Scabies is a common skin problem caused by a mite that acts as a parasite. People of different ages, ethnicities and social groups can get scabies, regardless of their personal hygiene.
How scabies is spread
The scabies parasite is transmitted by skin-to-skin contact and digs tunnels in the patient’s skin. Through these tunnels it feeds and lays eggs. It should be noted that it lives only in the upper layers of the skin and does not penetrate the bloodstream or other organs. After a few weeks, the patient manifests an allergic reaction which causes the typical intensely itchy rash of scabies.
How scabies presents
The rash may appear as pimples, hives, blisters or in the form of scaly or crusted nodules and can affect any area of the body. Even so, lesions are more frequent on the hands, feet, armpits, umbilical region and genitals. If the patient is under two years of age, the lesions may appear anywhere on the body. However, the scabies rash is usually more intense in the elderly or in people with a weakened immune system.
The itching and rash can be mild or very intense, depending on how the immune system responds to the mite. Each patient may have a different reaction, so some people may carry the parasite and have no itching or rash. It is not uncommon to observe that only one or two people in a household have the rash, even though everyone has been exposed to the mite. In any case, it is important to treat everyone who has been in contact with the parasite, not just the people with the rash.
How to diagnose scabies
The dermatologist can diagnose scabies by a careful examination of the skin. In some cases, a skin scraping is performed in order to locate the parasite under a microscope.
Topical treatment of scabies
There are different medications to treat scabies. Permethrin 5% cream is the most common treatment for most patients. The ointment needs to be applied over the entire skin surface, from the neck to the toes, ensuring that the crease areas and spaces between the toes are well covered. Scabies does not usually affect the face, so this area is not usually treated. However, the exception is children under two years of age, for whom application of the cream to the whole body is recommended. The ointment is left on the skin overnight and the next morning it is removed by showering or bathing. The same treatment should be repeated after one week.
Other creams and oral medications, such as ivermectin, may be used in special situations, although such treatments are not always suitable for children or pregnant women.
Your doctor may also prescribe other creams or oral medications to help soothe itching and skin irritation. The itching and rash may persist for several weeks, but if the patient notices the appearance of new bumps after a month of treatment, he or she should visit the doctor again. In addition to the person with the rash, treatment should be performed on all family members and close contacts. All should be treated at the same time to avoid reinfestation.
The mite lives on the skin, but can also survive outside the body on clothing or bed linens. This is why careful cleaning of clothing, towels, carpets, sofa covers or bedding, among others, is necessary.
Steps to follow for a proper treatment of scabies
– Follow the medication instructions carefully.
– Repeat treatment in 7 days
– Treat all close contacts and household members
– Treat everyone at once
– Washing clothes, bed covers and towels using hot water
– Items that cannot be washed can be decontaminated by dry-cleaning or placed in a closed plastic bag for at least 72 hours
– Vacuum carpets, furniture, car seats and baby strollers.
– Fumigation is not necessary
– Pets do not need to be treated (human scabies does not affect them).