Scabies is a disease of public health importance. It is a highly itchy skin disease caused by a mite. In this article, we will discuss what Scabies is, its signs and symptoms, diagnosis, prevention, and treatment.

What is Scabies Infection?

Scabies is a highly contagious skin condition caused by tiny mites known as Sarcoptes scabie, which burrow into the skin to lay their eggs. This results in intense itching, rashes, and discomfort. While scabies can affect anyone, regardless of age or hygiene, timely treatment can relieve symptoms and prevent further spread. In this article, we will cover the most common scabies symptoms, effective scabies treatment, and ways to prevent scabies from recurring or spreading. 

The mites live on the skin but can also burrow into the skin and live. They reproduce on the skin and if untreated, the scabies mites can live on the skin for months or years causing a highly itchy skin rash.

Scabies occurs worldwide. It is estimated to affect millions of people worldwide at every given time.  Scabies is not by any means an indication of poor hygiene. All races and social classes can be affected by scabies.

The commonly affected parts of the body are the area between the fingers, wrist, elbow, armpit, nipple, penis, waist, and buttocks. In children and immunocompromised adults, scabies can also affect the face, head, neck, hands, and soles of the foot.

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Mode of Transmission Of Scabies: How does one get infected by Scabies?

Scabies is transmitted through skin-to-skin contact with people affected by the disease. It is also sexually transmitted. The commonest means of spread of scabies among sexually active young adults is through sexual intercourse.

Scabies can also be transmitted through towels, underwear, clothing, or bedding that have been freshly contaminated by an infected person. This means of transmission is not very common. These scabies mites can only survive for 48 to 72 hours outside the human body.

It is important to note that since scabies is mostly transmitted via direct physical contact, the infestation can easily be passed on to friends, family members, and sexual partners.

Symptoms Of Scabies: How Does Scabies Present?

Before delving into scabies treatment, it’s essential to understand the symptoms of this condition to ensure that you can identify it early and seek treatment promptly.

1. Itching: The most prominent symptom of scabies is severe itching, which is often worse at night. The itching occurs due to the body’s allergic reaction to the mites, their eggs, and their waste products.

Scabies itching begins 2 to 6 weeks in freshly infected individuals but starts within 1 to 5 days in individuals previously exposed to scabies. This is called the incubation period of the illness.

2. Rash: A scabies rash usually appears as red bumps or blisters, often forming in the folds of the skin, such as the wrists, elbows, armpits, between the fingers, and around the waist. In some cases, the rash may look like small pimples or hives. Scabies rash appears as tiny bites, hives, bumps under the skin, or pimple-like bumps with the burrow tracks sometimes seen as red discolored lines on the skin.

3. Sores and Crusts: In severe cases, prolonged scratching can lead to sores and crusts. These sores may become infected, leading to additional complications such as bacterial infections.

4. Burrows: Scabies mites create tiny tunnels or burrows in the skin, which can be seen as thin, wavy lines on the surface of the skin. These burrows are often found on the hands, feet, and genital area.

5. Thickened Skin: In more advanced cases of scabies, especially in people with a weakened immune system, the skin may become thickened and scaly. This condition is called Norwegian scabies or crusted scabies, which is a more severe form of scabies. This form is also more contagious. It is common in immunocompromised individuals such as HIV/AIDS, people on steroids, etc. The scabies treatment here should be more aggressive.

6. Excessive or aggressive scratching can lead to sores. These sores can then get infected by bacteria.

How Scabies Spreads

Scabies is highly contagious, primarily spread through prolonged skin-to-skin contact. This makes it easy for the condition to spread within families, schools, nursing homes, and other close-knit environments. In rare cases, scabies can also spread through shared clothing, bedding, or towels.

Diagnosis Of Scabies

The diagnosis of scabies is mostly clinical. Your doctor can diagnose the illness by taking a history and doing a physical examination. Scabies diagnosis can be confirmed by examining skin scrapings for scabies mites with a microscope. Scabies is often mistaken for a fungal infection so ensure you see your doctor when you see the symptoms.

Scabies Treatment: How to Get Rid of Scabies?

The first line of treatment for scabies is usually a topical medication. These treatments include creams and lotions designed to kill the mites and their eggs. The main goal of Scabies treatment usually involves getting rid of the infestation with lotions, creams, and ointments (topical scabicides) which can be applied directly to the skin. Oral medications for Scabies Treatment (systemic scabicides) are also available. Over-the-counter medications are usually not effective in scabies treatment.

For simple scabies infestation, only the application of the cream or lotion will be enough. For more effective treatment of scabies, it is advised that you combine the topical scabicide with the systemic scabicide. Usually, a single dose of treatment is enough though symptoms may take some time to clear off completely.

In crusted or Norwegian scabies, treatment should be repeated after one week. In these cases, an oral Ivermectin should be taken along with the body cream.

