Scabies: Symptoms, Causes, Treatment

What are the symptoms of scabies?

Scabies is a skin infestation caused by the Sarcoptes scabiei mite. The symptoms include:

• Intense Itching: Persistent and severe itching, especially at night, is the most common symptom. It results from an allergic reaction to the mites, their eggs, and their waste.
• Rash: A rash typically appears as small red bumps or blisters. It often starts between the fingers, on the wrists, elbows, buttocks, and genitals, but can spread to other parts of the body.
• Burrows: Tiny, raised, and thread-like burrows may appear on the skin, often in the folds or creases. These are caused by the mites digging into the upper layer of the skin.
• Sores and Scratches: The intense itching leads to scratching, which can cause sores or secondary bacterial infections.
• Thickened Skin: In chronic cases or in people with weakened immune systems, the skin may become thickened and scaly, a condition known as crusted scabies.
• Rashes in Specific Areas: In infants and young children, scabies may present with rashes on the head, face, neck, palms, and soles, which are less common in older children and adults.

Scabies is highly contagious and spreads through close personal contact. If you suspect you have scabies, it’s important to seek medical treatment promptly to prevent spreading it to others.

What are the causes of scabies?

Scabies is caused by an infestation of the skin by the microscopic mite Sarcoptes scabiei. The primary causes of scabies include:

• Direct Skin Contact: The most common mode of transmission is through prolonged, close physical contact with an infected person. The mites can spread from one person to another through skin-to-skin contact, such as during sexual activity or living in crowded conditions.
• Infestation in Shared Environments: Scabies can spread in environments where people have close and prolonged contact, such as in nursing homes, dormitories, and childcare settings.
• Contaminated Items: Although less common, scabies can also spread through sharing contaminated clothing, bedding, or towels with an infected person. However, mites do not survive long outside the human body.
• Weakened Immune System: Individuals with weakened immune systems or those who are immunocompromised are more susceptible to severe forms of scabies, such as crusted scabies, which can be more difficult to treat and more contagious.
• Hygiene and Living Conditions: Poor hygiene or living in crowded and unsanitary conditions can increase the risk of scabies. However, scabies can affect individuals of all socioeconomic backgrounds.

The mites responsible for scabies burrow into the upper layer of the skin to lay eggs, causing an allergic reaction and leading to the characteristic itching and rash associated with the condition.

What is the treatment for scabies?

The treatment for scabies involves using medications to eliminate the mites and relieve symptoms. Common treatment options include:

• Topical Scabicides: Prescription creams or lotions, such as permethrin cream (5%) or sulfur ointment, are applied to the entire body from the neck down and left on for a specified period before being washed off. These medications kill the mites and their eggs.
• Oral Medications: In some cases, especially when topical treatments are ineffective or if the infestation is widespread (as in crusted scabies), oral medications such as ivermectin may be prescribed. Ivermectin is taken in pill form and is effective in treating severe or resistant cases of scabies.
• Treating Close Contacts: To prevent re-infestation, it is important that all close contacts and household members are treated simultaneously, even if they do not show symptoms. This helps to eliminate the mites and prevent the spread of scabies.
• Symptom Relief: Over-the-counter antihistamines or topical corticosteroids may be used to relieve itching and inflammation. However, these do not treat the mites and should be used in conjunction with prescribed treatments.
• Cleaning and Disinfection: Washing all clothing, bedding, and towels used by the infected person in hot water and drying them on a hot cycle can help remove any mites or eggs that may be present. Items that cannot be washed can be sealed in a plastic bag for at least 72 hours to ensure mites are killed.
• Follow-Up Care: It’s important to follow up with a healthcare provider to ensure that the treatment has been effective and to address any persistent symptoms. A second application of treatment may be necessary in some cases.

Prompt and complete treatment of scabies is essential to relieve symptoms and prevent the spread of the infestation.