Scabies: focus

Scabies is a skin infestation caused by mites, a small parasite. It causes intense itching and is a contagious disorder that can spread very rapidly, but can be resolved quickly and easily.

Description

Scabies causes intense itching and a rash that is characteristically worse at bed time when one lies down to sleep. It can therefore be much more bothersome at night than it is during the day.
As scabies is very contagious, treating it as soon as possible is important so as to prevent it from spreading to the entire household or to people with whom the sufferer comes into daily contact. For this reason, experts recommend treating anyone who may have been infected with the parasite. Infection occurs through direct physical contact or through the handling of personal items such as bedding or clothing.

Causes

The cause of scabies is Sarcoptes scabiei, a microscopic, eight-legged mite that burrows just under the skin where female mites deposit eggs. Three to four days after laying, the eggs hatch and the larvae rise to the surface of the skin, where they continue to develop. From here, the mites leave to colonize other areas of the skin or other people.

Symptoms

The allergic reaction triggered by the mites, their eggs and their waste causes an often intense itching that tends to worsen overnight. A rash of light blisters or pimples may accompany the itching, especially at the skin folds. The most affected areas of the body include the spaces between the fingers, armpits, the waist, the inside of the wrist, areas around the breasts and male genitals, and the buttocks. In children, the most affected areas are the scalp, face, neck, palms of the hands, and soles of the feet.

Diagnosis

A diagnosis of scabies involves a thorough examination of the skin by the doctor, who will look for signs of mites, including the tunnels it digs in the skin.
A doctor may take samples from the skin to observe under a microscope to definitively confirm the presence of the mite and its eggs.

Treatment

The treatment of scabies eliminates mites using medicine in the form of creams or lotions.

• Generally, the medicine should be applied all over the body in the evening and left on for at least eight hours.
• If itching recurs, a second application should be used.
• Due to the high contagiousness of the infestation, doctors may prescribe anti-scabies treatment to anyone who has come in contact with the patient even if they do not show symptoms.
• In cases of immune system deficiency, or a resistance to creams and lotions, oral medications might be prescribed.

After treatment, itching may still persist for some time. Wraps with astringent solutions and the application of Soothing Cream can be used to relieve any discomfort.
The most commonly used topical product is 30% Benzyl Benzoate in oil, which is applied for four consecutive evenings.
While 5% or 10% permethrin cream can also be used, mites have started showing resistance to this cream.
Ivermectin is prescribed orally.

Prevention

To prevent infection in the home, wash all clothing, linens and towels that could be contaminated. What cannot be washed at home should be dry cleaned. Alternatively, contaminated items that cannot be washed can be sealed in an airtight plastic bag for a couple of weeks.
Other prevention measures can include ensuring hotel bed sheets have been changed, avoiding sharing clothes and washing second-hand clothes before using them.