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The symptoms of scabies

  • Intense itching (pruritus).
  • Pimple like itchy rash.
  • Short, liner or nodular burrows between the fingers.
  • Tiny red bumps and blisters on the skin.
  • Scratching causes sores, which further get infected by bacteria.
  • Tiny burrows are visible as female mite form tunnels below the skin (skin color lines on the skin surface).
  • Itching and rash occur in common body sites (wrist, elbow, nipple, waist, penis, webbing between the fingers, waist, buttocks)

Scabies

Scabies is an infestation, in which tiny burrowing mites called Sarcoptes Scabiei borrow up in the outer layer of the skin and lay eggs inside the skin. This infestation by mites causes intense itchiness (especially strong flare-ups at night) and angry rashes in the area where mites burrow.

Scabies is contagious, as mites can spread quickly from physical contact, sexual activities (hug and quick handshake do not spread scabies), contaminated articles such as clothes, towels, bedding, chairs, and often spread quickly in places like prison, school classes, and nursing home. If someone in a family is suffering from scabies, then the entire family is recommended to be cautious and seek treatment.

Causative agent

The female eight-legged mite or itch mite (Sarcoptes Scabiei) that cause scabies is microscopic, and it makes burrows and tunnel beneath the skin to deposit its eggs. Once the eggs hatch, the larvae migrates to other areas of the skin and matures. This leads to the spread of scabies in the skin. Itching in scabies is caused because of the allergic response of the body towards the waste and eggs of the mites. The scabies mites in animals cannot affect human, as every species prefers a distinct type of host, but there is a probability that animal scabies mite can cause a few skin problems in humans.

Our skin specialists at Dermaworld Skin Clinics (Delhi) advise the patients not to scratch the skin as it increases the chances of secondary pathogen infection. For example, Staphylococcus infection that can cause impetigo.


Norwegian scabies

People with a compromised immune system due to HIV, AIDS, chronic leukemia, and older people are at a higher risk of developing the hard to treat Norwegian scabies or crusted scabies. In this type of scabies, the skin becomes crusty and hard as in this case, and the affected individual is infested with millions of mites (in typical scabies the individual is affected with 15-20 mites). This type of scabies is very contagious, and the people affected with crusted scabies must be provided with quick medical treatment to prevent outbreaks.

Diagnosis

The diagnosis of scabies is done based on the customary appearance, rash distribution, and presence of burrows. The microscopic examination for the existence of mites, eggs, and their fecal material is done. Dermoscopy and adhesive tape test is also done to check for the presence of mites.

TREATMENT

Products like scabicides (permethrin) kill the scabies mites, and they are available only after a doctor's prescription. Certain precautions may be recommended by our dermatologists at Dermaworld Skin Clinics pertaining to the application of scabicide lotion, which must be followed without fail. Antihistamines and certain lotions are also prescribed to obtain relief from itching.

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Precautions required

The clothes must be washed with hot water and must be dried under direct sunlight. Clean clothes must be worn after treatment. The family members of the affected individual must also be treated as the symptoms may take 2-3 weeks to display.

Scabies mites cannot survive for more than 2-3 days if they are not in contact with human skin. The affected articles can be decontaminated by washing them in hot water and drying them in the hot cycle, dry cleaning. The items that cannot be washed or dry cleaned can be decontaminated by removing any body contact for at least 72 hours.

If scabies is not treated, then it can cause allergic skin rash (dermatitis), and it is always recommended to consult a dermatologist to nip the evil in the bud. At Dermaworld Skin Clinics (Delhi), our dermatologist will examine the skin area, confirm the presence or absence of scabies, and accordingly prescribe the further actions to be taken. If the patient has scabies, he/she will be suggested an appropriate treatment. One must keep it in mind that the products used for scabies treatment must be applied or used only after a prescription from a certified medical professional.

Frequently Asked Questions

Scabies is a type of skin infestation that causes redness and itching on the skin. This condition is caused by mites known as the Sarcoptes scabiei, that live under the outermost layer of the skin. If left untreated, these mites can live under the skin for several months and can cause severe skin infection such as redness, itchiness, and rashes on the skin. This condition is generally seen in children, but it can affect any individual of any age group. Common sites of scabies include:

  • Wrist
  • Elbow
  • Armpits
  • Buttocks
  • Around nipple
  • Folds in thighs
  • Bends at the knees
  • Folds around the private parts
  • Under the fingernails
  • Between the folds of fingers and toes

Scabies a highly contagious skin condition that can quickly spread from an individual to another through close physical contact, such as sitting or sleeping together, holding hands, sharing live spaces such as bedding, clothing, or towels that have been used by scabies infected person.

Symptoms and signs of scabies include:

  • Rash
  • Soreness
  • Thick crusts
  • Small blisters or bumps on the skin
  • An itchy rash that seems like a pimple
  • Burrow track of mite can even be seen on the skin
  • Curve white or thin red lines where mites have burrowed under the skin
  • Itching that worsens at night especially at body sites (in between fingers, armpits, waistline, inner part of the wrist, soles of feet, knees, buttocks)

To diagnose scabies, the doctor may examine the skin to check for signs of mites in the skin. They will also check for rash distribution and the presence of burrows in the skin. It may also be possible that the doctor will scrape off a small section of the skin to get the tissue sample and then check it under a microscope to check the existence of mites, eggs, and their fecal material. The doctor may also perform dermoscopy and adhesive tape test to check the presence of mites in the skin.

Yes scabies is treatable. If an individual is noticing any signs or symptoms of scabies, then they should primarily consult with their doctor about it. If left untreated, then it may cause serious secondary skin infections. Treatment of scabies is usually done to get rid of infestation with oral and topical medications. The doctor will probably suggest applying medication at the body part where mites are most active. Medicines like scabicide kill the scabies mites and can help in easing out the symptoms. But, these medications are only available on a doctor's prescription after checking the skin condition.

Good hygiene does not always give a guarantee to avoid scabies. However, following good hygiene, there is less chance of occurrence of scabies. As scabies spreads from direct skin to skin contact with a person having scabies, so there is a chance of spreading from the things used by the infected person. Thus, it is important to maintain good hygiene to prevent the occurrence of scabies. Avoid using or even touching the clothing, bedding, and towels used by an infected person. Maintain good hygiene and always change and wash the towel/s and bed-sheets/bed linen in hot water every 24 hours.


Dr. Rohit Batra, an MD (Dermatology,
Venereology & Leprology), is an adult,
pediatric and cosmetic dermatologist
& dermato-surgeon based at New Delhi.


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