Scabies Causes, Symptoms, and Treatments: Everything You Need to Know

Introduction 

Scabies causes, symptoms, and treatments are important to know for anyone dealing with this contagious skin condition. Scabies is caused by tiny mites that burrow into the skin, leading to severe itching and rashes. Understanding the causes and recognizing the symptoms can help you seek the right treatments quickly. Whether you’re experiencing scabies or looking to prevent it, knowing about scabies causes, symptoms, and treatments is essential for effective care and management.

What is Scabies?

Scabies is a highly contagious skin condition caused by the Sarcoptes scabiei mite, a microscopic parasite that burrows into the skin, After 3 to 4 days, the mite larvae emerge and move to the skin’s surface, where they grow into adult mites. This infestation leads to symptoms like severe itching, especially at night, and a rash that may appear as small pimples (papules) or blisters. The condition spreads rapidly in crowded environments like hospitals, nursing homes, and childcare facilities. “It affects individuals of all ages and can be challenging to resolve without timely solutions.

Symptoms of Scabies

The main symptoms of scabies include:

• Severe itching, often worse at night.
• Red bumps or blisters (papules) that may cluster together.
• Burrow tracks: Thin, irregular lines on the skin where the mites burrow.
• Crusted patches of skin in more severe cases, such as Crusted Scabies (Norwegian scabies).

Commonly affected areas include:

• Hands (between the fingers)
• Elbows
• Waistline
• Buttocks
• In children: the head, neck, and soles of the feet

        Red bumps or blisters on hands

                       Crusted Scabies

                         In children

                  Burrow track

What is Crusted Scabies?

Crusted scabies are a severe form of infection, often seen in people with weakened immune systems. It presents as thick, crusty patches of skin that harbor large numbers of mites. Immediate treatment is essential to prevent widespread outbreaks in communal environments.

How Scabies Spreads

Scabies is highly contagious and spreads through:

1. Direct skin-to-skin contact with an infected person, including holding hands or sexual contact.
2. Indirect contact via shared personal items like towels, bedding, or clothing.

In settings where people live in close quarters, such as schools or care homes, scabies can cause outbreaks that spread rapidly without immediate action.

Diagnosis and Treatment for Scabies

If you suspect you have scabies, seek medical attention for proper diagnosis and treatment. Diagnosis typically involves a physical exam, and in some cases, a skin scraping to detect the presence of mites or eggs under a microscope.

Effective Treatments for Scabies:

1. Prescription Creams/Lotions:

   Permethrin cream (5%):

   • Applied over the entire body from neck down, and washed off after 8-14 hours. 
   • Mechanism of Action (MOA) of permethrin: Permethrin disrupts the sodium ion channels in the nerve cells of parasites, specifically lice and scabies mites. By binding to these sodium channels, it prolongs sodium influx into nerve cells, which causes repetitive, uncontrolled nerve firing.
   • Malathion (0.5%): Commonly used in cases resistant to other treatments.
   • Mechanism of Action (MOA) of Malathion: Malathion works by inhibiting acetylcholinesterase (AChE), an enzyme necessary for breaking down acetylcholine, a neurotransmitter. This inhibition causes acetylcholine buildup at nerve endings, leading to continuous stimulation of the nerve cells.
2. Oral Medications:
   • Ivermectin: An oral medication prescribed for severe or widespread scabies, especially in Crusted Scabies cases, Dosage is typically 200 mcg/kg, repeated in 7-14 days.
   • Mechanism of Action (MOA) of Ivermectin: works by binding to glutamate-gated chloride channels in parasites, causing hyperpolarization and paralysis, which ultimately leads to their death.

3. Antihistamines/Corticosteroids:

   • These are used to relieve itching and reduce skin inflammation during the treatment process.

                 Ivermectin Cream

       Malathion 0.5% liquid

                  Permethrin 5% w/w cream

Important: Ensure that all household members and close contacts are treated simultaneously to prevent reinfestation, even if they don’t show symptoms.

How to Prevent Scabies Outbreaks

Preventing the spread of scabies is critical. Follow these steps:

1. Avoid direct contact with infected individuals until they have completed treatment.
2. Wash bedding, clothing, and towels in hot water (at least 60°C) and dry them on high heat.
3. Vacuum carpets, furniture, and other surfaces to eliminate any mites that might have transferred from the skin.
4. If you suspect an outbreak in a communal environment (e.g., daycare or elderly care home), contact a healthcare professional immediately for proper containment measures.

FAQs About Scabies

1. Can scabies go away on its own?
No. infection will not go away without treatment. You need to use prescription medications, either topically or orally, to kill the mites and prevent them from laying more eggs.

2. How long is scabies contagious?
Scabies is contagious until all mites and eggs are eradicated. After treatment, you can remain contagious for 24-48 hours until the mites die off completely. Make sure all close contacts are treated simultaneously to prevent re-infestation.

3. What if symptoms persist after treatment?
If your symptoms persist or return after treatment, consult your healthcare provider. You may need a second round of medication, or there may have been a re-infestation.

Related Resources:

• Centers for Disease Control and Prevention. (2023). Scabies. Retrieved from https://www.cdc.gov/parasites/scabies
• World Health Organization. (2023). Scabies Fact Sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/scabies
• Mayo Clinic. (2023). Scabies: Symptoms and Causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/scabies
• National Health Service. (2023). Scabies Overview. Retrieved from https://www.nhs.uk/conditions/scabies/
• DermNet NZ. (2023). Scabies. Retrieved from https://dermnetnz.org/topics/scabies/