Scabies

What are scabies?
Scabies is a contagious skin disease caused by a mite (sarcoptes scabiei) which is becoming increasingly common for reasons which are unknown. Scabies spreads from person to person usually by close skin to skin contact or shared clothing or bed linen but it is now accepted that mites can pass by just standing close to the infected person. Mites are 0.1mm in diameter. The mite is disk-shaped, and pearly-white in colour with brown legs.

Causes
Scabies is transferred when fertilised female mites gnaw their way through the skin and create little passage ways in the process. In these passage ways, they lay their eggs and die. Approximately three weeks later the eggs hatch and a new generation of itch mites are ready to reproduce. It will also take about three weeks from the time of infection before the itch starts. It will make the victim scratch the skin day and night and can cause bleeding. Scabies is highly contagious - if you have close contact with a person infested with the scabies mite, your chances of catching it are fairly high. Crowded living conditions, close body contact - for instance, sleeping in the same bed - even holding hands for a while, can easily allow the mite to spread from one person to another.


Symptoms
The mite burrows into the skin, especially around the hands, feet, male genitalia, women's nipples and arm pits. It does not usually affect the neck and head, although it may in infants.

The itching is due to an allergic reaction to the tiny mites, and is associated with a rash of red, raised spots. The itch is worse at night, and may often affect more than one family member.

Diagnosis
If only one member of the family has a rash a diagnosis can often be missed as the scabie rash can look like other itchy conditions eg eczema. Diagnosis is often made clearer if more than one family member has an itchy rash. Sometimes burrows can be seen, especially near to the wrists.

Treatment
The treatment for scabies is simple and efficient. The medication can be bought without a prescription.

Permethrin. Is one of the best treatments to use in view of its relative safety, ease of application, and as it tends not to irritate the skin. A one-time application of permethrin (Nix®) cream or lotion to the skin cures scabies over 90% of the time. Sometimes a second application will be needed after a week. The whole body has to be cleaned (with warm water, not hot) and covered with the cream. Clean clothes should be put on during treatment - 12 to 14 hours - and then again after the cream has been washed off.
Benzyl benzoate emulsion. This is washed off after twenty four hours, and repeated two or three times. In infants or young children it is wise to dilute in two or three times as much water, as this helps reduce skin irritation.
Derbac. This is washed off after twenty four hours and should be repeated 7-10 days later.
When treating the problem the whole household and people that come in contact with the infected person should be treated at the same time and all beding, towels and clothing that has been worn should be washed immediately. If your child gets infected with scabies there is no reason why you should keep him/her off school once you have treated the problem. The mites die as soon as treated and can not be passed on. But you should let the schoool know that your child has scabies as soon as the diagnosis has been made.

Get special instructions from your doctor or pharmacist about how much cream infants or young children need. A small amount of permethrin can be absorbed through the skin, and might come out in breast milk. If you're pregnant or nursing, talk to your doctor about an alternative treatment.

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