What is it?
Scabies is an infestation of the skin by a mite (Sarcoptes scabei). It is so small that it can only be seen by a microscope. If not treated it will live its whole life in the skin, even laying its eggs. It can affect any person as it only needs skin-to-skin contact to pass to another person. Scabies can be passed sexually as the skin-to-skin contact during sex is ideal for transmission. It is also commonly passed without sex and is found in children as well as adults.
How do you get it?
To contract scabies you need direct, prolonged, skin-to-skin contact with a person already infested with scabies. This means that a quick handshake or hug will usually not spread infestation, but it can occur by sharing clothing, towels, and bedding as the mite can survive for 48-72 hours away from the human body.
What are the symptoms?
Scabies shows up as a rash, which is most commonly found on the hands, particularly the webbing between the finger, the skin folds on the wrist, elbow or knee, the penis, breast or shoulder blade. It can also cause small bumps (common on the penis and scrotum) and small curling lines (common between the fingers). Most commonly there is severe itching, especially at night, and frequently over much of the body. The rash and itchiness is the body's response to the mites living in the skin. Where the itchiness/rash is the worst, though, there may be no mites. Severe itching can cause people to get bacterial infections of the skin. This infection is caused by the scratching which destroys the protective layer of skin. When a person is infested with scabies mites for the first time it can take 2-6 weeks for these symptoms to show. After the first infection, people usually become sensitized to mites and symptoms usually occur within 1 to 4 days.
What is the test like?
The diagnosis of scabies is usually made by a health care provider, based upon the appearance and distribution of the rash and presence of burrows (red or white swollen lines on the skin). There is no blood test or swab that can be done to confirm the scabies infestation. The only way to confirm this is to do a skin scraping to detect the mite under a microscope. A specialist, such as a dermatologist, usually carries out this procedure.
How do I get treated?
There are several lotions available to treat scabies. Make sure that you always follow the directions provided by your physician or the directions on the package insert. Permethrin and Lindane (Kwellada, Nix) can be purchased over the counter at your drug store without a doctor's prescription and will kill the mites. Apply the lotion to a clean body from the neck down to the toes, paying particular attention to areas on the fingernails, areas between the fingers and toes, armpits and genital areas. It may be very useful to have someone help you do this, as it can be difficult to get to some areas. The lotions are typically left for 12 to 14 hours and then washed off.
All clothes, bedding, and towels used by the infested person over the 2 days before treatment, should be washed in hot water and dried in a hot dryer. Mattresses of an infested person should not be used for 2 days. A second treatment of the body with the same lotion may be necessary 7-10 days later if scabies mites or new skin lesions appear. Pregnant women or nursing mothers need to consult a physician or pharmacist as a milder medication will probably be needed.
Remember that you will also need to treat any partners or the scabies will return. This will also include any other people with whom you have close contact (e.g. your children). This treatment should be done at the same time, as one person may be treated and then get it back again from an untreated person.
Do not over-treat scabies. Do not use more than the recommended number of treatments as this may irritate the skin. It may take several weeks for the itchiness to go even though all the mites have been killed. No new burrows or rashes should appear 24-48 hours after effective treatment.
Immune compromised
People with weakened immune systems and the elderly are at risk for a more severe form of scabies, called Norwegian or crusted scabies.
Related concerns
Although scabies is a relatively minor STD, it often indicates that you may be infected with another and potentially more serious STD. When you have one STD be sure to ask your doctor to check you for others.
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