Are you scared of Scabies!!!

Scabies is one of several skin conditions that can cause itching and rashes. It is a dermatologic condition caused by sarcoptes scabiei, an eight-legged microscopic mite.

What is Scabies ?

Scabies is a contagious skin infection that is caused by Sarcoptes scabiei, a microscopic mite. Infestation is common, found worldwide, and affects people of all races and social classes. Scabies is not an infection, but an infestation. As the mites burrow and lay eggs inside the skin, the infestation leads to relentless itching and an angry rash.

Scabies is contagious and can spread very easily from person to person through close physical contact. This makes an outbreak likely in settings such as the family home, child care group, school class, nursing home, or prison. It is highly contagious, being easily spread through close physical contact and by sharing bedding, clothing, and furniture infested with mites.Scabies spreads by direct, prolonged, skin to skin contact with a person already infested with scabies. Infestation may also occur by sharing clothing, towels, and bedding. Mites burrow under the outer layer of skin. They lay their eggs under the skin and feed on blood. The burrows sometimes appear as short, wavy, reddish, or darkened lines on the skin surface. For a person who has never been infested with scabies, it may take 4 to 6 weeks to begin symptoms. For a person who has had scabies, symptoms appear within several days. When living on a person, an adult female mite can live up to a month. Diagnosis is made by a skin scraping to look for mites, eggs, or mite fecal matter.

Signs & Symptoms

The infection begins as small, itchy bumps, blisters, or pus-filled bumps that break when you scratch them. A common symptom is severe itching, which may be worse at night or after a hot bath or shower. The common areas that are affected are the hands and feet (especially the webs of skin between the fingers and toes), inner part of the wrists, and the folds under the arms, elbows and the areas around the breast, genitals, navel, and buttocks. Sores on the body caused by scratching can sometimes become infected with bacteria such as staph or strep.

The onset of symptoms of scabies varies depending on whether or not a person has previously been exposed to mites. The first time a person is exposed to the scabies mite, it can take upwards of 2 to 6 weeks for symptoms to develop. This timeframe is significantly shorter in subsequent infestations as the body's immune system is quicker to react, typically within 1 to 4 days.

Signs and symptoms of scabies include :

• Itching: This is often worse at night and can be severe and intense. Itching is one of the most common scabies symptoms.

• Rash: When the mite burrows into the skin, it forms burrow tracks, or lines, which are most commonly found in skin folds, and resemble hives, bites, knots, pimples, or patches of scaly skin. Blisters may also be present.

• Sores caused by scratching: These occur in infested areas where a person has scratched at the skin. Open sores can lead to impetigo, commonly caused by secondary infection with Staphylococcus aureus.

• Thick crusts: Crusted scabies, also known as Norwegian scabies, is a form of severe scabies in which hundreds to thousands of mites and mite eggs are harbored within skin crusts, causing severe skin symptoms.

Infants and young children experience infestation in other areas of the body, including the:

• scalp

• face

• neck

• palms of the hands

• soles of the feet

The most common site of infestation in adults and older children include:

• in between the fingers

• around fingernails

• armpits

• the breasts, particularly the areas around the nipples

• male genitalia

• knees

• waistline

• inner parts of the wrists

• inner elbow

• soles of the feet

• shoulder blades

• buttocks.

Prevention

To prevent re-infestation and spread, take the following steps:

• Quick identification and treatment is very important to control further spread of scabies.

• Infected persons should be excluded from school or work until the day after treatment.

• Wash or dry-clean all clothes, towels, linens, etc. When washing, use hot soapy water and dry on high heat. Place items that cannot be washed in a sealed plastic bag for one to several weeks to starve the mites.

• Vacuum the entire home on the day treatment is initiated, including carpets, rugs, upholstery, etc., and discard the bag or thoroughly clean the vacuum's canister.

If you have a concern that you may have, or may be at risk for, contracting scabies, speak with a doctor. To prevent re-infestation and to prevent the mites from spreading to other people, take these steps:

• Clean all clothes and linen. Use hot, soapy water to wash all clothing, towels and bedding used within three days before beginning treatment. Dry with high heat. Dry-clean items you can't wash at home.

• Starve the mites. Consider placing items you can't wash in a sealed plastic bag and leaving it in an out-of-the-way place, such as in your garage, for a couple of weeks. Mites die after a few days without food.

Treatment

Several prescription lotions and creames are available to treat scabies. Itching may continue for 2 to 3 weeks after treatment. This does not mean that scabies is still present. A health care provider may prescribe additional medication to relieve itching. Everyone should receive treatment at the same time to prevent reinfestation. In addition to applying insecticidal lotion/creme one should wash and dry all bedding, clothing, and towels used by the infected person prior to treatment with hot water and the high heat setting on the dryer.

Scabies treatment involves eliminating the infestation with medications. Several creams and lotions are available with a doctor's prescription. Your doctor will likely ask you to apply the medication to your whole body, from the neck down, and leave the medication on for at least eight to 10 hours.

Scabies is generally treated with topical medications such as 5 percent permethrin cream, crotamiton cream, or lindane lotion. In some cases, a 25 percent benzyl benzoate lotion or 10 percent sulfur ointment may be used. Most topical preparations are applied at night and washed off in the morning.

Medications commonly prescribed for scabies include:

• Permethrin cream (Elimite). Permethrin is a topical cream that contains chemicals that kill scabies mites and their eggs. It is generally considered safe for adults, pregnant women, and children ages 2 months and older.

• Crotamiton (Eurax). This medication is available as a cream or a lotion. It's applied once a day for two days. The safety of this medication hasn't been established in children, adults 65 and older, or women who are pregnant or nursing. Frequent treatment failure has been reported with crotamiton.

• Lindane lotion. This medication — also a chemical treatment — is recommended only for people who can't tolerate other approved treatments or for whom other treatments didn't work. This medication isn't safe for children younger than age 10 years, women who are pregnant or nursing, or anyone who weighs less than 110 pounds (50 kilograms).

• Ivermectin (Stromectol). Doctors may prescribe this oral medication for people with altered immune systems, for people who have crusted scabies, or for people who don't respond to the prescription lotions and creams. Ivermectin isn't recommended for women who are pregnant or nursing, or for children who weigh less than 33 pounds (15 kilograms).

Although these medications kill the mites promptly, you may find that the itching doesn't stop entirely for several weeks. Doctors may prescribe other topical medications, such as sulfur compounded in petrolatum, for people who don't respond to or can't use these medications.

Ivermectin, an oral medication, may be recommended for people who are immunocompromised, those with crusted scabies, or those who did not respond to topical therapy.

Ivermectin should not be used during pregnancy or while breastfeeding nor by children weighing less than 33 pounds.

Other medications, such as antihistamines, anti-itching lotions like Pramoxine lotion, antibiotics, and steroid creams might be prescribed to offer relief from symptoms.

Diagnosis

To diagnose scabies, your doctor examines your skin, looking for signs of mites, including the characteristic burrows. When your doctor locates a mite burrow, he or she may take a scraping from that area of your skin to examine under a microscope. The microscopic examination can determine the presence of mites or their eggs. A doctor can diagnose scabies by examining the skin or by looking at skin scrapings under a microscope.

home remedies

Itching may persist for some time after you apply medication to kill the mites. These steps may help you find relief from itching:

• Take antihistamines. At your doctor's suggestion, you may find that over-the-counter antihistamines relieve the allergic symptoms caused by scabies.

• Cool and soak your skin. Soaking in cool water or an oatmeal bath, 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.

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