows made up of tiny blisters on the skin.

In adults, scabies may be found as irregular burrows in:

  • Folds of skin.

  • Almost any part of the body.

In older children, scabies is found in the following sites:

  • Between the fingers.

  • The armpits

  • Around the waist.

  • On the knees.

  • Around the breasts.

  • Along the insides of the wrists.

  • On the inner elbows.

  • On the soles of the feet.

  • Around the male genital area.

  • On the buttocks.

In infants and younger children, scabies is found on:

  • Scalp.

  • Soles of the feet.

  • Palms of the hands.

If you have experienced scabies before, these signs and symptoms develop within a few days of exposure.

If you have not experienced scabies before, it may take six weeks for signs and symptoms to appear.

Can Scabies Spread From One Person to Another?

Scabies is a contagious infection that can spread from one person to another. Therefore, scabies can be transmitted between members in a closed circle like friends, family, and sexual partners. However, transmission is also possible in schools, rehabilitation centers, nursing homes, prisons, and sports locker rooms. Transmission of scabies infection can take any of the following routes:

  • Persistent skin contact with the affected individual, like holding hands.

  • Sharing personal items like towels, bedding, clothing, etc.

  • Sexual contact with the person affected with scabies infection.

How Can Scabies Be Diagnosed?

Scabies can generally be diagnosed by an experienced healthcare provider based on history and physical examination. It is only rare that investigation may be needed. To diagnose scabies, your doctor will look for signs of mites, along with the characteristic burrows. When the doctor finds a mite burrow, they may scrape the skin from that area to examine under a microscope. The microscopic examination determines the presence of mites or their eggs.

How to Use Externally Applied Anti-scabies Medication?

The scabies treatment involves using externally applied medications (in addition to other medicines) which either are used in the following manner or as per the physician’s advice. Please note that the following method has a scientific basis, and you need to follow it in the manner prescribed to get the best results. This method is suitable only for an adult patient.

  • In the morning of day one, have a bath with warm water and scrub your skin using a rough cotton towel applying a little extra force. Immediately after that, use the first coat of prescribed medicine to all body areas, from the neck downwards (except head and face). The medication should be vigorously massaged for not less than 15 minutes. You may seek help from another person for thorough application to reach all areas of the body. After the first coat, put on ordinary cotton undergarments and dress, and you can pursue your everyday routine.

  • On the same day, after at least 10 hours of using the first coat, proceed on to the second coat of application done in the same manner.

  • The following day (day two), skip the bath and apply a third coat in the morning.

  • On the second day, 10 to 12 hours after the third coat, you can have a regular bath, and the first set of three applications is over.

  • You need to repeat the second set of three applications as detailed above, every week for the following three to four weeks or as advised by your physician.

  • All contacts and family members need to undergo simultaneous treatment in the same manner as for the patient.

  • The medication used for such applications might differ from patient to patient and is best decided by your caregiver.

  • The treatment for pregnant women, infants, children, and those on some form of other medications may be different.

Epidemics of scabies have been known to occur with devastating effects. Therefore, late evening or night itch symptoms should not be taken lightly, and home remedies should be better avoided.

What Are the Home Remedies for Scabies Treatment?

1. Tea Tree Oil:

Although tea tree oil has no benefits in conditions where the mites are present underneath the skin, it can help treat scabies and provide relief from itchiness and rashes.

2. Soaps:

The use of soaps, oils, and creams that contain active components from the trees, extracted from the roots, bark, seeds, and leaves, can help treat scabies.

3. Capsaicin Cream:

Cayenne peppers contain a compound called capsaicin. Creams made from this compound may ease the pain and discomfort caused by the mites and desensitize the skin, making you less bothered about the pain. However, they do not have a lethal effect on the mites.

4. Aloe Vera:

It helps treat scabies by reducing the redness and irritation associated. It is always advisable to use a pure form of aloe vera rather than a product that contains it.

5. Essential Oils:

Essential oils like clove oil, nutmeg oil, lavender oil, and lemongrass oil can help treat scabies. Of which, clove oil is very much helpful as it is a natural killer of bugs.

How Can We Prevent Scabies Infection?

Scabies infection can be prevented by the following:

  • Avoid direct skin contact with the scabies-infected person.

  • Do not touch or use any bedding, clothing, or personal items used by a person infected with scabies.

  • Wash the clothes, beddings, pillows, and towels with hot water at a temperature of 50°C and eventually dry them out in a dryer at an increased temperature for about 10 to 30 minutes.

  • Personal items that cannot be washed should be cleaned with the help of a vacuum. Vacuum, in turn, should be washed with hot water and bleach.

  • Other surfaces should also be cleaned with hot water and bleach.

Remember, once the mite falls off the body, it can live for three to four days. Therefore, following adequate preventive measures are needed to prevent the occurrence of recurrent infection.

Points to Remember

  • Scabies is an infectious condition that is caused by a parasite that lays eggs on the skin.

  • The adult parasite and even the transference of eggs through physical contact or shared objects like bed linen can result in the spread of the disease. Therefore, close contact is the dominant mode by which an individual gets the infection.

  • Scabies can affect people of all age groups and all socio-economic strata.

