How do you end up with them?

Just hearing the word “scabies” can make some people itchy. Most of us view it as a condition that affects people with poor hygiene. However, that’s not always the case. How do you get scabies? What can you do to treat an infection? How do you prevent spreading it?

Definition

Scabies is a skin condition that is caused by a microscopic, eight-legged mite (Sarcoptes scabiei). The female mite burrows just beneath the skin, making a tunnel where it deposits eggs. Eventually, the eggs hatch, and the larvae work their way to the surface of your skin. Once they mature, they can spread to other parts of your body or to others. This is why close physical contact and, in some cases, sharing clothing or bedding can result in the mites spreading to others.

The main symptom of scabies is itching, which results from an allergic reaction your body has to the mites, their eggs, and their waste. The itching can be severe and is usually worse at night. The other common sign is thin, irregular burrow tracks made of tiny blisters or bumps on the skin. While they can appear anywhere, they often appear in folds of skin. The most frequent locations include between the fingers, in the armpits, around the waist, along the insides of the wrists, on the inner elbows, on the soles of the feet, around the breasts, around the male genital area, on the buttocks, and on the knees. For infants and young children, the burrows show up on the scalp, palms of the hands, and sole of the feet. If you’ve had scabies before, symptoms can develop within a few days of exposure. However, if you’ve never been infected, it can take up to six weeks for them to begin. It’s vital to note that you can still spread scabies even if you don’t have any symptoms.

The main complication is the result of vigorous scratching. It’s a secondary bacterial infection, like impetigo. Impetigo is a superficial infection most often caused by staph (staphylococci) or strep (streptococci) bacteria. A severe form of scabies is crusted scabies (or Norwegian scabies) and can impact those with weakened immune systems, older people, and those who are already ill. It makes the skin crusty and scaly covering large areas of the body. It’s highly contagious and is hard to treat. The person with a typical scabies infection might have 10 – 15 mites, whereas a person with crusted scabies will have millions of mites.

Treatment

Treatment of a scabies infection involves medication, usually in the form of creams or lotions. Typically, you’ll need to apply it to your whole body from the neck down and leave it on for at least 8 – 10 hours. Some treatments need to be repeated a second time, and others need to be repeated if new burrows or a rash appear. Due to the contagious nature of the condition, your doctor will recommend that all household members and other close contacts be treated as well (even if they don’t show any signs of being infected).

Some commonly used medications are permethrin cream, ivermectin (oral medicine for those who don’t respond to other treatments, those with weakened immune systems, or those with crusted scabies), and crotamiton cream or lotion (not as effective). It’s important to note that while the medication kills the mites within a short period, the itching usually doesn’t go away for several weeks.

To help with this, there are things you can try. One option is soaking in cool water or an oatmeal bath. Another solution is applying a cool, wet washcloth to irritated areas of your skin. It can also be helpful to apply soothing lotion, like calamine lotion. As long as it’s been approved by your doctor, try over-the-counter antihistamines.

Prevention

The prevention techniques to keep mites from spreading to others or avoiding a re-infestation are the same. The first step is to wash all clothes, towels, and bedding used within three days before beginning treatment in hot, soapy water. Next, dry the linen with high heat. For items you can’t wash at home, have them dry-cleaned. Another option is to starve the mites. You can do this by placing items you can’t wash in a sealed plastic bag for a couple of weeks. After a few days without food, mites die.

Scabies isn’t something you want to have, but with the right treatment and time, the infection will go away. If you have any questions or concerns about scabies, please speak with your doctor. If you would like more information, please visit the Centers for Disease Control and Prevention’s scabies page at https://www.cdc.gov/parasites/scabies/index.html