Scabies — BIMC Hospital Bali


Posted on : May 9, 2011

Dotted lined skin rash on the palms and soles. Unbearable night itch worsening by time. It might be a sign of scabies.

Scabies is a skin condition caused by parasite infestation, the itch mite Sarcoptes scabies. They are eight-legged parasites, just 1/3 mm long. The mite digs in the skin creating a burrow, they look like tiny threadlike projections, ranging from 2 mm-15 mm long, which appear as thin gray, brown, or red lines. The burrows can be very difficult to see and often mistaken for linear scratch marks that are large and dramatic and appear in people with any itchy skin condition. The skin rash may also be as small red bumps and blisters.

After creating the burrow, the scabies mite will lay eggs. After the eggs hatch and mature, the new mites work their way to the surface of your skin, where they mature and can spread to other areas of your skin or to the skin of other people. The itching of scabies results from your body’s allergic reaction to the mites, their eggs and their waste.

Scabies may involve the webs between the fingers, the wrists and the backs of the elbows, the knees, around the waist and umbilicus, the maxillary folds, the areas around the nipples, the sides and backs of the feet, the genital area, and the buttocks.

Direct skin-to-skin close contact is the mode of transmission. The most common form of transmission is by sexual contact, therefore scabies is also considered as a sexually transmitted disease. The transmission is more likely to occur when partners spend the night together than with a brief sexual encounter. Less common transmission is by prolonged close contact, which is why family members, people living in the same house can get the disease simultaneously. Another form of transmission is indirectly such as sharing clothing. It is hard, if not impossible, to catch scabies by shaking hands, hanging your coat next to someone who has it, or even sharing bedclothes that had mites in them the night before.

It’s important to know that sometimes someone is already infected by the mite but does not show symptoms.  They are called a symptomatic carrier.

Diagnosis is made by finding the mite microscopically. A sample may be taken from skin scraping or biopsy. In areas where there isn’t the facility to diagnose the mite, diagnosis can be based on exclusion.

The treatment for scabies is quite unique. Your doctor will prescribe a cream you will need to apply from neck to toe so that there isn’t a single area left for the mite or eggs to hide and remain untreated. All close contacts are recommended to have the same treatment. Treatment needs to be repeated after 1 week. All clothes, bed sheets, towels and possible objects where the mite can hide should be laundered with hot water and dried with high heat and repeated after 1 week. Objects that can not be washed should be kept in a sealed plastic bag for 1 week. However, even after the treatment, itchiness can still persist up to 3 weeks.

To relieve itchiness here are some things you can do:

  • Cool and soak your skin. Soaking in cool water or applying a cool, wet washcloth to irritated areas of your skin may minimize itching.
  • Apply soothing lotion. Calamine lotion, available without a prescription, can effectively relieve the pain and itching of minor skin irritations.
  • Take anti-histamines. At your doctor’s suggestion, you may find that over-the-counter anti-histamines relieve the allergic symptoms caused by scabies.

There isn’t much serious complication from the mite itself, but complications can develop from scratching. With scratching, your skin breaks and tends to get bacterial infection easily, in medical terms, secondary infection. The infections can be bad and will need antibiotic treatment.

Some facts about scabies:

  • Scabies is a great clinical imitator. It is difficult to diagnose it clinically, since the symptoms are similar to other diseases.
  • The phrase “7-year itch” was first used with reference to persistent, undiagnosed infestations with scabies.
  • Scabies has been a source of human infestation for more than 2500 years, dating back to Roman times.

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