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Scabies: Treatment, symptoms, advice and help

About Scabies

Scabies is a contagious skin infection that occurs among humans and animals. It is caused by a parasite—the mite Sarcoptes scabiei—which burrows under the host's skin, causing him or her to suffer intense itching.

Scabies: Incidence, age and sex

Scabies is one of the three most common skin disorders in children along with tinea and pyoderma. Scabies is more often seen in crowded areas with unhygienic living conditions. About 1–10% of the global population is estimated to be infected with scabies, but in certain populations, the infection rate may be as high as 50–80%.

Signs & symptoms of scabies: Diagnosis

Scabies is a condition characterized by small grey or red lines on the skin which are very itchy. The itch, or pruritus, may become more intense especially at night. Infected individuals may have numerous sores and scabs all over their bodies due to the constant scratching of the itchy burrows.

Diagnosis is made by identifying the scabietic burrow and by extracting the mite using a blunt needle. Involvement of the genital area in boys is pathognomonic. The main symptom is itch. The clinical features include secondary eczematisation elsewhere on the body. The face and scalp are never involved, except in the case of infants.

Causes and prevention of scabies

Scabies is caused by Sarcoptes scabies. Scabies spreads in households and environments where there is intimate personal contact. It is difficult to prevent scabies. If a person is known to have scabies, they should not have close skin-to-skin contact with others until they have been treated. If one member of a household has scabies, all other household members, sexual partners, and close contacts should be treated simultaneously. Mass treatment programmes that use topical permethrin or oral ivermectin have been effective in reducing the prevalence of scabies in a number of populations.

Scabies: Complications

These sores and scabs may get infected and start having pus after some time. Elderly and people, who have an impaired immune system, such as HIV and cancer sufferers or transplant patients on immunosuppressive drugs, are susceptible to crusted scabies: the mites, who spread over his or her body, except the face. Sufferers of crusted scabies exhibit scaly rashes, slight itching, and thick crusts of skin that contain thousands of mites.

Scabies: Treatment

Topical treatment of scabies is required for the affected individual and all asymptomatic family members/ physical contacts to ensure eradication. Two applications, one week apart of an aqueous solution of either permethrin or malathion to the whole body, excluding the head, are usually successful. If there is poor compliance, immune-compromise or heavy infestations (Norwegian scabies), systemic treatment with ivermectin (200µg/kg) as a single dose is appropriate.