  • The symptoms of scabies include late evening or night itch, small raised lesions over areas with thin skin like finger web spaces (between the fingers), wrists, armpits, abdomen, thighs, genitals, etc. However, it spares the face and scalp in adults and can involve palms and soles in the young.

  • Treatment for scabies should include simultaneous treatment of all contacts and family members.

  • The itching caused by this condition does not start immediately upon developing the infection but some days or even a couple of weeks after the infection. While the patient is recovering from an illness, it takes several days to weeks before the itching subsides completely.

Conclusion:

Scabies infection is highly contagious and can spread among friends and family of the infected person if preventive measures are not adequately followed. Do follow the proper precautions and prevent yourself and your family from such an infection.

Frequently Asked Questions

1.

How Does One Get Scabies?

The scabies infestation is caused by Sarcoptes scabiei that live and lay eggs on the skin surface. These are tiny mites that spread from one person to another through direct skin contact or contact with infested person’s clothing and bedding.

2.

How Does Scabies Lesion Look Like?

Scabies lesions are pimple-like skin lesions. They are raised and filled with clear fluid. There can be blisters, gray lines, scales, and patches of red skin.

3.

What Signs and Symptoms Are Indicative of Scabies?

- Worsening skin itches at night.
- Skin rash.
- Redness of the skin.
- Blisters and sores in the following areas,
- On the buttocks.
- On the palm.
- Side of wrists.
- Between fingers.
- Armpits.
- Outside of the elbows.
- Waistline.
- Nipples and around the breasts.
- On men’s genitals.
- In children, lesions occur on the head, scalp, and neck.
- Scaly and crusty sores.

4.

For How Long Does the Scabies Infestation Last?

Scabies infestation does not resolve without treatment. After treating scabies, the lesions last for approximately two to four weeks.

5.

What Is the Color of Scabies Lesions?

Scabies lesions can either be skin-colored, grayish, reddish, or pink.

6.

Do Scabies Spread?

Scabies are highly contagious and spread easily within a household, hostels, prisons, etc. Since the initial symptoms like itching and skin lesions are evident only after weeks of infestation, the infested person keeps on spreading it to others unknowingly.

7.

How Does Scabies Spread to Other People?

Scabies spreads from one person to another through direct skin contact or contact with infested person’s clothes, bedsheets, towels, sharing cots, and other household items.

8.

How to Confirm Whether or Not Scabies Has Gone?

After treating scabies with scabicides for two weeks, the skin rash and lesions will heal and fade off. However, itching might be present for up to four weeks and is normal. These are healing signs of scabies. If itching lasts for more than four weeks, retreatment is necessary.

9.

How Long Can a Person With Scabies Spread It?

A person having at least 10 to 15 scabies mites in the skin or an asymptomatic person who is in the incubation period (within 4 to 8 weeks of new scabies infection) transmits scabies to others.

10.

Can Scabies Worsen With Hot Showers?

Hot showers can worsen scabies itching. But it is recommended to have lukewarm or hot showers during scabies treatment to maintain hygiene.

11.

Do Any Other Lesions Resemble Scabies?

The following skin lesions resemble scabies,
- Contact dermatitis.
- Atopic dermatitis.
- Psoriasis.
- Folliculitis.
- Eczema.
- Insect bites.
- Papular urticaria.

12.

How Babies Develop Scabies?

Since scabies spread through skin contact, babies might acquire scabies from contact with infested parents or siblings or when babies sleep together with the infested person on the same bed.

13.

What Are the Symptoms of Scabies in Babies?

Symptoms of scabies in babies include pimple-like fluid-filled pink to red bumps on,
- Head.
- Neck.
- Trunk.
- Arms.
- Legs.
- Palms.
- Soles.
These skin lesions present with itching that worsens at night. Other symptoms include,
- Irritability.
- Poor feeding.

14.

Will Scabies Resolve on Its Own?

Scabies do not resolve on their own. Treatment with necessary scabicide lotions, creams, and pills is essential to cure it and prevent its spread to others.

15.

Can Scabies Be Left Untreated?

If left untreated the scabies mites continue to reproduce and lay eggs under the skin resulting in unresolving skin itching and sores.

16.

Does Vaseline Help in the Management of Scabies?

Vaseline or petroleum jelly alone cannot kill the scabies mites. 5% to 10% Sulfur when mixed with petroleum jelly and applied over the skin, effectively manages scabies mites.

17.

What Measures Help Me Get Rid of Scabies?

- Since scabies is contagious it is essential to decontaminate infested person’s bedding, clothing, towels, and other items with hot water, hot dryer, or keep it untouched and wrapped in a plastic cover for two to three days.
- Scabicide lotions and creams like Permethrin, Sulfur ointments, etc., to be applied from neck to toes as suggested by the physician.
- In the case of children and infants, it must be applied to the scalp, head, and neck also.
- Apply on a clean body.
- Wear clean cotton loose-fitting clothes.
- Additionally, oral Ivermectin, antihistamine lotions, steroid creams, and Pramoxine lotions are also of benefit.

18.

Which Medicine Treats Scabies Effectively?

- 5% Permethrin cream.
- 25% Benzyl Benzoate lotion.
- Sulfur ointment.
- 1% Lindane lotion.
- 10% Crotamiton cream.
- Ivermectin pills.
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Dr. Vinay Kumar
Dr. Vinay Kumar

Dermatology

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