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So, what is scabies? Scabies is a contagious infestation of the skin by the human itch mite, Sarcoptes scabiei var. hominis. The microscopic scabies mite burrows into the upper layer of the skin where it lives and lays its eggs. Scabies infestation is frequently complicated by bacterial infection leading to the development of skin sores that in turn can cause more serious consequences such as septicemia, heart disease, and chronic kidney disease. One of the most common dermatological conditions accounting for a substantial proportion of skin disease in developing countries. Crusted Norwegian Scabies. A sever form of scabies, it has thick crusts of skin that contain large numbers of scabies mites and eggs. It's very contagious to other persons and may not show the usual signs and symptoms of scabies such as the characteristic rash or itching. It can be spread easily both by direct skin-to-skin contact and by contamination of items such as their clothing, bedding, and furniture. Persons with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent outbreaks of scabies. Norwegian scabies may occur in some persons who are immunocompromised, which means they have a weak immune system, the elderly, the disabled, or the debilitated. So, how is scabies primarily transmitted? Well, it's usually spread by direct, prolonged, skin-to-skin contact with a person who has scabies. The contact generally must be prolonged. Scabies is spread easily to sexual partners and household members. Scabies in adults frequently is sexually acquired and scabies is less transmitted via contact with clothing, towels, bedding used by an infected person. The incubation period is usually between two to six weeks after being infested. It's important to remember that an infested person can spread scabies during this time even if he or she does not have the symptoms yet. Remember that there is a period of communicability. Scabies is communicable until mites and eggs are destroyed by treatment. This is usually two courses one week apart and itching may persist for two or more weeks after successful eradication of the mite. If a person has had scabies before, symptoms appear much sooner usually one to four days after exposure. An infested person can transmit scabies even if they do not have symptoms, until they are successfully treated and the mites and eggs are destroyed. Itching is very common and also a skin rash. Severe itching, especially at night, is the earliest and most common symptom of scabies. A pimple-like papular, itchy, scabby rash is also very common. Itching and rash may affect much of the body or be limited to common sites such as between the fingers, wrists, elbow, armpits, penis, nipple, waist, buttocks, and shoulder blades. How do we diagnose for scabies? Well, diagnosis is usually made based on the customary appearance and distribution of the rash and the presence of burrows. It's confirmed by identifying the mite, mite eggs or mite fecal matter. This can be done by carefully removing a mite from the end of its burrow using the tip of a needle or by obtaining skin scraping to examine under a microscope for mites, eggs or mite fecal matter. It is important to remember that a person can still be infested even if mites, eggs or fecal matter cannot be found. Typically, fewer than 10-15 mites can be present on the entire body of an infested person who is otherwise healthy. However, persons with crusted scabies can be infested with thousands of mites and should be considered highly contagious. How long can scabies mites live? Well, on a person, scabies mites can live for as long as one to two months. And off from a person, scabies mites usually do not survive more than 48-72 hours. They will die if exposed to a temperature of at least 50 degrees Celsius, that is 122 degrees Fahrenheit, for at least 10 minutes. What is the best treatment for scabies? Well, scabicides is usually found in a lotion or a cream. It's a medication used to treat scabies. Scabicides kill scabies mites. Some also kill mite eggs. It should be applied to all areas of the body from the neck down to the feet and toes. Available only from a doctor's prescription, no over-the-counter or non-prescription products have been tested and approved to treat scabies. For infants, only permethrin or sulfur ointment may be used and all persons should be treated at the same time to prevent re-infestation. Let's talk about scabies prevention and control. Scabies is prevented by avoiding direct skin-to-skin contact with an infested person or with items such as clothing or bedding used by an infested person. All household members and other potentially exposed persons should be treated at the same time as the infested person to prevent possible re-exposure and re-infestation. Bedding and clothing worn or used next to the skin anytime during the three days before treatment should be machine washed and dried using the hot water and hot dryer cycles or be dry-cleaned. Items that cannot be dry-cleaned or laundered can be disinfected by storing in a closed plastic bag for several days to a week. Scabies mites generally do not survive more than two to three days away from human skin. Persons with crusted scabies and their close contacts include household members and they should be treated rapidly and aggressively to avoid outbreaks. Institutional outbreaks can be difficult to control and require a rapid, aggressive, and sustained response. Rooms used by a patient with crusted scabies should be thoroughly cleaned and vacuumed after use. Environmental disinfection using pesticide sprays or fogs generally is unnecessary and is quite discouraged.
