SCABIES

General Information

DEFINITION--A disease of the skin caused by a mite (the "itch" mite) with a characteristic pattern of distribution. Scabies is contagious from person to person (by shared clothing or bed linen) and from one site to another in the same person. It may be misdiagnosed as poison ivy, eczema, allergies or other skin conditions.

BODY PARTS INVOLVED--Skin of the finger webs and folds under the arms, breasts, elbows, genitals and buttocks.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Small, itchy blisters (usually in a thin line) in several parts of the body. The blisters break easily when scratched.
• Broken blisters leave scratch marks and thickened skin, crisscrossed by grooves and scaling.

CAUSES--A mite, Sarcoptes scabiei, that burrows into deep skin layers, where the female mite deposits eggs. Eggs mature into adult mites in 3 weeks. Mites are 0.1mm in diameter and can only be seen under a microscope. Scratching collects mites and eggs under the fingernails, so they spread to other parts of the body.

RISK INCREASES WITH

• Crowded or unsanitary living conditions.
• Contact with an infested person (usually by physical contact, but mites can pass by just standing close to infected person).

HOW TO PREVENT

Avoid contact with persons or linen and clothing that you suspect may be infected with scabies. > Maintain personal cleanliness:

Bathe daily, or at least 2 to 3 times a week. Wash hands before eating. Launder clothes often.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor. The diagnosis is confirmed by discovering the mite, lifting it from its burrow and identifying it under a microscope.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment. Medicine used for treatment is very effective.

POSSIBLE COMPLICATIONS

• Secondary bacterial infection of mite-infested areas of inflammation.
• A rare form of scabies (Norwegian) may occur in immunocompromised patients.

PROBABLE OUTCOME--Itching usually disappears quickly, and evidence of the disease is gone in 1 to 2 weeks with treatment. In some cases, re-treatment is necessary in 20 days.

How To Treat

GENERAL MEASURES--

• Wash clothing and bedding after your treatment.
• Extensive cleaning and fumigating of furniture and other items is unnecessary, since scabies only survive a short time off the body.

MEDICATION--Your doctor may prescribe:

• An insecticide lotion such as permethrin, lindane, crotamiton, or 5% sulfur ointment. (Infants and pregnant women may need a pediculicide that is less toxic, such as a 6% solution of sulfur). Bathe thoroughly before applying the prescribed medicine. Apply from the neck down, and cover the entire body. Wait 15 minutes before dressing. Leave medicine on the skin for 12-24 hours before bathing. Your family or other close contacts should be treated at the same time. You may need to repeat in 1 week.
• Topical steroids or other drugs to relieve the itching.
• Antibiotic ointments or oral antibiotics if a secondary bacteria infection develops.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of scabies.
• After treatment, the lesions show signs of infection (redness, pus, swelling or pain).
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.