SCABIES

Scabies is a highly contagious skin condition where the main symptom is intense itching. It is called by tiny mites which burrow into the skin. The causative mites are scientifically known as Sarcoptes scabiei.

Scabies spreads through prolonged skin to skin contact, or sexual contact with an infected person. It can also be passed on by sharing items of daily use, especially bedding. The incubation period for scabies in 8 weeks, which means you could develop the infection up to 8 weeks after exposure to an infected person. Scabies can spread quickly through close physical contact in a family, child care group, school class, nursing home or prison. Because of the contagious nature of scabies, doctors often recommend treatment for entire families or contact groups.

Scabies is more common in the developing world, due to population density, especially in areas with humid weather. Scabies like warm places on the skin, such as skin fold, between the fingers, under fingernails and breasts, and around the buttocks. The intense itching from scabies can be very worrisome, and usually intensifies at night. Rarely, scabies may get lead to a secondary infection if the skin breaks of becomes inflamed due to excessive itching. Another uncommon but troublesome complication is crusted scabies, which usually affects older people with weakened immune systems.

SYMPTOMS

Scabies signs and symptoms include:

  • Itching, often severe and usually worse at night
  • Thin, irregular burrow tracks made up of tiny blisters or bumps on your skin

The burrows or tracks typically appear in folds of your skin. Though almost any part of your body may be involved, in adults and older children scabies is most often found:

  • Between fingers
  • In armpits
  • Around your waist
  • Along the insides of wrists
  • On your inner elbow
  • On the soles of your feet
  • Around breasts
  • Around the male genital area
  • On buttocks
  • On knees
  • On shoulder blades

In infants and young children, common sites of infestation include the:

  • Scalp
  • Face
  • Neck
  • Palms of the hands
  • Soles of the feet

Without treatment of scabies, the life cycle of the scabies mite can continue indefinitely. These mites are resistant to soap and hot water, and cannot be scrubbed out of the skin.

People who are more prone to getting scabies are:

children, due to exposure to closed environments such as creches and schools

young mothers – who are in close contact with children

elderly people – especially those living in nursing homes

sexually active people

DIAGNOSIS AND MANAGEMENT

The burrows of scabies under the skin can be highlighted by an ink test, where ink is rubbed around an itchy area of the skin and wiped off with an alcohol pad. Skin with burrows will show them up by absorbing some of the ink.

If you have or suspect yourself of having scabies, it is advisable to visit your doctor at your earliest to prevent passing on the infection.

Permethrin cream is the commonest used application for scabies. If it proves ineffective, malathion lotion can be used. It is important that all members of the family be treated. It is also important to apply the cream/lotion when the body is cool and dry, as opposed to warm and wet. Apply it to the whole body neck downwards, especially between the fingers and skin folds. Try to leave it on for 8-12 hours.

Follow up treatment after 7 days is highly recommended to ensure the treatment is successful.

It is also advisable to wash all clothes, bed linens and other items of daily use such as towels etc at a wash temperature higher than 50 C. If an item can not be washed, place it in an airtight bag for 72 hours, which will kill the mites by depriving them of oxygen.

Dr. Annie

Physician, mom and wife

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