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Scabies

Definition

Scabies is an easily spread skin disease caused by a very small type of mite.

Alternative Names

Sarcoptes scabiei

Causes, incidence, and risk factors

Scabies is found  among people of all groups and ages around the world.

  • Scabies spread by skin-to-skin contact with another person has scabies.
  • Less often it can be spread by sharing clothes or bedding. Sometimes whole families are affected.

Outbreaks of scabies are more common in nursing homes, nursing facilities, college dorms, and child care centers.

The mites that cause scabies burrow into the skin and lay their eggs. This forms a burrow that looks like a pencil mark. Eggs hatch in 21 days. The itchy rash is an allergic response to the mite.

Pets and animals cannot spread human scabies. It is also not very likely for scabies to be spread by:

  • A swimming pool
  • Contact with the towels, bedding, and clothing of someone who has scabies, unless the person has what is called "crusted scabies"

Symptoms

  • Itching, most commonly at night
  • Rashes, mostly between the fingers
  • Sores (abrasions) on the skin from scratching and digging
  • Thin, pencil-mark lines on the skin

Mites may be more widespread on a baby's skin, causing pimples over the trunk, or small blisters over the palms and soles.

  • In young children, the infection may be on the head, neck, shoulders, palms, and soles of feet. 
  • In older children and adults, the infection may be on the hands, wrists, genitals, and abdomen.

Signs and tests

The doctor will examine your skin for signs of scabies. The doctor will look at scrapilngs taken from a burrow to look for the mites. A skin biopsy can also be done.

Treatment

HOME CARE

Before treatment, wash underwear, towels, and sleepwear in hot water.

Vacuum the carpets and upholstered furniture.

Use calamine lotion and soak in a cool bath to ease itching.

Take an oral antihistamine if your doctor recommends it for very bad itching.

MEDICINES FROM YOUR HEALTH CARE PROVIDER

The whole family or sexual partners of infected people should be treated, even if they do not have symptoms.

Creams prescribed by your health care provider are needed to treat scabies.

  • The cream most often used is permethrin 5%.
  • Other creams include benzyl benzoate, sulfur in petrolatum, and crotamiton.
  • Lindane is rarely used because of its side effects.

Apply the medicine all over your body. Creams may be used as a one-time treatment tor they may be repeated in 1 week. 

For hard to treat cases, your health care provider may also prescribe a pill known as Ivermectin.

 

Expectations (prognosis)

Itching may continue for 2 weeks or more after treatment begins. It will disappear if you follow your health care provider's treatment plan.

Most cases of scabies can be cured without any long-term problems. A severe case with a lot of scaling or crusting may be a sign that the person has a disease such as HIV.

Complications

Intense scratching can cause a secondary skin infection, such as impetigo.

Calling your health care provider

Call your health care provider if:

  • You have symptoms of scabies
  • A person you have been in close contact with has been diagnosed with scabies

References

Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2009:chpat 15.

Diaz JH. Scabies. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2009:chap 294.


Review Date: 11/20/2012
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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