Scabies

Introduction

Scabies is a common, itchy skin reaction caused by a parasitic mite (Sarcoptes scabiei) that affects only humans. The mite is very small and can only be seen under a microscope. The female mites burrow under the skin to feed and lay eggs. These mites cannot jump or fly and in most cases can only survive for 3 days off of the body. An infested person typically has only 10-15 mites on their body. Scabies is found worldwide and affects people of all races and social classes.

What are the symptoms of scabies?

Symptoms of scabies include an extremely itchy rash with red bumps and burrows that look like thin, wavy, gray or white lines. Common places on the body where the rash and burrows are seen are in the webbing between the fingers, around the wrists and elbows, the armpits and around the waistline, although scabies can be found on other areas of the body too. In infants and young children, the head, neck, palms of the hands and soles of the feet may also be affected. The rash is extremely itchy, especially at night. The itching may be caused by an allergic reaction to the mites, their eggs and their waste. Although the mites themselves are not dangerous, scratching the rash may lead to secondary bacterial infections that can be dangerous. Symptoms may occur two to six weeks after coming in contact with the skin of an infested person or their personal items. A person who has previously had scabies may have symptoms within several days of an exposure, because they are already sensitized to the mites. Their symptoms may also be milder.

Treatment

Follow these steps for effective treatment of scabies:

1. Confirm scabies diagnosis with a health professional and discuss the most appropriate treatment preparation (scabicide).
2. Trace and inform all possible close contacts (family members, friends and sexual contacts).
3. Treat all those suspected of being infectious (regardless of symptoms) at the same time.
4. Carefully follow the manufacturer’s instructions for the use of the scabicide, including steps you need to take before and after application.
5. Before removing the scabicide, wash all contaminated bedding, towels and clothes in hot water (at least 60oC) and/or heated tumble drying or ironing.
6. Items that cannot be washed should be dry- cleaned or placed in a sealed plastic bag for 5 days to kill any mites or eggs. Mattresses and upholstered furniture can be vacuumed or gently ironed to remove mites/eggs.
7. Repeat the application of scabicide in 5-7 days and follow the manufacturer’s instructions.
8. Follow-up with a health professional after one month to ensure that treatment was successful (or earlier if you are concerned).