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Scabies: Signs, Symptoms, Treatment and Management

What Is Scabies?

The mite Sarcoptes scabiei causes scabies which is a very itchy dermatosis. Scabies is transmitted by direct skin-to-skin contact.  A patient with typical scabies rash may have 12 mites on average, whereas those with crusted scabies may have thousands. The infection affects people of all ages, but it is more common in youngsters. It’s a common public health issue in impoverished areas, and it’s prevalent in many underdeveloped nations.

Look Out For Scabies Symptoms

Scabies symptoms and signs include:

  • Itching is the most prevalent symptom, especially at night. The itching might be so bad that it keeps you up at night.
  • Scabies rash affects a large number of people. This rash is characterized by little pimples that often form a line. Hives, tiny bites, knots under the skin, or pimples can all be mistaken for bumps. Eczema-like scaly patches appear in some people.
  • Scratching the itchy rash can result in sores. It’s easier for the sores to get infected.

Itching
  • Thick crusts occur on the skin when a person has scabies, especially in the severe form of scabies. The rash and itching grow severe when there are so many mites crawling into the skin. 
  • The persistent scratching can be caused by a significant itch. An infection might develop as a result of the constant scratching. Continuous scratching can lead to sepsis, a potentially fatal illness that develops when an infection enters the bloodstream.

  • Scabies can appear on any part of the body. However, the mites prefer to burrow in specific areas of the body. Itching and a rash are most common in the following areas:
  1. Mites like to burrow between the fingers and around the nails on the hands.

  2. Mites that live in the elbows and wrists.

  3. Mites are most prone to burrow in the buttocks, belt line, penis, and skin surrounding the nipples. Mites will burrow in skin that is covered by a bracelet, watchband, or ring.

Mites

Treatment For Scabies

  • Treat all household members and close contacts as the known case to prevent reinfection.
  • Individual morbidity and the danger of scabies spread can be decreased by improving living conditions and developing local competence in your area. Oral ivermectin is an alternative that has been used successfully in community control programmes. Plant derivatives such as turmeric, neem, and tea tree oil are also promising future treatments. The disease is strongly associated with poverty and overcrowding, and the associated stigma can ostracise affected individuals. Treatment of scabies in poor countries needs to integrate drug treatment programmes with efforts to improve the socioeconomic conditions and education programmes to reduce stigma. We expect the future to bring more sensitive and specific clinical and laboratory-based diagnostic methods, as well as new therapeutic strategies.

Creams and lotions

Cream

Scabies is usually treated with lotions and creams. Your doctor, pharmacist, or nurse can help you decide which treatment is best for you.

Even if they don’t have any symptoms, all members of your family and any close contacts, including recent sexual partners (see diagnosing scabies for more information), should be treated at the same time as you to avoid reinfection.

Except for your head, the cream or lotion should be applied to all of your body’s skin. Make sure your skin is cool and dry before applying it. It should not be used after a hot bath. It will swiftly sink into your skin and will not remain in the area where the scabies burrows are if you apply it when your body is hot.

You should also pay attention to the tips listed below.

  • Details on how to apply the cream or lotion can be found in the patient leaflet that comes with it. Some products should be used all over the body, including the scalp and face, while others should only be used from the neck down.
  • Pay special care to hard-to-reach regions including your back, your feet’s soles, in between your fingers and toes, beneath your fingernails, and on your genitals.
  • Apply the lotion under fingernails and toenails with a cotton bud or an old toothbrush. Place the used cotton bud or toothbrush in a bag and discard it later.
  • Allow the lotion to sit on your skin for 8 to 24 hours (depending on the preparation) before properly rinsing it off. Follow the manufacturer’s directions for how long the cream or lotion should be left on.
  • Reapply the cream or lotion to any parts of skin that have been washed throughout the application period.
  • After the initial application, wash bed linens, nightwear, and towels.
  • Repeat the procedure for 7 days after the initial application to guarantee that it is working. The second application will kill any mites that have developed from existing eggs.
  • If the itching persists after two weeks of treatment and you detect new burrows on your skin, see your doctor.
  • The general itching can take up to a month to go away and the lumpy genital lesions can take much longer. Your doctor may suggest that you repeat the  application of lotion or use a different lotion.
  • If you have any persistent side effects, you should consult your doctor or pharmacist.

Infection prevention

Wash Bed

All bed linen, nightwear, and towels should be washed at a temperature above 50C on the day you first apply the cream or lotion. Sheets, pillowcases, and blankets, as well as apparel worn adjacent to the skin (underwear, T-shirts, socks, and pants), should be washed and dried on a hot cycle.

If you don’t have access to hot water, seal all linen and apparel in plastic bags and store them away from family members and close contacts for five to seven days. The mite cannot live for more than four days without coming into contact with human skin.

If you have crusted scabies, you should clean your floors and vacuum your carpets and furniture, particularly armchairs and sofas, completely.

If you’ve been diagnosed with scabies, stay away from others for as long as possible until you’ve taken your medication. You should also stay away from other members of your home until their therapy is finished.

After the initial treatment, both children and adults can return to school or job.

Itchiness

Your doctor should be able to provide anti-itch medications, such as a moderate steroid cream. Menthol cream or gel, available without a prescription from pharmacies, can also help to soothe irritated skin.

Oral sedative antihistamines are also available at your local pharmacy and can be used to relieve itching and improve sleep quality.

If you’re taking antihistamine, you should avoid driving or using heavy machinery if you’re feeling drowsy.

Scabies itching is not relieved by non-sedating antihistamines. If you’re unsure, consult your doctor or pharmacist.

It’s possible that you’ll be irritated for a few weeks after your therapy is over because your immune system is still reacting to the presence of dead mites and their droppings.

If you’re still itchy six weeks after finishing your therapy, see your doctor.