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Scabies is a condition that causes a rash and severe itching on the skin.
Scabies is caused by a tiny mite called Sarcoptes scabiei. Scabies mites are tiny parasites. They differ from insects because mites have eight legs while insects have only six legs. Scabies mites are too small to be seen without a magnifying glass or microscope. They are able to walk, but do not jump or fly.
Scabies mites burrow into the upper layer of the skin where they lay their eggs. When the eggs hatch, the new mites continue the life cycle by maturing and laying more eggs. The presence of the mites in the skin triggers an allergic reaction which is the cause of intense itching.
Scabies infection is found all over the world and is common in all races and social classes. It is estimated that there are about 300 million cases of scabies worldwide each year.
Human scabies mites cause the scabies infection only in humans. The same mites do not infect animals, so a scabies infection cannot be spread by contact with pets or other animals. The mite that causes infection in dogs or cats may cause a mild itch if they come in contact with a human, but because those mites cannot thrive on human skin, the itching will soon go away.
Scabies is most often spread by skin-to-skin contact, especially prolonged contact. Sexual activity is a common way scabies can be shared, which has led some people to refer to scabies as an STD or sexually transmitted disease.
Sharing scabies involves close contact, so it is unlikely that you could catch scabies by brief contact such as shaking hands. Scabies mites can only live away from a host body for 24 to 36 hours, so it is not likely that mites will be transferred off bed linens or from clothing hung together in a closet.
Effective treatments are available to get rid of scabies. Left untreated, the infection and itching will become increasingly severe. If you are concerned that you may have been exposed to scabies or may have the condition, talk to your health care provider.
Treatment: it is essential to remove scabies from the living environment to avoid re-infestation after treatment. All bedding and clothing must be thoroughly laundered. Other members of the household or institution ought to be treated.
Permethrin cream 5%
Scabies is usually treated by applying permethrin cream 5%. It is applied to the skin from the neck down. The cream is left on for 8-12 hours. Excessive use of this medication can be harmful. Carefully read and follow the directions. Do not repeat treatments unless told to do so by a doctor.
If new, itchy bumps continue to appear in the days following your treatment, be sure to alert your doctor.
It may take several weeks for itching to disappear following successful treatment. Itching can be temporarily relieved with:
Antihistamines and corticosteroids
Some severe cases may respond poorly to other treatments. In this case, an oral medication, called ivermectin , is sometimes prescribed. It is given as a single dose.
Alternative topical creams include crotamiton 10% and lindane 1%.
Lindane is a second line treatment. It should only be given to patients who are unable to take other medications or who have not responded to them. Lindane can be toxic. It should not be overused. Follow the directions as given.