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Scabies

Human scabies; Sarcoptes scabiei

 

Scabies is an easily-spread skin disease caused by a very small mite.

Causes

 

Scabies is found among people of all groups and ages around the world.

  • Scabies spread by skin-to-skin contact with another person who has scabies.
  • Scabies is easily spread among people who are in close contact. Whole families are often affected.

Outbreaks of scabies are more common in nursing homes, nursing facilities, college dorms, and child care centers.

The mites that cause scabies burrow into the skin and lay their eggs. This forms a burrow that looks like a pencil mark. Eggs hatch in 21 days. The itchy rash is an allergic response to the mite.

Pets and animals usually do not spread human scabies. It is also not very likely for scabies to be spread through swimming pools.

A type of scabies called crusted (Norwegian) scabies is a severe infestation with very large numbers of mites. People whose immune systems are weakened are most affected.

 

Symptoms

 

Symptoms of scabies include:

  • Severe itching, most often at night.
  • Rashes, mostly between the fingers and toes, undersides of the wrists, arm pits, women's breasts, buttocks.
  • Sores on the skin from scratching and digging.
  • Thin lines (burrow marks) on the skin.
  • Babies will likely have a rash all over the body, especially on the head, face, and neck, with sores on the palms and soles.

 

Exams and Tests

 

The health care provider will examine the skin for signs of scabies.

Tests that may done include:

  • Scraping the skin burrows to remove mites, eggs, or mite feces to examine under the microscope.
  • In some cases, a skin biopsy is done.

 

Treatment

 

HOME CARE

  • Before treatment, wash clothes and underwear, towels, bedding and sleepwear in hot water and dry at 140°F (60°C) or higher. Dry cleaning also works. If washing or dry cleaning can't be done, keep these items away from the body for at least 72 hours. Away from the body, the mites will die.
  • Vacuum carpets and upholstered furniture.
  • Use calamine lotion and soak in a cool bath to ease itching.
  • Take an oral antihistamine if your provider recommends it for very bad itching.

MEDICINES FROM YOUR HEALTH CARE PROVIDER

The whole family or sexual partners of infected people should be treated, even if they do not have symptoms.

Creams prescribed by your provider are needed to treat scabies.

  • The cream most often used is permethrin 5%.
  • Other creams include benzyl benzoate, sulfur in petrolatum, and crotamiton.

Apply the medicine all over your body. Creams may be used as a one-time treatment or they may be repeated in 1 week.

For hard to treat cases, the provider may also prescribe a pill known as ivermectin as a one-time dose.

 

Outlook (Prognosis)

 

Itching may continue for 2 weeks or more after treatment begins. It will disappear if you follow the provider's treatment plan.

Most cases of scabies can be cured without any long-term problems. A severe case with a lot of scaling or crusting may be a sign that the person has a weakened immune system.

 

Possible Complications

 

Intense scratching can cause a secondary skin infection, such as impetigo.

 

When to Contact a Medical Professional

 

Call your provider if:

  • You have symptoms of scabies.
  • A person you have been in close contact with has been diagnosed with scabies.

 

 

References

Diaz JH. Scabies. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 295.

Tucker WFG, Powell JB. Scabies. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 215.

 
  • Scabies rash and excoriation on the hand

    Scabies rash and excoriation on the hand - illustration

    Rash and open scratches from a scabies infection. (Image courtesy of the Centers for Disease Control and Prevention.)

    Scabies rash and excoriation on the hand

    illustration

  • Scabies mite, photomicrograph

    Scabies mite, photomicrograph - illustration

    This is a photomicrograph of the scabies mite. This animal burrows in the skin, depositing both eggs and feces. Scabies infestation causes intense itching (pruritus) which leads to scratching and damage of the skin (excoriation). The infestation may last for years without treatment and has been called the "seven year itch".

    Scabies mite, photomicrograph

    illustration

  • Scabies mite, photomicrograph of the stool

    Scabies mite, photomicrograph of the stool - illustration

    This is a photomicrograph of scabies feces in skin scrapings. This material is thought to cause an allergic-type reaction which may be responsible for the intense itching. The itching may persist long after the scabies mites are killed because the dead eggs and mite feces remain in the skin.

    Scabies mite, photomicrograph of the stool

    illustration

  • Scabies mite, photomicrograph

    Scabies mite, photomicrograph - illustration

    This is a highly-magnified photograph of the mite that causes scabies.

    Scabies mite, photomicrograph

    illustration

  • Scabies mite, photomicrograph

    Scabies mite, photomicrograph - illustration

    This is a photomicrograph of the scabies mite. They burrows into the skin, depositing both eggs and feces. A scabies infestation causes intense itching (pruritus) which leads to scratching and damage of the skin (excoriation). If left untreated, the infestation may last for years, and has been called the "seven year itch".

    Scabies mite, photomicrograph

    illustration

  • Scabies mite, eggs, and stool photomicrograph

    Scabies mite, eggs, and stool photomicrograph - illustration

    This is a photomicrograph of a skin scraping that contains a scabies mite, eggs, and feces. This animal burrows into the skin, depositing both eggs and feces. A scabies infestation causes intense itching (pruritus) which leads to scratching and damage of the skin (excoriation). If left untreated, the infestation may last for years, and has been called the "seven year itch".

    Scabies mite, eggs, and stool photomicrograph

    illustration

    • Scabies rash and excoriation on the hand

      Scabies rash and excoriation on the hand - illustration

      Rash and open scratches from a scabies infection. (Image courtesy of the Centers for Disease Control and Prevention.)

      Scabies rash and excoriation on the hand

      illustration

    • Scabies mite, photomicrograph

      Scabies mite, photomicrograph - illustration

      This is a photomicrograph of the scabies mite. This animal burrows in the skin, depositing both eggs and feces. Scabies infestation causes intense itching (pruritus) which leads to scratching and damage of the skin (excoriation). The infestation may last for years without treatment and has been called the "seven year itch".

      Scabies mite, photomicrograph

      illustration

    • Scabies mite, photomicrograph of the stool

      Scabies mite, photomicrograph of the stool - illustration

      This is a photomicrograph of scabies feces in skin scrapings. This material is thought to cause an allergic-type reaction which may be responsible for the intense itching. The itching may persist long after the scabies mites are killed because the dead eggs and mite feces remain in the skin.

      Scabies mite, photomicrograph of the stool

      illustration

    • Scabies mite, photomicrograph

      Scabies mite, photomicrograph - illustration

      This is a highly-magnified photograph of the mite that causes scabies.

      Scabies mite, photomicrograph

      illustration

    • Scabies mite, photomicrograph

      Scabies mite, photomicrograph - illustration

      This is a photomicrograph of the scabies mite. They burrows into the skin, depositing both eggs and feces. A scabies infestation causes intense itching (pruritus) which leads to scratching and damage of the skin (excoriation). If left untreated, the infestation may last for years, and has been called the "seven year itch".

      Scabies mite, photomicrograph

      illustration

    • Scabies mite, eggs, and stool photomicrograph

      Scabies mite, eggs, and stool photomicrograph - illustration

      This is a photomicrograph of a skin scraping that contains a scabies mite, eggs, and feces. This animal burrows into the skin, depositing both eggs and feces. A scabies infestation causes intense itching (pruritus) which leads to scratching and damage of the skin (excoriation). If left untreated, the infestation may last for years, and has been called the "seven year itch".

      Scabies mite, eggs, and stool photomicrograph

      illustration


     

    Review Date: 10/9/2015

    Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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