Scabies
Symptoms of Scabies including Tests and Treatment
Scabies is a common contagious skin infection caused by a skin parasite (or mite) called Sarcoptes scabiei. These mites burrow into the host's skin where they feed, mate and lay eggs. The main symptom of scabies is an intense skin itch and usually a mild rash caused by a type of allergic response to the mite and it's waste products. The scabies mite is microscopic and can not be visualised by the naked eye, but a localized itchy, red rash usually occurs around the burrows. It is most commonly transmitted by skin to skin contact from infected individuals but can also live in bedding, towels or clothes for a short period of time.1
Causes of Scabies
You can only catch scabies from other infected people (not animals). The most common form of transmission is by skin to skin contact. Scabies mites are very sensitive to the outside environment and can only live off a human host for up to 36 hours. It is very hard to catch scabies by shaking hands with someone who is infected and unlikely to be spread from peole who do not have prolonged physical contact with each other. Sexual contact is one of the most common causes of transmitting the infection and it is frequently transmitted among sexually active young people. Simple physical contact can also cause infection such as between family members i.e. mothers hugging their children. Scabies can also be spread by children who are more likely to have greater physical contact with each other whilst they play.2
Symptoms of Scabies
The most common symptom of scabies is intense itching. The skin itch occurs around the burrows of the scabies mite, most commonly in areas where the skin folds such as at the wrists, groin, elbows and knees or in between the fingers and toes. This is where the scabies mite is most likely to burrow to mate and lay eggs. The itch is caused by a type of allergic response to the scabies mite and it's faeces or waste products. Occasionally the rash can be much more severe causing a red, crusty (or raised) rash. This is commonly caused by a more severe form of the mite known as Norwegian Scabies or Crusted Scabies. This type of the scabies mite got it's name because it was first discovered in Norway and because of the type of rash that develops due to it's increased severity.3
Tests for Scabies
Scabies is usually diagnosed clinically by inspection of the rash. Under magnification the burrows of the mite can usually be identified that are associated with itching and the subsequent scratch marks around it. Occasionally a skin scraping may be performed and sent to the laboratory for analysis under a microscope, which may identify the mites or eggs that are living in the skin burrows.4
Treatment of Scabies
Scabies treatment generally involves a topical preparation such as a Permethrin cream or Benzyl Benzoate lotion to the whole body. It is important to treat all close contacts otherwise reinfection may occur from those who have not been treated. All bedding, towels and clothes that have been worn recently should also be washed. In people who have definitely been diagnosed with scabies a second application of the cream or lotion should be done to the whole body a week later to make sure that the infestation has been erradicated. It is important to note that the itch and rash that was caused by the scabies infestation may take more than a month to settle, even if all the mites have been killed by treatment. This is because the bodies of the mites and their waste products may still cause an allergic reaction in the skin until they have been shed along with the dead skin, which can take up to a few weeks. Occasionally resistant or more severe types of infection such as Norwegian Scabies may require a single oral dose of an anti-parasitic medication such as Ivermectin, but this needs to be monitored closely by a medical practitioner as this medication is dangerous and can cause organ damage if used improperly.5
If you are worried you may have scabies we strongly suggest you see a qualified medical practitioner to help with diagnosis.
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References for Scabies
1. Wikipedia "Scabies". Retrieved 28 January 2011.
2. Alan Rockoff, MD, and Melissa Conrad Stoppler, MD "How do you catch scabies?". MedicineNet.com. Retrieved 20 May 2010.
3. Mary D. Nettleman, MD. "Symptoms and Signs of Scabies". eMedicineHealth. Retrieved 7 October 2010.
4. Dr Christopher Commens and Dr John R Sullivan "Diagnosis of Scabies". Australasian College of Dermatologists. Retrieved 18 October 2001.
5. WebMD "Causes and Treatment of Scabies". Retrieved 30 March 2009.
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