SCABIES

What is scabies?

Scabies is an itchy skin condition caused by the infestation of the Sarcoptes scabiei mite. This condition is contagious and spreads quickly from one person to another through direct skin contact. Diagnosis is typically made based on clinical examination, and effective treatment options are readily available for management.

What is cause of scabies?

The Scabies mite is a tiny eight-legged insect with a white-brownish color, often not visible to the naked eye. Female mites infest the skin and lay eggs within it. While the parent mite dies within 1-2 months, the hatched eggs give rise to new mites that surface on the skin, perpetuating the cycle. Research indicates that an individual with scabies typically harbors around 12 mites concurrently. Symptoms usually manifest around 3-4 weeks after infection. When not in contact with the skin, mites can survive for 24-36 hours, and in colder environments, they may persist a bit longer. This explains why scabies is more prevalent during winter compared to summer. Overcrowding also increases the risk of spread.

How is scabies spread?

Modes of transmission for scabies include:

• Close skin-to-skin contact (such as within families, where infection can spread easily).
• Sexual contact, particularly among young adults.
• Contact with objects or surfaces used by an infected person (like bedding or clothes).
• From pets (though the mite species affecting pets typically doesn't reproduce on human skin and resolves spontaneously in a few days).

Who can get infected?

The risk factors for scabies transmission include:

• Close family members of an infected person (such as siblings, parents, and children).
• Young adults, especially those who are sexually active.
• Healthcare staff and doctors working in nursing homes.
• Residents of extended care facilities.
• Patients with prolonged hospital stays.
• Individuals with compromised immune systems, particularly those with crusted scabies.

What are the symptoms of scabies?

Typical scabies

• Generalized itching, which intensifies in the evening or at night.
• Lesions are typically small red bumps, occasionally containing clear or pus-filled tops. Some lesions may also have scaling on the surface.
• Burrows (tunnel signs) may be visible in affected areas.
• Common sites of involvement include web spaces and fingers, skin folds like wrists, underarms, groin, behind knees, umbilicus, male genitalia (penis, scrotum), buttocks, thighs, and feet. The back and head are usually unaffected.

Scabies in children: it can involve whole body including head. Palm and sole may have clear fluid or pus filled skin bumps. Lesions are more in number in under arms. Babies become irritable and stay awake all night because of intense itching.

Crusted Scabies

• A severe variant of scabies, often seen in immunocompromised individuals.
• Characterized by large, crusted red patches and bumps on the skin.
• More commonly affects the scalp, hands, and feet.

How do dermatologists diagnose scabies?

Scabies is often diagnosed through clinical examination and medical history alone, which is usually adequate. However, in some cases, skin scraping from burrows can be examined under a microscope. The presence of eggs or mites in the scraping confirms the diagnosis.

How is scabies treated?

Treatment for scabies typically involves using insecticide to kill the mites, along with anti-itch medications. Additionally, measures are taken to prevent re-exposure. If the lesions become secondarily infected, oral antibiotics may be prescribed.

How to use anti scabies cream or lotion?

Here's a rewritten version of the points you provided:

• Apply the anti-scabies cream or lotion at night just before bedtime for optimal effectiveness.
• Taking a bath before applying the medication can enhance its effects.
• Both the patient and close contacts should apply the medicine on the same night.
• Adults should use about 30 grams of cream or lotion in one application, covering the entire body below the neck. Apply a bit more on common affected areas. Avoid washing hands immediately after application.
• Children can apply a lesser amount as needed to cover their entire body, including the head and face except for the eyes and mouth.
• Leave the medicine on the body for 6-8 hours overnight.
• Upon waking in the morning, the first step should be bathing to wash off the medication.
• Wash all clothing worn in the past 3-4 days.
• Expose bedding and furniture to sunlight if possible.