Dermatology

Listen

Scabies

Definition:

Scabies is a contagious skin disease that affects all age groups and is not an indication of poor hygiene.

Transmission:

It is easily spread by direct, prolonged, skin-to-skin contact with a person who has scabies, or indirectly through sharing clothing, towels, or bedding and others used by an infested person.

Cause:

Scabies occurs due to transmission of the parasitic mites from the infected person to another one, and the itching is a result of the body's allergic reaction to the mites and their eggs.

Parasitic Mite:

It is a parasitic mite that is invisible to naked eye.
Scientific name: Sarcoptes scabiei var.
Often the mite cannot live for more than 2-3 days outside of the human body.

Symptoms:

Intense itching, especially at night.
A pimple-like rash.
Scratches caused by itching.
Thick scales on the skin.
A child may experience severe red rash, especially in the inner surface of the wrist or between the gingers of the hands or feet.

It is most often found in the following parts of your body:

Hands and feet (particularly between fingers).
Navel and buttocks.
The inner part of the wrists.
Folds under arms (armpits).
The elbows.
Around breasts.
Genitals.

In Infants and Young Children:

Scalp.
Face.
Palms of the hands.
Soles of the feet.

Incubation period:

If a person has never had scabies before, symptoms may take as long as 4-6 weeks to begin. It is important to remember that an infected person can spread scabies during this time, even if he/she does not have symptoms yet.

Most Vulnerable Categories:

Persons with weak immune system.
Inpatients.
Babies.
Mothers.
Elderly
Disabled.
Health professionals.

When to see a doctor?

When you notice signs and symptoms that may indicate scabies.

Diagnosis:

Clinical examinations of the patient's skin from head to toe.
Conduct a test to confirm the infection: by rubbing (scratching) the skin of the affected area gently and take a sample (biopsy) to examine under a microscope to check the presence of the mite or eggs.

Treatment:

Those infected with the disease must quickly seek medical treatment to prevent outbreaks. Products used to treat scabies are called (scabicides), and doctor's instructions must be followed carefully, with keenness to complete the course. These medicines are often applied to the skin and infants and young children often need to treat their scalp and face as per doctor's instructions. In addition, persons in close contact with the infected person will need treatment at the same time, even if they have no signs or symptoms.

Medications Used to Treat Scabies:

Medication	Trade Name	How to Use	Notes
Permethrin cream 5%	Elimite	It is a topical cream, used all over the body, must comply with usage instructions.	It is safe for children ages 2 months and older. It is the best medicine for scabies.
Crotamiton lotion 10% and Crotamiton cream 10%	Eurax	It is used all over the body, must comply with usage instructions.	It is recommended for adults only.
Sulfur (5%-10%)	There are different types of the drug in the market.	It is used all over the body, must comply with usage instructions.	It is safe for children ages 2 months and older.
Lindane lotion 1%		It is used all over the body, must comply with usage instructions.	It is not the preferred drug for treatment as it considered a toxic substance, be careful when using it and avoid entering mouth. It should be avoided during pregnancy and while nursing. It is not recommended for children. It should not be used for persons with sensitive skin.
Ivermectin	Stromectol	It is taken by mouth (tablets). Taken while eating. Dosage depends on the patient's weight.	It should not be used for persons who weigh less than 110 pounds. It is a safe and effective treatment for scabies, however it's not yet (the American Food and Drug Administration) FDA-approved for this purpose. It used when patient does not respond to other medications. No studies approved that the drug is safe for children weighing less than 15kg or pregnant women.

Prevention:

Ensure that the affected person's clothes are laundered separately.
Ensure that bed linen and cloths, which were used three days prior to treatment, are laundered using a hot water cycle and dried at a high temperature.
Avoid sharing clothing, towels and others with the affected person.
Avoid crowded places.
If items are unable to be laundered, place them in a sealed plastic bag and leave them for a week.
Keep rooms well-cleaned using household detergents.
Avoid sex with the infected partner.