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Scabies

What are Scabies? 

A mite causes this common skin condition. Called the human itch mite, this eight-legged bug is so small that you cannot see it on the skin. People get scabies when the mite burrows into the top layer of skin to live and feed. When the skin reacts to the mite, an extremely itchy rash develops. 

This mite can travel from the infected person to another person. Most people get scabies from direct, skin-to-skin contact. Less often, people pick up mites from infested items such as bedding, clothes, and furniture. The mite can survive for about 48 to 72 hours without human contact. Worldwide, there are millions of cases of scabies each year.

Anyone can get scabies. It strikes people of all ages, races, and income levels. People who are very clean and neat can get scabies. It tends to spread easily in nursing homes and extended-care facilities. The good news is that a dermatologist can successfully diagnose and treat scabies. With today’s treatments, scabies need only cause short-term distress.

What are the signs and symptoms of scabies?

After the mite burrows into the skin, it takes time to develop signs and symptoms. If you've had scabies before, the itching usually begins within one to four days. When a person has not had scabies, the body needs time to develop a reaction to the mite. It can take two to six weeks to develop symptoms.

Itching, mainly at night: Itching is the most common symptom. The itch can be so intense that it keeps a person awake at night.

Rash: Many people get the scabies rash. This rash causes little bumps that often form a line. The bumps can look like hives, tiny bites, knots under the skin, or pimples. Some people develop scaly patches that look like eczema.

Sores: Scratching the itchy rash can cause sores. An infection can develop in the sores.

Thick crusts on the skin: Crusts form when a person develops a severe type of scabies called crusted scabies. Another name for crusted scabies is Norwegian scabies. With so many mites burrowing in the skin, the rash and itch become severe. You'll find more information about crusted scabies below.

The severe itch can lead to constant scratching. With non-stop scratching, an infection can develop. Non-stop scratching can even lead to sepsis, a sometimes life-threatening condition that develops when the infection enters the blood.

Scabies can develop anywhere on the skin. The mites, however, prefer to burrow in certain parts of the body. The most common places to have itching and a rash are:

  • Hands: Mites like to burrow in the skin between the fingers and around the nails.
  • Arms: Mites like the elbows and wrists.
  • Skin usually covered by clothing or jewelry: The buttocks, belt line, penis, and skin around the nipples are likely places for mites to burrow. Mites also like to burrow in skin covered by a bracelet, watchband, or ring.

In adults, the mites rarely burrow into skin above the neck.

How do dermatologists treat scabies?

To get rid of scabies, treatment is essential. Medicine that treats scabies is only available with a doctor’s prescription.

 Medicines that may be prescribed include:

  • 5% permethrin cream: This is the most common treatment for scabies. It is safe for children as young as 1 month old and women who are pregnant. 
  • 25% benzyl benzoate lotion.
  • 10% sulfur ointment. 
  • 10% crotamiton cream.
  • 1% lindane lotion.

Treatment for widespread scabies: Scabies that covers much of the body and crusted scabies often require stronger medicine. A patient with this type of scabies may receive a prescription for ivermectin. This medicine can be prescribed to children and patients who are HIV-positive. Many patients need only to take 1 dose. Some patients need to take 2 or 3 doses to cure scabies. The pills are usually taken one week apart.

Treatment can get rid of the mites, eliminate symptoms such as itch, and treat an infection that has developed. For the first few days to a week, the rash and itch can worsen during treatment. Within 4 weeks, your skin should heal.

If your skin has not healed within 4 weeks, you may still have mites. Some people need to treat 2 or 3 times to get rid of the mites. Be sure to see your dermatologist for treatment. You should never use a scabicide used to treat crops or livestock.

People who develop crusted scabies, also known as Norwegian scabies, often need repeat treatments to get rid of the mites.

To get rid of the mites and prevent getting scabies again, you have to do more than treat the skin or take a pill. You will need to wash clothes, bedding, and towels to get rid of mites that may have fallen off your skin. You also should vacuum your entire home.

To schedule an appointment with Dr. Greenberg, please contact our office at (941) 282-3376. Our staff will be happy to assist you in scheduling a visit at your convenience.