What is Scabies?
Scabies is defined as a transmissible, ectoparasite scabies skin mite infection. This means that it can be passed on i.e. it is contagious and it is caused by a parasite that lives on the skin.
Scabies is a skin condition caused by a skin mite called Sarcoptes scabiei. The female skin mite burrows into the skin in a bid to lay eggs and reproduce. This burrowing action is what causes intense itching and reddening of the skin. Often the scratching action due to the itching can tear the skin, causing secondary infection.
If untreated, the scabies mites continue to multiply until the host begins to suffer from cracked, scaly skin called Norwegian scabies. Although the scabies rash is curable, the scabies treatment for Norwegian scabies is difficult due to the number of scabies mites living on the skin. Scabies is contagious and can be transmitted by direct contact with infected skin. Treating scabies can be difficult if not detected early.
The scabbies mite, Sarcoptes scabiei, is a type of skin parasite. A parasite is an organism that obtains nourishment from another living organism (called a host) in order to reproduce. In the process it causes damage to the host – leading to what is called an infection (in this case – scabies rash).
The scabies mites belong to the same subclass as ticks that live on the bodies of animals. In animals, scabies is caused by a different skin mite, which cannot reproduce on human skin. Therefore, it is not possible to contract scabies from infected animals.
The size of the scabies mite ranges from about 0.3 to 0.9 mm. It is microscopic (cannot be seen with the naked eye), however at times, it can be spotted at a tiny white pin point at the end of the burrow.
On a human being an adult skin mite lives for about two to three weeks. The female skin mite, upon burrowing, lays about two- three eggs per day for two months. Within 3 or 4 days, larvae emerge. It takes about 9-11 days for the larvae to develop into an adult male and 17 days to develop into a female.
Once developed into adults the male and the female mate and once again the female will lay eggs into the burrows. Usually on an infected person there are about 10-15 scabies mites. This number will increase if a scabies treatment is not sought.
Scabies is transferred from person-to-person by direct skin contact. Prolonged handshakes, hugging, carrying children who are infected can pass on the skin mite to healthy people as well. Contrary to popular belief, scabies rashes do not spread due to lack of hygiene, and neither is it prevalent in any particular social or economic strata.
Since the skin mite cannot survive off the human skin for more than 24- 36 hours, it is uncommon to get it by sharing or using the same bed sheet, towels or clothes. (However, this is no excuse to not wash them). It is very common for an entire household to suffer from scabies due to just one infected person, and usually this is the case; therefore treating scabies for the entire household and treating the home is advisable.
It is also easier to contract scabies from places where one is in physical proximity to many people like hospitals, day care centers or even on very crowded trains. Scabies can also spread through sexual intercourse with an infected person. Therefore it is also classified as an STD.
Symptoms of Scabies
Intense itching is the first scabies symptom of a scabies rash. The itching usually does not start for a few (4 to 6) weeks, then increases gradually until, in about 2 months, it becomes relentless. However, in a person who has suffered the infection before, the itching can start within 1 to 4 days.
Unlike in other skin infections, where the itching happens in spurts, in scabies the itching is continuous and tends to worsen at night. Most patients are not able to sleep at all – such is the extent of the itching. If you suffer from itching that wakes you up in the middle of the night, you mostly suffer from scabies.
The itching occurs when the female skin mite burrows into the skin, since she uses her jaws and legs to cut into the upper layer of the skin. It is also caused when larvae become adults and begin to roam around on the skin or attach themselves to hair follicles. The itching particularly occurs in areas of the body such as:
- The wrists
- Between finger
- Around the nipples (in women)
- Around the genitals (in men)
- Areas around the buttocks
- Inner elbows
- Around the waist and umbilicus
- Sides of the feet
The other scabies symptom is rashes with tiny red bumps on the skin. These are actually the ‘burrows’ or ‘tunnels’ in which the skin mite lays her eggs. These burrows are quite thin, almost threadlike and anywhere between 2 mm to 15 mm in length. They appear gray or red in color.
Burrows are usually very difficult to see, however, if looked at carefully, you could see a skin mite at the end of a burrow as a tiny white point. The scabies rashes are often confused with stretch marks or even dry skin; therefore treating scabies can be difficult if misdiagnosed.
Tests & Diagnosis of Scabies
Scabies is rarely misdiagnosed due to the distinctive relentlessness of the itching and since the tests are very simple. There are two ways in which a doctor will diagnose scabies:
Microscopic Exams of Scrapings from suspicious lesions: An infected individual has usually 10-15 scabies mites living on them and many eggs in the burrows of the skin. The skin is scrapped from the infected area and examined under a microscope. (The scabies mite is not hard to see under a microscope)
Burrow Ink Test (BIT): Usually presence of burrows on the skin confirms scabies. These burrows are, however hard to locate. In this case, the doctor will mark the area with a felt-tip pen and the wipe off with alcohol. If burrows are present, the ink will penetrate into them, highlighting their presence.
Topical Tetracycline Solution: This solution is applied when diagnosis from the ink test is difficult. This solution is applied on the rash and wiped off with alcohol. The rash is then examined under a special light which will illumine the pattern of the burrows.