In this lesson, we'll be digging into all things scabies related – what it is (the digging into will make more sense then), a common type of scabies, how it's transmitted, the signs and symptoms, how it's diagnosed, and the various ways to prevent and treat scabies.
What is Scabies?
Scabies is a contagious infestation of the skin by human itch mites, otherwise known as, for you Latin-speaking students, sarcoptes scabiei var. hominis. The microscopic scabies mite burrows (or digs) into the upper layer of your skin where it then decides to hunker down, live, and lay some eggs.
Scabies infestations are frequently complicated by the presence of bacterial infections, leading to the development of skin sores that can cause more serious conditions such as septicemia, heart disease, and chronic kidney disease.
Scabies represents one of the most common dermatological conditions and skin diseases for those living in developing countries.
Crusted Norwegian Scabies
This severe form of scabies involves the presence of thick crusts of skin that contain large numbers of scabies mites and eggs. It's very contagious and can easily be spread to others by direct skin to skin contact or by contact with items like bedding, clothing, and furniture. And it might not show the usual symptoms – rash and itching.
Pro Tip #1: People with crusted scabies should receive quick and aggressive medical treatment to prevent further infestations and outbreaks. You'll recognize it by the crustiness of the skin around the infestations.
Crusted scabies can more easily occur in the following groups of people:
- Those with weakened immune systems
- The elderly
- The disabled
- The debilitated
How is Scabies Transmitted?
Pro Tip #2: Scabies is usually spread by direct and prolonged skin to skin contact with someone who has been infested. It generally must be prolonged. For this reason, it's spread easily and frequently to sex partners.
Scabies can also be spread among household members who aren't sexually active, though less so, by sharing or touching infested items like clothing, bedding, furniture, etc.
The incubation period for scabies is between two and six weeks after being infested. It should be noted that a person infested with scabies can spread the condition to others during this time and even when no symptoms are present.
The period of communicability lasts until all mites and eggs have been destroyed by treatment, which usually consists of two courses of treatment one week apart. Itching can still persist for two more weeks following the successful eradication of mites and eggs.
Signs and Symptoms of Scabies
Pro Tip #3: For anyone who has previously had scabies, signs and symptoms can appear much sooner – one to four days after exposure.
Common scabies symptoms include:
- Severe itching, especially at night (earliest and most common symptom)
- Pimple-like rash is also quite common
Scabies can affect much of the body, or it can be limited to common areas, such as:
- Between fingers
- Wrists
- Armpits
- Penis
- Nipples
- Waist
- Buttocks
- Shoulder blades
How is Scabies Diagnosed?
Diagnosis is usually done by appearance – the distribution of a rash and the presence of burrows (where scabies mites make their home in the skin).
Diagnosis is usually confirmed by the identification of mites, mite eggs, and mite fecal matter and can be done by carefully removing a mite from the end of its burrow using the tip of a needle, or by scraping the skin. It's then examined under a microscope.
It's important to understand that a person can still be infested with scabies even if no mites, eggs, or fecal matter are found.
Typically, there are fewer than 10 to 15 mites present on an entire body of an infested person. However, for those with crusted scabies, there can literally be thousands of mites. It should go without saying, that anyone with crusted scabies is highly contagious.
Scabies mites can live on a person for as long as one to two months and off a person for usually not longer than 48 to 72 hours. And mites will die if they are exposed to temperatures greater than 50 C and 122 F for at least 10 minutes.
Scabies Treatment
The main treatment for scabies is scabicide (in lotion or cream). This is the most common medication used to kill scabies mites and some even kill the eggs. It must be applied all over the body, from head to toe. It's only available with a doctor's prescription, and all people in the same household should be treated at the same time to avoid reinfestation.
There are over-the-counter lotions and creams used to treat scabies, but these have not been tested or approved.
Warning: For infants, ONLY permethrin or a sulfur ointment should be used.
Scabies Prevention and Control
Scabies is prevented by avoiding direct skin-to-skin contact with an infected person or with the items that an infected person has used, like bedding, clothing, and such.
Also, all bedding and clothing worn or used by an infected person three days prior to completing treatment should be machine washed with hot water and a hot dryer cycle, or dry cleaned. Items that cannot be washed or dry cleaned can be disinfested by storing them in closed plastic bags for several days to one week.
Scabies mites will not usually survive more than two to three days away from human skin.
Institutional outbreaks of scabies can be difficult to control and require swift and aggressive treatment to avoid further spread. Rooms used by people with crusted scabies should be thoroughly cleaned and vacuumed. And environmental disinfestation using pesticides sprays or fogs are usually not necessary and discouraged.