Scabies is a skin condition caused by a tiny mite called Sarcoptes scabiei that burrows into the skin of the infected person and deposits its eggs. According to MedlinePlus, scabies is found worldwide and is passed from person to person by direct contact. It can also be spread by contact with infected clothing and bedding. Occasionally, an entire family may become infected, making eradication especially difficult.
Symptoms of Scabies
The primary symptom of scabies is intense itching, especially on the hands and in skin folds such as in the elbows, behind the knees or under the breasts. In infants and very young children, the rash may also appear on the face, neck, palms and soles of the feet. According to the Centers for Disease Control, itching is often followed by a rash that is an allergic reaction to the proteins and feces of the parasite.
Appearance of Scabies
In addition to the development of a rash, tiny burrows often appear on the skin of a person infected with scabies. The borrows are made by the female mites as they tunnel just beneath the skin to lay their eggs. The burrows look like tiny, grayish raised lines on the surface of the skin. Sometimes an infection can become severe, and the infected person will develop thick, crusty patches containing large numbers of mites. The Centers for Disease Control states severe cases are more likely to occur among the elderly or in a person whose immune system has been compromised.
Diagnosis
Scabies is normally diagnosed by the appearance of the rash and by the presence of skin burrows. The diagnosis may be confirmed by visualizing the mites under a microscope. To do this, a doctor may use the tip of a needle to remove and examine a mite from one of the burrows, or he may take a skin scraping and examine it microscopically. The presence of either the mite itself, its eggs or its feces in the scraping confirms the person is infected with scabies.
Treatment of Scabies
Scabies is treated with one of several medications that will kill the mite. The American Academy of Dermatology recommends topical use of 5 percent permethrin cream on the entire body. The cream is left on overnight and then washed away, followed by a second treatment one week later. A lotion containing 1 percent lindane may be also used, although it is not recommended for infants, children or pregnant or nursing women. Infants may be treated safely with a cream containing 10 percent sulfur. Severe cases are sometimes treated orally with ivermectin, although this is not recommended for infants or pregnant women.
Eradication of Scabies
The incubation time for scabies may be six to eight weeks, so symptoms may not be obvious right away. Because of this, the American Academy of Dermatology recommends all exposed individuals should be treated, whether or not they show symptoms. It also recommends all clothing and bedding be washed in very hot water or placed in the dryer on a high setting for 30 minutes. Carpets and upholstery should also be thoroughly vacuumed. As a final measure, any other items that might have been exposed to the mites may be tightly sealed in a plastic bag for two weeks, since any contained mites will die without a food source.
