It was a quiet Sunday morning, and the usual chatter of families filled the local park. Parents watched their children play while catching up on neighborhood gossip. I had decided to join the gathering to share some health tips with the community. Little did I know, this casual visit would turn into an important discussion about a condition that often gets overlooked – scabies.
While sipping tea under a tree, Kavita, a mother of two energetic toddlers, approached me with a worried look. “Dr. Priya, can I ask you something? My son Arjun has been scratching his hands incessantly. He has this red, bumpy rash, and it seems worse at night. Could it just be an allergy?”
I invited Kavita to sit down, and as she described Arjun’s symptoms, I realized it sounded like a classic case of scabies.
What is Scabies?
“Scabies is a highly contagious skin infestation caused by a tiny mite called Sarcoptes scabiei,” I explained to Kavita. “These mites burrow just beneath the skin to lay their eggs. The eggs hatch into tiny mites that spread over the skin and live for about 30 days. They cause an allergic reaction that leads to intense itching and a rash.”
Kavita looked surprised. “I had no idea such tiny creatures could cause so much trouble!”
How is Scabies Spread?
“Scabies spreads through close personal contact, like skin-to-skin contact,” I continued. “This includes situations like cuddling, sitting close to someone, or sharing bedding and clothes. While sexual contact is also a common mode of transmission among adults, scabies can spread easily within families, especially in crowded living conditions.”
Kavita’s concern grew. “Does that mean the rest of us could have it too?”
I nodded. “It’s possible. Scabies is very contagious, and it’s important to treat the whole family, even if only one person has symptoms.”
What Are the Symptoms of Scabies?
Kavita listened intently as I described the symptoms:
- Intense itching: Especially at night, when it can become unbearable.
- A red, bumpy rash: Common on the hands and wrists. Other areas include the armpits, elbows, waistline, nipples in females, feet, and ankles.
- Tiny burrows: In some cases, small wavy lines can be visible where the mites burrow under the skin.
Kavita added, “Arjun’s rash is mainly on his hands and wrists, but I’ll check the rest of his body too.”
Image courtesy wikipedia
Where Does Scabies Occur?
I explained, “Scabies usually occurs on the hands and wrists, but it can also affect the armpits, elbows, waistline, nipples, feet, and ankles. In some cases, it appears on the genital area, buttocks, or other folds of the skin.”
How is Scabies Diagnosed?
“A diagnosis is usually made based on symptoms and the appearance of the rash,” I said. “But to confirm, your doctor may examine the rash under a microscope to identify the mites or their eggs. The burrows are a key indicator.”
What is the Treatment for Scabies?
“Treatment involves topical medications to kill the mites,” I explained.
Topical Medications:
- Permethrin 5% cream: Safe for all ages except children under 6 months.
- Benzyl benzoate 25% solution: Diluted in water, this is used for children under 6 months.
How to Apply:
- Apply the cream or lotion to the entire body, from the jawline down to the soles of the feet and the tips of the toes.
- Treat all areas, including under the nails and between the fingers and toes. For genital scabies, ensure the cream reaches the affected areas.
- Avoid the eyes, nose, and mouth.
- Leave the treatment on for a minimum of 8 hours (overnight) before washing it off. For treatment failures, leave benzyl benzoate on for 24 hours.
How Often?
“The treatment should be repeated in a week to ensure that all mites and eggs are eradicated,” I added.
Clothing and Bedding
“You’ll also need to treat your home,” I emphasized. “Wash all clothing, bedding, and towels in hot water and dry them on a hot setting. Items that cannot be washed should be sealed in a plastic bag for at least 72 hours to kill any remaining mites.”
Kavita took notes as I continued, “Spray pillows, mattresses, and other soft articles with insect spray. And remember, even if others in the family don’t have symptoms, everyone should be treated at the same time to prevent reinfestation.”
Additional Notes:
- Sexual partners should be treated.
- Itching may continue for some time even after successful treatment, but this doesn’t mean the infestation is still present. Your doctor may prescribe an anti-itch cream if needed.
- Repeat treatments may be necessary, so follow up with your doctor if symptoms persist.
A Follow-Up with Kavita
Two weeks later, Kavita returned to the park with a smile. “Dr. Priya, Arjun is doing so much better. The itching is gone, and the rash is clearing up. Thank you for your advice!”
I smiled, relieved to hear the good news. “I’m glad to help. Scabies can be tough, but with the right treatment and precautions, it’s entirely manageable.”
FAQs About Scabies
How long does scabies last after treatment?
itching may persist for up to 2 weeks. This doesn’t mean the mites are still alive; it’s an allergic reaction to their remains. Consult your doctor if itching continues beyond this period.
Can scabies spread without close contact?
Scabies is primarily spread through prolonged skin-to-skin contact. However, it can also spread through infested bedding, clothing, or towels, though this is less common.
How can I prevent scabies from spreading at home?
To prevent scabies from spreading, wash all clothes, bedding, and towels in hot water and dry them on high heat. Seal unwashable items in plastic bags for at least 72 hours. Treat all family members simultaneously.
Can pets carry scabies?
No, pets cannot carry the type of scabies that affects humans. However, there is a different type of mite that can affect animals. Consult a veterinarian for pet-related concerns.
Is scabies a sign of poor hygiene?
No, scabies is not related to hygiene. It can affect anyone, regardless of cleanliness, and is more common in crowded living conditions.
Can scabies return after treatment?
Yes, reinfestation can occur if contact with untreated individuals or contaminated items continues. Ensure everyone in close contact is treated and follow cleaning guidelines thoroughly.