Scabies is a contagious condition caused by a parasite invisible to the naked eye, a tiny mite called 'sarcoptes scabei'.
The female tunnels under the skin, where it lays its eggs. The eggs hatch into mites after a few days. As the mites burrow into the skin it causes silvery lines, a rash on the skin and intense itching.
Itching if often worse during the night, or after a hot bath and once the itching starts a rash appears which is red, blotchy and lumpy.
Transmission of scabies
Skin to skin
contact with someone infected is how you get scabies as well as direct contact with clothing, bedding and towels of an infected person.
The eggs from mites remain on the surface of the skin. It takes 10 to 14 days for the hatched egg to mature into an adult scabie.
Location of scabies
Scabies are primarily located:
- Between the fingers
- External genitalia
Scabies in a baby and young children
Scabies tends to affect non-hair-baring areas. Pink-brown nodules
are typical features in the young. Babies scratch themselves. They behave in an agitated way, moving in all directions trying scratch their backs.
Scratching starts in one place and gradually develops all over, even though the infestation is in one area. The rash is generally blister like filled with pus
, sometimes small solid round lumps less than 0.5cm.
A secondary infection of the lesions can occur making the symptoms worse and causing a fever.
The characteristic silvery burrows of scabies are not always present and babies can just feed poorly and be miserable. Presence of nodules at the bottom of the spine
, the genital organs and the armpits. Presence of papules or pustules on the palms of the hand
and of the soles of the feet
The diagnosis of Scabies is often difficult and can be confused with other similar looking rashes. The burrows and blisters do not always accompany the itch symptoms.
The doctor will take skin scrapings and send them for microscopic examination. Extraction of a mite from a burrow with a sharp needle may also confirm diagnosis and finally Indian ink painted over lesions and washed off after a few minutes will highlight a burrow.
Treatment of scabies
Topical treatments are prescribed by your doctor. Permtherin 5% cream and Malathion 0.5% liquid are first line treatments. The whole body must be treated, except the head and neck are covered. Follow the instructions given with the treatment
DO NOT have a hot bath prior to treatment - it can affect the absorption of the drug causing systemic side effects. It is recommended that the cream or lotion should bed applied twice 1 week apart
Clothing and bedding should be washed. All contacts MUST be treated
Itching can still persist for several days after treatment