Scabies Treatment

Scabies treatments

For scabies treatment, doctors typically prescribe topical ointments, creams, or lotions, while oral medications may also be prescribed in some cases.

The medication is typically applied at night, as the mites are most active then, maximizing treatment effectiveness.

It's usually necessary to treat the entire body from the neck down, and the medication can be washed off the next morning. This process is often repeated for several days or weeks. Common medications for scabies include:

Derbac M (malathion) lotion. 5% permethrin cream, 25% benzyl benzoate lotion, 10% sulfur ointment, 10% crotamiton cream, and 1% Lindane lotion, Oral ivermectin

PATIENT INFORMATION LEAFLET SCABIES

About scabies

Scabies is a parasitic skin infestation caused by the tiny mite called Sarcoptes scabiei var. Hominis. These mites burrow into the outer layers of human skin and lay eggs, leading to intense itching and a red, bumpy rash.

Scabies spread primarily through close skin contact with someone who has it. It's more common in poor tropical areas, and children and older adults in these areas are at higher risk.

The most common symptoms include unbearable itching, especially at night when the mites are more active, and the development of small, red, raised bumps. The infestation typically affects areas like fingers, wrists, elbows, and the groin.

It can also make your skin sore and, in rare cases, lead to secondary infections. Doctors treat it with topical creams/lotion or pills.

Scabies mites

The scabies mite, scientifically known as Sarcoptes scabiei var. hominis, is a tiny arachnid causing scabies in humans.

It belongs to the Acarina group, alongside other tiny creatures like ticks and dust mites. Within Acarina, scabies mites fall into the categories of Astigmata and Sarcoptidae.

These mites, invisible without a microscope, they feed by using their mouthparts and front legs to burrow into the outer layer of your skin (epidermis).

Scabies mites life cycle with four stages:

Scabies mites burrow into the top layer of the skin, where the adult female lays eggs. The eggs hatch in 3–4 days, developing into adult mites in 1–2 weeks. Allergic reactions to mite proteins and feces in the burrow cause intense itch and rash after 4–6 weeks.

Larvae: The journey begins with larvae, tiny six-legged creatures that hatch from eggs laid by adult female mites.

Nymphs: After a short period as larvae, they molt into nymphs, which are still relatively small but now have eight legs.

Adults: Nymphs mature into adult mites, also with eight legs. Adult female mites burrow into the skin to create tunnels where they lay eggs.

Eggs: The eggs laid by adult female mites hatch into larvae, completing the life cycle in a few weeks.

How do Scabies mites spread?

Scabies mites primarily spread through close and prolonged skin contact. However, it's also possible—although rare—for scabies to spread by sharing clothing, towels, and bedding with someone who is infected.

Although they can survive off the body for a short time, they need the warmth and moisture of human skin and quickly die without it. This means they can't easily move to new people and require direct, prolonged contact for transmission.

Types of scabies

There's only one type of tiny mite, Sarcoptes scabiei var. hominis, that causes scabies in people. However, it can lead to different types of scabies with varying severity and symptoms.

Classic Scabies: This is the most common type, causing intense itching on the hands, wrists, elbows, and between fingers.

Nodular Scabies: This type creates itchy, raised bumps or lumps, especially around private areas, armpits, or the groin.

Crusted Scabies: This is a more serious and highly contagious form of scabies, also known as Norwegian scabies. It creates thick crusts on the skin containing large numbers of mites and eggs.

People with weakened immune systems, like those living with HIV, using certain medications (such as some for rheumatoid arthritis), or undergoing chemotherapy, are more susceptible to developing crusted scabies.

Where do scabies appear the most?

Scabies can occur on various parts of the body, and the common areas where the infestation is often found include:

• Wrists
• Between the fingers
• Folds of the armpit
• Elbow creases
• Groin area
• Nipple
• Penis
• Creases of the buttocks

Most challenging facts about scabies?

Scabies can be problematic for several reasons, and the most challenging aspects include:

Intense Itching: The persistent and intense itching, especially at night, can significantly impact one's quality of life and disrupt sleep.

