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Scabies is a condition that results in an itchy skin and is caused by a mite that is attracted to humans, called Sarcoptes scabiei. This mite burrows under the skin and causes itching to occur in these burrows, and especially at night.

Scabies is highly contagious and it tends to spread very quickly through close physical contact in scenarios where lots of people live around each other such as in families, school classes, child care groups and nursing homes.

Since scabies is very contagious, doctors recommend treating everyone the patient has contact with.

Cause

The mite that causes scabies in humans is microscopic, and it's the female mite that burrows just under the skin so she can lay her eggs. When the eggs hatch, the larvae find their way to the surface of the skin where they mature and then spread to other areas of the skin, or to the skin of others. The reason why this condition itches so much is because of the allergic reaction caused by the mites, their eggs and their waste products.

Symptoms

Symptoms and signs of scabies include:

  • Irregular and thin burrow tracks that are made up of tiny bumps or blisters on the skin.
  • Itching which can be severe, and is mostly worse at night.

Almost any part of the body can be involved, but usually the tracks and burrows can be found in the folds of the skin. In older children and adults, scabies is mostly found:

  • In the armpits.
  • Between the fingers.
  • On the inside of the wrists.
  • Around the waist.
  • Around the breasts.
  • On the inside of the elbows.
  • On the shoulder blades.
  • On the knees.
  • On the soles of your feet.
  • Around the male genitalia.
  • On the buttocks.

In young infants and small children, scabies may involve the following areas:

  • Face.
  • Scalp.
  • Neck.
  • Soles of the feet.
  • Palms of the hands.
Patients who have been diagnosed with scabies before may develop signs and symptoms of the infestation within a few days. Those who have never had scabies can take as long as six weeks for symptoms and signs to begin. The take home message here is that scabies can still be spread even if you don't have any symptoms or signs of the condition yet.

Complications

The following complications may occur with scabies:

  • Severe scratching can lead to open wounds where bacteria can cause secondary infections such as impetigo or even cellulitis.
  • Crusted scabies, which is hard and scaly, can occur which affects high-risk patients such as those with a compromised immune system.

Management

The treatment of scabies is with certain medicated lotions that have to be applied all over the entire body from the neck down, and left on for at least 8 hours and then washed off. Treatment with a second round is needed if new burrows and rashes occur.

Medications

  • 5% Permethrin cream.
  • Lindane lotion. 
  • Crotamiton. 
  • Ivermectin.
  • Sulphur compounded in petrolatum for those who can't use the mentioned medications, or who have resistant scabies.

Home remedies and prevention

The mentioned medications kill the mites quickly, but itching can still occur for up to several weeks. The following suggestions may help to relieve this issue:

  • Soak the skin in cool water or apply a cool, wet washcloth to irritated areas.
  • Calamine lotion can be applied on the affected areas.
  • Over-the-counter antihistamines can help relieve the allergic symptoms of this condition.

 

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