What is this?
Scabies is a
parasitic infestation caused by tiny mites that burrow into the skin and lay
eggs, resulting in intense itching and a rash.
Scabies can cause
skin sores and serious complications, such as septicemia (a bloodstream
infection), heart disease, and kidney problems. Treatment involves the use of
creams or oral medications.
Scabies is highly
contagious and spreads through skin-to-skin contact. It is prevalent worldwide
but is most common in low-income tropical regions. Children and older adults in
resource-poor areas are at higher risk.
Symptoms of scabies
typically begin 4–6 weeks after infestation, although visible signs may appear
before symptoms develop.
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Severe Itching: Often worse at night.
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Itchy Lines and Bumps: Linear burrows and papules on fingers,
wrists, arms, legs, and belt area.
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Inflamed Bumps: On male genitalia and female breasts.
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Larger Rash in Infants and Small Children: Including palms, soles of the feet,
ankles, and scalp.
Most individuals are
infected with 10–15 mites.
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Severe Infection: Can affect people with suppressed immune systems,
including those with HIV, and may involve thousands or millions of mites,
causing dry, scaly areas on the skin.
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Lack of Itch: Often does not cause itching.
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Easy Spread: Highly contagious and can lead to secondary infections.
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Life-Threatening: Can be fatal if not treated.
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Mite Burrowing: Scabies mites burrow into the top layer of skin where
the adult female lays eggs.
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Egg Hatching: Eggs hatch in 3–4 days and develop into adult mites in
1–2 weeks.
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Allergic Reaction: After 4–6 weeks, an allergic reaction
to mite proteins and feces in the burrows causes intense itching and rash.
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Skin Infections: Mite effects on immunity and scratching can lead to
bacterial inoculation, resulting in impetigo (skin sores), especially in
tropical regions.
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Deeper Infections: Impetigo can progress to deeper skin
infections such as abscesses or serious invasive diseases, including
septicemia.
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Chronic Conditions: In tropical settings,
scabies-associated skin infections are common risk factors for kidney disease
and potentially rheumatic heart disease.
How is it transmitted?
Scabies is transmitted through close skin-to-skin contact with an infested person, such as living in the same household. The risk of transmission increases with the severity of the infestation, being highest when in contact with individuals who have crusted scabies. While transmission through infested personal items (e.g., clothes and bed linens) is uncommon with typical scabies, it can be significant for those with crusted scabies. Since there is an asymptomatic period after infestation, transmission can occur before the initially infested person shows symptoms.
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Highly Infectious: Patients with crusted scabies are a
significant source of reinfection for the community.
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Intense Treatment: Requires intense treatment with both
topical and oral medications.
How to avoid it?
Treating scabies
promptly is the best way to prevent outbreaks. The mites that cause scabies
typically die within 2–3 days away from human skin.
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Avoid Skin-to-Skin Contact: Stay away from direct contact with an
infested person, particularly if they have an itchy rash.
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Household Treatment: Treat all household members if someone
is infested to prevent the spread of mites.
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Wash and Dry Bedding and Clothing: Use hot water and dry items in direct
sunlight, a hot dryer cycle, or use dry cleaning for bedding and clothing that
have been in contact with the infested person.
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Seal Unwashable Items: Place items that cannot be washed in a
plastic bag for a week to eliminate the mites.
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Clean and Vacuum: After an infested person has been treated,
thoroughly clean and vacuum or sweep rooms, especially if the person had
crusted scabies.