Basically, scabies is a skin condition that is highly contagious and itchy. It is caused by the microscopic human itch mite, which burrows into the upper skin layer where it lives and lays its eggs. The main symptoms are a pimple-like rash and intense itching. It is transmitted through direct and prolonged skin-to-skin contact with an infected person.
It is commonly viewed as a sexually transmitted disease because sexual contact is the most common method of transmission of the condition among sexually active young people. Treatment usually consists of scabicidal creams.
It is estimated that about 300 million cases of scabies occur annually worldwide, and has been reported for over 2,500 years.
Those are the basics. But let’s take a microscopic look at this condition. I must warn you, though. The details are rather creepy for those who have a natural aversion to bugs.
How does Scabies Start and How do you Get it?
As mentioned, scabies is caused by the human itch mite. A mite is a tiny eight-legged parasite measuring only 1/3 of a millimeter long. It is the female mites that do the infesting. The mite is unable to fly or jump, but it does crawl. And, even though they are immobile at temperatures below 20 degrees C (68 F), they can survive for long periods of time at these temperatures.
Since the scabies mite cannot fly or jump, like fleas, they can only move from one person to another through direct, prolonged, skin-to-skin contact. The emphasis here is on prolonged. “It is hard, if not impossible, to catch scabies by shaking hands, hanging your coat next to someone who has it, or even sharing bedclothes that had mites in them the night before ... School settings typically do not provide the level of prolonged personal contact necessary for transmission of the mites.” (Medicinenet.com) Transmission can occur, however, through sexual contact and hugging.
Symptoms & Signs of Scabies
The first time a person is infested, symptoms of itching and rash do not usually appear for up to two months, although a person can still spread the infestation during this time. If a person experiences a recurrence, symptoms appear within one to four days after exposure. Again, even if symptoms are not present, transmission of scabies can still occur until treatment is received that kills the mites and the eggs.
The scabies rash looks like small red bumps and blisters. While the rash can appear anywhere on the body, it usually appears on the:
• webbing between fingers
• shoulder blades
In infants and young children, the head, face, neck, palms and soles of the feet can also be involved.
Another common symptom is the appearance of tiny burrows on the skin caused by the female scabies mite tunneling beneath the surface of the skin. These burrows ranging from 2 to 15 millimeters (1/7 of an inch to 1/2 an inch) long appear as raised and crooked grayish-white or skin-colored line on the surface of the skin.
The itching, which is the most common symptom, “is insidious and relentless ... typically worse at night. For the first weeks, the itch is subtle. It then gradually becomes more intense until ... sleep becomes almost impossible ... Other itchy skin conditions — eczema, hives ... — tend to produce symptoms that wax and wane ... rarely prevent sleep or awaken the sufferer in the middle of the night.” (Medicinenet.com)
Treatments for Scabies
Particularly in the case of first-time infestation, once the diagnosis of scabies is made, it is usually recommended that family members or sexual partner(s) who have had direct, prolonged skin-to-skin contact within a month of the diagnosis be examined and treated for scabies as well.
Treatment usually takes the form of prescribed scabicide creams, which kill scabies mites (and in some cases their eggs as well). To date, there are no over-the-counter products that have been tested and proven effective in treating scabies.
Scabicide lotions or creams are applied to all areas of the body from the neck down. In infants and children, the lotion or cream should also be applied to their entire head and neck.
“Bedding, clothing, and towels used by infested persons or their household, sexual, and close contacts ... anytime during the three days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours. Scabies mites ... do not survive more than 2 to 3 days away from human skin.
“Because the symptoms of scabies are due to [an allergic] reaction to mites and their feces, itching ... may continue for several weeks after treatment even if all the mites and eggs are killed. If itching still is present more than 2 to 4 weeks after treatment or if new burrows or pimple-like rash lesions continue to appear, retreatment may be necessary.” (Centers for Disease Control)
Scabies. Medicinenet.com. Web 7 Sept. 2011. http://www.medicinenet.com/scabies/article.htm)
Parasites - Scabies. Centers for Disease Control. Web 7 Sept. 2011. http://www.cdc.gov/parasites//scabies/
Reviewed September 8, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith