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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Skin Disorders Scabies infestation

Scabies infestation

Scabies is an infestation by the itch mite, Sarcoptes scabiei. They are tiny, just 1/3 millimeter long, and burrow into the skin to produce intense itching, which tends to be worse at night. The mites which cause scabies are not visible with the naked eye but can be seen with a magnifying glass or microscope.

How do you get scabies?

  • Transmission of the mites involves close person-to-person contact of the skin-to-skin variety
  • 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
  • The physical contact required to contract scabies may, however, be sexual, and sexual contact is the most common form of transmission among sexually active young people
  • However, other forms of physical contact, such as mothers hugging their children, are sufficient to spread the mites. Over time, close friends and relatives can contract it this way, too
  • School settings typically do not provide the level of close personal contact necessary for transmission of the

Signs and symptoms of scabies

  • Scabies produces small red bumps and blisters and affects specific areas of the body
  • Scabies may involve the webs between the fingers, the wrists and the backs of the elbows, the knees, around the waist and umbilicus, the axillary folds, the areas around the nipples, the sides and backs of the feet, the genital area, and the buttocks
  • The bumps (medically termed papules) may contain blood crusts. It is helpful to know that not every bump is a bug
  • In most cases of scabies affecting otherwise healthy adults, there are no more than 10 or 15 live mites even if there are hundreds of bumps and pimples

Treatment for a scabies infestation

  • Apply a mite-killer like permethrin
  • These creams are applied from the neck down, left on overnight, and then washed off
  • This application is usually repeated in seven day
  • An alternative treatment is 1 ounce of a 1% lotion or 30 grams of cream of lindane, applied from the neck down and washed off after approximately eight hours
  • Since lindane can cause seizures when it is absorbed through the skin, it should not be used if skin is significantly irritated or wet, such as with extensive skin disease, rash, or after a bath
  • As an additional precaution, lindane should not be used in pregnant or nursing women or children younger than 2 years old
  • Lindane is only recommended if patients cannot tolerate other therapies or if other therapies have not been effective

 

 

An oral medication, ivermectin, is an effective scabicide that does not require messy creams to be applied.


Although taking a drug by mouth is more convenient than application of the cream, ivermectin has a greater risk of toxic side effects than permethrin and has not been shown to be superior to permethrin in eradicating scabies.

 

Antihistamines, such as diphenhydramine, cetrizine, loratidine etc can be useful in helping provide relief from itching.

 

Wash linens and bedclothes in hot water. Because mites don't live long away from the body, it is not necessary to dry-clean the whole wardrobe, spray furniture and rugs, and so forth.

 

Treat sexual contacts or relevant family members (who either have either symptoms or have the kind of relationship that makes transmission likely).

 

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