Scabies is a skin condition caused by the scabies mite (Sarcoptes scabiei var hominis). The mite burrows under the skin. It is so small it can hardly be seen with the naked eye. It belongs to the same family as the spider. Scabies has been around for a long time and is probably responsible for the term “Seven Year Itch.” These bugs have three pairs of strong, stubby legs, which the female uses to burrow under the skin.
Scabies are usually sexually transmitted but scabies can also be passed between members of a household by skin-to-skin contact, shared clothing, towels, and bedding. Children often pass it to one another and to adults through everyday contact.
The mites can live for up to 3 days outside of the human body. Unfortunately, it may be difficult to tell how you got infected, because symptoms can take up to 4 to 6 weeks to appear after initial exposure, and last for up to 2 to 3 weeks after treatment.
Scabies are very easily spread. Scabies passed from person to person through close contact – in many cases through sexual contacts. Scabies can pass also through close contacts – shared clothing, towels, bedding, sheets and even furniture.
The typical incubation period for scabies is five weeks, but since symptoms are due to an allergic reaction, if you’ve had scabies before, you’ll notice symptoms sooner.
Scabies are so tiny – they cannot be seen with the naked eye. However, you can often see the burrows under the skin made by the female when she lays her eggs, particularly in the spaces between your fingers.
Often the symptoms of scabies are not visible. When there are symptoms, they may include
- skin rash which can appear in different places of body – scabies causes a skin rash that primarily shows up on folds of skin, such as between the fingers, on the wrists and ankles, and in the genital area;
- intense itching — usually at night or after exercise or after hot baths or showers; scabies rash is hard to miss;
- pimple-like small bumps that appear in dirty-looking, small curling lines, especially on the penis, between the fingers, on buttocks, breasts, wrists, and thighs, and around the belly button;
- sores from scratching;
- sores can become infected.
It usually takes 3–4 weeks for the symptoms of scabies to develop. But if you’ve recently had scabies and get re-infected, you may have itching within hours. Hands, arms, feet, ankles, armpits and buttocks, as well as the genitals, can all be affected by scabies.
If you think you might be infected with scabies, try not to scratch. Scratching may cause sores, which can get infected by other bacteria and lead to further problems.
Approximately 7% of all people infected with scabies get a rash of itchy, reddish-brown bumps, especially on the genitals. This is just a more severe allergic reaction than normal but it may take weeks or months to disappear. People whose immune systems are working overtime—for example, those who’ve had another illness for a long time—may notice thick, flaky lesions on their skin. This is called Norwegian scabies, and it is extremely contagious.
Scabies is normally diagnosed by the appearance of the skin rash it causes. Doctors can also take a scraping of the rash to test it for the presence of the scabies mites, their eggs, or their feces, but this test has a high occurrence of false negatives. You may still have scabies even if the skin scraping comes back negative.
If you’re not sure it’s a scabies burrow, you can apply some blue or black ink from a pen or marker to the suspect area. Soak a cotton swab with alcohol and rub off the excess ink. If you’re dealing with a burrow, the ink will be sucked into it and you will be able to see a thin line of ink under your skin. For an exact diagnosis, your doctor can scrape off some affected skin and examine it under a microscope.
Scabies are treated with topical pesticides. There are several recommended treatment regimens. One is 5% permethrin cream (Elimite) applied all over the body, and washed off eight to 14 hours later. Nix or Scabene also can be used for scabies. You may have to apply the medicine from neck-to-toe more than once.
Another treatment is a one ounce application of 1% lindane lotion or 30 grams of lindane cream (Kwell) applied thinly all over the body and washed off eight hours later. Both these treatments are effective, but lindane is less expensive. Lindane should not be used by people with extreme dermatitis because this could cause seizures.
Crotamiton 10% (Eurax) can also be used. It is applied after a bath or shower, with a second application 24 hours later. A cleansing bath should be taken 48 hours after the last application.
You might be asked to come in for a follow-up after a week if the symptoms do not disappear. It is normal to feel itchy several weeks after treatment. All sex partners from the last month should be notified and treated, and family members should be checked too. Clothing and bed linen used in the two days prior to treatment should be washed and dried, or sent for dry cleaning. All floors should be thoroughly vacuumed in your home, too. Everyone who may have been in close contact with you should be treated at the same time. That way you can avoid becoming infected again.
You are more likely to get scabies if you or your partner have multiple or casual sexual partners. Overcrowded living conditions, poor hygiene, and malnutrition probably contribute to the problem.
Scabies is easily spread, and there is no protection. The only thing that can reduce your risk of getting scabies is limiting the number of people with whom you have intimate or sexual contact. Since scabies are mostly spread in environments where there is a lack of good hygiene, avoid using unclean towels, bedding, and clothing.
If you have scabies, do not have sex until you and your partner(s) have completed treatment.
Scabies and pregnancy
Pregnant or breastfeeding women should not use treatments containing lindane.
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