Contagious Nature: Scabies are highly contagious and easily spread through close personal contact, making it challenging to control outbreaks, especially in crowded environments.

Diagnostic Challenges: Figuring out if you have scabies can be tricky because they look different for everyone and can seem like other skin problems. This might make it take longer to get the right treatment.

Treatment Resistance: In some cases, scabies mites may develop resistance to certain treatments, requiring adjustments in the therapeutic approach.

Impact on Vulnerable Populations: Scabies is more prevalent in low-income tropical areas, affecting vulnerable populations such as children and older individuals. This can make health differences worse and make it harder to fix the problem.

Complications and Secondary Infections: Scratching the itchy rash can lead to open sores, increasing the risk of bacterial infections. In severe cases, complications such as cellulitis or impetigo may occur.

Psychological Impact: Persistent itching and visible skin manifestations can have a psychological toll, causing stress, anxiety, and discomfort for individuals dealing with scabies.

How to prevent Scabies?

Dealing with scabies needs a good plan, like getting the right treatment, and making sure it doesn't spread around too much.

To avoid getting scabies, it's important to keep a few simple steps in mind. First, always wash your hands and stay clean.

Try to avoid touching your skin too much with others, especially if someone you know has scabies. Don't share clothes, towels, or bedding with someone who has scabies, and make sure to wash your things like clothes and bedding in hot water to kill any mites.

If someone in your home has scabies, they should get treated right away to stop it from spreading. And don't forget to let people close to you know if you have scabies so they can take steps to stay healthy too.

Keeping your living space clean, including furniture and carpets, is also important to make sure those pesky mites don't stick around.

Sources

https://www.ncbi.nlm.nih.gov/books/NBK544306/

https://www.who.int/news-room/fact-sheets/detail/scabies

https://www.nhs.uk/conditions/scabies/

https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/scabies/

https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-scabies-overview

https://www.nhs.uk/conditions/impetigo/

The mites responsible for causing scabies are tiny parasites (an organism – a parasite that lives

on or inside another organism – the host) smaller than a pinhead, scientifically known as Sarcoptes scabiei var. hominis.

The mites burrow into the outer layer of the skin, where they lay eggs, and trigger an allergic reaction, leading to the characteristic symptoms of intense itching and a rash.

The mites are primarily transmitted through close personal contact (sexual activity) with an infected person, and occasionally through shared clothing, towels, or bedding.

People with scabies usually have around 10-12 adult mites on or in their skin, although some may carry more.

Scabies is easily spread between individuals, but it is not caused by a lack of cleanliness.

In rare cases, a severe form called 'crusted scabies' occurs in individuals with a weakened immune system or those who are elderly and ill. This variant is highly contagious, with thousands of mites on the skin.

It's important to note that scabies in animals are referred to as 'mange,' caused by a different type of mite that cannot live on or in humans.

Advice for Topical Scabies Medication

When using skin treatments for scabies, put the medicine on ALL of your skin, not just the itchy parts. The mites could be anywhere, so covering all areas ensures better treatment. Follow the instructions carefully for effective use.

Several treatments are available including topical (applied to the skin) and oral (tablets), such as:

Derbac M liquid (malathion 5%). 5% permethrin cream, 25% benzyl benzoate lotion, 10% sulfur ointment, 10% crotamiton cream, and 1% Lindane lotion, Oral ivermectin

When someone is infested with scabies, the symptoms typically develop after an incubation period, which is the time between initial exposure to the mites and the onset of noticeable signs.

If you've had scabies before, the itching usually starts within 1 to 4 days because your body recognizes the mites and reacts quickly.

However, if it's your first time getting scabies, your immune system needs more time—about 2-6 weeks—to react and show symptoms like itching and skin problems.

So, how fast you notice the signs depends on whether your body has dealt with these tiny mites before.

The symptoms of scabies include:

• Intense itching particularly worsened at night.
• Itchy lines (linear burrows) and bumps (papules) on fingers, wrists, arms, legs, and the belt area.
• Inflamed bumps on male genitalia and female breasts.
• Larger rash in infants and small children, appearing on the palms, soles of the feet, ankles, and scalp.
• Typically, most individuals are infected with 10–15 mites.