Doctors usually prescribe Pyrethrum and Lindane as a scabies remedy. Both of these ingredients are labeled with CAUTION, and Lindane has been banned in several states because of its high toxicity. These toxic ingredients cause serious side affects and they are also responsible for death, neurological problems, asthmatic breathing, nasal stuffiness, headaches, nausea, loss of coordination, tremors, convulsions, facial flushing and swelling, burning and itching.
Infant and small children are the most common victims of severe poisonings reported because they are not able to efficiently break down these pesticides when using them for a scabies remedy.
Traditional toxic medication prescribed:
Permethrin (5%): Also known as Elimite lotion; it is one of the most popular toxic scabies remedies that is being prescribed. This is to be applied to areas from neck-down, left on overnight and then washed off in the morning. The doctor will usually ask you to repeat the application for this toxic scabies remedy in seven days.
Lindane (1%): Lindane is only recommended where the Permethrin has failed since it can cause seizures if absorbed through the skin and is considered the last choice when prescribing a scabies remedy. Lindane is again to be applied neck-down and left on the skin for about 8 hours and washed off with warm water to ensure it is completely removed. However, one must not use very hot water as that can cause the lotion to seep into the skin. If you’re pregnant or nursing – do not use Lindane. Same applies to children below 2 years of age.
Malathoin Lotion (0.5%): This lotion is another one of the most popular scabies remedies and when applied for 24 hours is effective in eliminating scabies mites and eggs; however is also considered a highly toxic scabies remedy.
Sulphur based creams and soaps have also been known to be mildly effective in some cases when infestation is caught early on. They come with the advantage of being cheaply available and can be used by pregnant or nursing women. Sulphur based products are considered a natural cure for scabies.
At times oral medication may be used along with topical scabies treatments. The doctor might prescribe a dose of Ivermectin which is also highly toxic and also can create serious side effects.
After much review, research and scrutiny on available Scabies treatment options, DermaTechRx™ Research Center recommends the use of All Stop™ brand of scabies treatment products. All of the natural, non-toxic products are safe enough to be used even by small children.
Tips to Aid in Getting Rid of Scabies
Get the entire family and anyone who is in regular physical contact with you treated whether they show scabies symptoms or not; it’s the only way for a successful scabies cure.
Wash all bed sheets, linen every three days, during the period of scabies treatment in hot water.
Use medication only as directed. You can use non-toxic scabies cure treatments as often as you need; unlike the toxic prescriptions traditionally used.
Maintain strict personal hygiene. Get rid of unwanted hair, clean and cut nails regularly.
Complication in Scabies
The most common complication can arise out of a secondary infection due to scabies. A second infection will usually be caused due to scratching, which might tear the skin, exposing it to the scabies mites or other infection. Chances of such an infection are higher in individuals with an immune deficiency or a condition which thwarts recovery.
The other complication is the progression of the infection to a severe form called as norwegian scabies. (This has nothing to do with Norway). This is a condition where the skin gets crusted and scaly and begins to fall off if scratched in any manner.
Those suffering from an impaired immune system are at a greater risk of Norwegian Scabies. Norwegian scabies have very little itching but skin can turn extremely dry, scaly and flake easily. The very toxic oral medication Ivermectin is usually prescribed for treatment of norwegian scabies.
Itching will continue for up to 2 weeks after a scabies treatment is done. This condition is called ‘post-nodular scabies.’ It does not mean that a scabies treatment has failed or that scabies is recurring. This itching is due to debris and secretions of the scabies mites that remain encrusted in the burrows or under the skin. The body develops an allergic reaction to the remnants and hence the itching. However, this should subside in 3-6 weeks, as your skin regenerates. Gently scrubbing or exfoliation will often help matters.
It is quite possible that a scabies rash will reoccur. There is no vaccination for it neither is the system completely immune to it. Therefore, it is essential to maintain hygiene even after a successful scabies treatment. Simple precautions exercised around the house will help in preventing spread of the disease:
- Regularly vacuum all those objects which you cannot wash easily like soft toys, thick coats and jackets, etc.
- Steam clean beddings while washing them
- If you share your mattress with someone, ensure it is vacuumed everyday or use a cover and wash that everyday
- Do not use a towel twice without washing it
- If it’s not possible to wash linen, bed sheets, covers, etc everyday: they should be tumbled in a dryer at very high temperature (140 degrees +) in order to eliminate the scabies skin mites.
- Ensure that your car seats, office chairs, carpets, curtains etc are steam cleaned while you are being treated.
- Infested objects which cannot be vacuumed or cleaned must be placed in a bag for about 2 weeks since scabies mites cannot go that long off of a human host
- Abstain from any physical contact while under scabies treatment.
Scabies is in no manner life threatening. It only causes discomfort and inconvenience and if one is not careful, then a secondary infection due to the scratching. Norwegian Scabies is a possibility, however only in those who suffer from a deficient immune system like patients with HIV. During the period of scabies treatment, it is advisable that one not come into direct contact with other people lest they get infected or the infection may recur.
As a final note, this guide is meant to be informative only. This guide is not designed or intended to diagnose, treat, prevent or cure scabies or any other condition.