Topical Scabies Treatment options:

The most common scabies creams include:

1. 5% Permethrin Cream: Permethrin is one of the most commonly prescribed treatments for scabies. It is a topical insecticide that kills the mites. The cream is applied to the skin from the neck down and left on for around 8-14 hours before washing it off. Permethrin is generally considered safe for adults and children over 2 months old.
2. 10% Crotamiton Lotion: Crotamiton is another option for scabies treatment. It works by relieving itching while also killing the mites. This lotion is typically applied to the skin for several consecutive days.
3. Sulfur Ointment: Sulfur is an older treatment but is sometimes recommended for infants, pregnant women, or individuals who cannot tolerate other medications. It is applied to the affected areas and is typically used over several days.
4. Others are: 1% lindane lotion, 10% sulfur ointment, 25% Benzyl benzoate lotion

If topical treatments are ineffective or if scabies is widespread, a healthcare provider may prescribe oral medications. The most common oral medication for scabies is Ivermectin.

Oral Medications / Systemic Treatment for Scabies.

Ivermectin: Ivermectin is an oral medication that is often prescribed for cases of severe scabies or scabies that do not respond to topical treatments. It works by killing the mites and their eggs. In some cases, a second dose is required to fully eradicate the infestation.

Other additional Medication in Scabies Treatment 

While the primary goal of scabies treatment is to eliminate the mites, managing the intense itching and any possible secondary bacterial infection of the wounds on the skin is also important.

Anti-Itch Treatments:

Common treatments for itching in scabies treatment include:

• Antihistamines: These can help reduce itching and promote sleep, especially when itching is worse at night.
• Topical Steroids: Hydrocortisone creams may be prescribed to reduce inflammation and itching.
• Calamine Lotion: This can be applied to soothe irritated skin.

Antibiotics: Treating Secondary Infections

In some cases, scratching scabies lesions can lead to bacterial infections. If this occurs, a doctor may prescribe antibiotics to treat the infection.

Some Home Remedies Used in Scabies Treatment

While prescription medications are generally the most effective way to treat scabies, some home remedies can help alleviate symptoms:

1. Tea Tree Oil

Tea tree oil is known for its antibacterial and anti-inflammatory properties, and some people find it helpful in managing itching and irritation associated with scabies. It can be diluted with a carrier oil and applied to the affected areas.

2. Aloe Vera

Aloe vera has soothing properties that can help calm inflamed skin and relieve itching. Apply fresh aloe vera gel directly to the rash for relief.

3. Coconut Oil

Coconut oil has moisturizing properties and may help soothe the skin. It can also be used to hydrate dry, flaky skin after the scabies treatment.

4. Oatmeal Baths

Soaking in an oatmeal bath can help soothe irritated skin and reduce itching. Use colloidal oatmeal, which is specially processed to be finely ground and dissolved in water.

Prevention of Scabies

Once scabies is treated and the symptoms are under control, it’s crucial to take steps to prevent the condition from spreading or recurring. The good thing about scabies is that we can prevent it. Scabies infection can be prevented by the following tips:

1. Avoid Close Contact: Since scabies is highly contagious, it’s essential to avoid close skin-to-skin contact with infected individuals. If you suspect you have scabies, it’s important to inform others who may be at risk.

2. Wash Bedding and Clothing: All clothing, bedding, and towels used by an infected person should be washed in hot water and dried on high heat. If washing is not possible, items can be sealed in a plastic bag for at least 72 hours to kill the mites.

3. Disinfect Personal Items: Disinfect items that may have come into contact with scabies, such as combs, brushes, and other personal care items. These should be thoroughly cleaned to prevent re-infestation.

4. Treat Close Contacts: Even if no symptoms are present, close contacts of someone with scabies should also be treated, as scabies can be spread before symptoms appear.

5. Keep Skin Clean and Moisturized: Keeping your skin clean and moisturized can help prevent scabies and other skin conditions. Regularly using a gentle soap and moisturizer will keep your skin in good condition.

6. Avoid Sharing Personal Items: Avoid sharing personal items such as towels, clothing, and bedding, as scabies can spread through indirect contact with these items.

When to See Your Doctor

While scabies is generally treatable with over-the-counter or prescription medications, you should see a healthcare provider if:

• You are unsure whether you have scabies.
• The rash or itching persists after treatment.
• Secondary bacterial infections develop from scratching the scabies lesions.
• The scabies condition worsens, such as the appearance of crusted lesions or thickened skin.

Conclusion

Scabies is a highly contagious condition that causes itching, rashes, and discomfort. If you experience symptoms, early treatment with the appropriate scabies treatment can help you get rid of the mites and prevent further complications. Whether through prescription creams, oral medications, or home remedies, effective scabies treatment can bring relief. Remember that prevention is key to avoiding the spread of scabies, so practice proper hygiene and take precautions to protect yourself and others from re-infestation.

By understanding the symptoms, treatments, and prevention methods of scabies, you can manage the condition and reduce the risk of spreading it to others. Always consult with a healthcare provider for personalized advice and Scabies treatment recommendations.