Scabies is caused by a tiny mite that has infested humans for at least 2,500 years. It is often hard to detect, and causes a fiercely, itchy skin condition. Dermatologists estimate that more than 300 million cases of scabies occur worldwide every year. The condition can strike anyone of any race or age, regardless of personal hygiene. The good news is that with better detection methods and treatments, scabies does not need to cause more than temporary distress.
The human eye can barely see the microscopic mite that causes scabies. Being a tiny, eight-legged creature with a round body, the mite burrows in the skin. Within several weeks, the patient develops an allergic reaction causing severe itching; often intense enough to keep sufferers awake all night.
Human scabies is almost always caught from another person by close contact. It could be a child, a friend, or another family member. Everyone is susceptible. Scabies is not a condition only of low-income families and neglected children, although, it is more often seen in crowded living conditions with poor hygiene.
Attracted to warmth and odor, the female mite burrows into the skin, lays eggs, and produces toxins that cause allergic reactions. Larvae, or newly hatched mites, travel to the skin surface, lying in shallow pockets where they will develop into adult mites. If the mite is scratched off the skin, it can live in bedding for up to 24 hours or more. It may take up to a month before a person will notice the itching, especially in people with good hygiene and who bathe regularly.
The earliest and most common symptom of scabies is itching, especially at night. Little red bumps like hives, tiny bites, or pimples appear. In more advanced cases, the skin may be crusty or scaly.
Scabies prefers warmer sites on the skin such as skin folds, where clothing is tight, between the fingers or under the nails, on the elbows or wrists, the buttocks or belt line, around the nipples, and on the penis. Mites also tend to hide in, or on, bracelets and watchbands, or the skin under rings. In children, the infestation may involve the entire body including the palms, soles, and scalp. The child may be tired and irritable because of loss of sleep from itching or scratching all night.
Bacterial infection may occur due to scratching. In many cases, children are treated because of infected skin lesions rather than for the scabies itself. Although treatment of bacterial infections may provide relief, recurrence is almost certain if the scabies infection itself is not treated.
Crusted scabies s a form of the disease in which the symptoms are far more severe. Large areas of the body, like the hands and feet, may be scaly and crusted. These crusts hide thousands of live mites and their eggs, making treatment difficult because medications applied directly to the skin may not be able to penetrate the thickened skin. This type of scabies occurs mostly among the elderly, in some AIDS patients, or in people whose immunity is decreased and is extremely infectious.
Your dermatologist will do a thorough head-to-toe examination in good lighting, with careful attention to the skin crevices.
Many cases of scabies can be diagnosed without special tests by your dermatologist. To confirm scabies, your dermatologist can perform a painless test that involves applying a drop of oil to the suspected lesion. The site is then scraped and transferred to a glass slide, which is examined under a microscope. A diagnosis is made by finding scabies mites or their eggs.
Scabies is most common in those who have close physical contact with others, particularly children, mother of young children, sexually active young adults and elderly people in nursing homes.
Scabies among resident patients of nursing homes and extended care facilities has become a common problem due to delayed diagnosis since it can be mistaken for other skin conditions. The delay allows time for scabies to spread to nursing home staff and other residents. Because residents require assistance in daily living activities, this exposure provides an opportunity for the scabies to spread.
Successful eradication of this infestation requires the following: