Scabies is a highly contagious skin infestation caused by the mite Sarcoptes scabiei. These tiny mites burrow into the skin, causing intense itching and a characteristic rash. Scabies spreads easily through close skin-to-skin contact and is common in crowded living environments.
Cause
Scabies is caused by the female scabies mite, which burrows under the skin to lay eggs. The itching is due to an allergic reaction to the mites and their waste products.
How Scabies Spreads
- Direct skin contact (most common)
- Sharing clothes, towels, or bedding
- Prolonged close contact in families, hostels, prisons, or nursing homes
Symptoms of Scabies
- Severe itching, especially at night
- Small red bumps or blisters
- Burrow tracks—thin, wavy lines on the skin
- Rash between fingers, wrists, elbows, waist, and buttocks
- Secondary bacterial infections due to scratching
Diagnosis
- Clinical examination of typical rash
- Skin scraping under microscope to identify mites or eggs
- History of close contacts with similar symptoms
Treatment of Scabies
1. Topical Medications (First-line)
- Permethrin 5% cream – applied neck to toe, left overnight
- Benzyl benzoate lotion
- Sulfur ointment (safe in infants and pregnancy)
2. Oral Treatment
- Ivermectin – single dose, repeated after 7–14 days
Used in severe cases, outbreaks, or when topical therapy fails.
Treatment Guidelines
- Treat all household members at the same time
- Wash clothes, towels, and bedding in hot water
- Items that cannot be washed should be sealed in a bag for 3 days
- Hydrocortisone cream may be used for itching (after treatment)
Complications
- Secondary bacterial infections (impetigo)
- Crusted scabies in immunocompromised individuals
- Intense scratching leading to skin damage
Prevention
- Avoid close contact with infected individuals
- Do not share clothing or bedding
- Maintain personal hygiene
- Early treatment reduces the risk of outbreaks
Patient Counseling
- Apply permethrin cream thoroughly as instructed
- Itching may continue for 1–2 weeks even after successful treatment
- Treat family members simultaneously to prevent reinfection
- Keep nails short to avoid skin damage from scratching
- Wash all clothes and bedding used in the last 3 days
- Return if itching worsens or new lesions appear
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