Scabies

• Scabies is a contagious skin condition caused by a tiny mite called Sarcoptes scabiei. These mites burrow into the skin, laying eggs and triggering an intense allergic reaction, which causes itching, rashes, and irritation.

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• Scabies can spread quickly through close skin-to-skin contact or sharing clothing, bedding, or towels. It affects people of all ages and backgrounds and is common in crowded environments like schools, nursing homes, or shelters.

The cause of scabies is an infestation by microscopic mites that dig into the upper layer of skin.

• Key Transmission Sources:

  • Direct skin contact with an infected person

  • Sharing clothing, towels, or bedding

  • Sexual contact (in adults)

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Scabies is not caused by poor hygiene, but cleanliness plays a role in controlling outbreaks.

• Symptoms typically appear 2–6 weeks after infestation (or sooner in previously infected people).

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• Common Signs:

  • Severe itching, especially at night

  • Red bumps or blisters

  • Thin, wavy burrow lines (often between fingers, wrists, elbows, or waist)

  • Crusting or scabbing from scratching

  • Sores caused by secondary infection

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• In infants and elderly people, scabies may also affect the scalp, face, and soles of feet.

• Scabies requires prescription medications to kill the mites and their eggs. Over-the-counter creams and lotions won’t work for scabies.

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1. Permethrin Cream (5%)

• First-line treatment for scabies

  • Apply from neck down (entire body) and leave for 8–14 hours

  • Safe for adults and children over 2 months

  • Usually one treatment is enough, but a second may be done after 1 week

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• Highly effective and well-tolerated

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2. Ivermectin (Oral)

• Oral medication used for:

  • Severe or crusted scabies

  • People who can't use creams

  • Large outbreaks (e.g., in institutions)

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• Usually taken as a single dose, and repeated in 7–14 days.

• Safe and effective, even in mass treatment

• Not usually used in pregnant women or children under 15 kg

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3. Benzyl Benzoate Lotion

• Kills mites but can cause skin irritation

  • Often used in low-resource settings

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4. Sulfur Ointment (5–10%)

• Safe for pregnant women and infants

  • Messy and has strong odor

  • Used when other options aren’t suitable

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5. Crotamiton Cream (Eurax)

• Relieves itching and kills mites

  • Less effective than permethrin

  • Requires multiple applications

• Common Side Effects:

  • Temporary redness, burning, or itching after application

  • Mild skin irritation or dryness

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• Serious Reactions (Rare):

  • Allergic reactions (swelling, rash, trouble breathing)

  • Overuse of strong topical treatments can damage skin

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• Itching may continue for 1–3 weeks after treatment due to the body’s reaction—even if mites are gone. This is called post-scabies itch.

• Doctors usually diagnose scabies by:

  • Physical exam and patient history

  • Looking for burrow lines and typical rash

  • Skin scraping test (microscope used to detect mites, eggs, or fecal matter)

  • Ink test or dermatoscope to highlight burrows

• Even after treatment, it’s crucial to prevent re-infestation:

  • Wash all clothing, bedding, and towels in hot water and dry on high heat

  • Items that can’t be washed? Seal in a plastic bag for 72 hours

  • Everyone in close contact (family, roommates, partners) should be treated at the same time, even if they don’t show symptoms

  • Clean furniture, mattresses, and carpets

  • Avoid sharing clothes, combs, or towels

1. Can scabies go away on its own?

• No. Scabies won’t go away without medication. The mites must be killed to stop the infection.

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2. Is one treatment enough?

• Sometimes yes, but many doctors recommend a second treatment after 7 days to kill newly hatched mites.

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3. Can scabies come back?

• Yes, especially if contacts aren't treated or if mites remain on bedding or clothing.

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4. How long is scabies contagious?

• Until 24–48 hours after starting treatment. Avoid close contact during this time.

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5. Can I get scabies again?

• Yes. Having scabies once does not make you immune. You can be reinfested.