Dr. M.J. Bazos, MD.
Scabies is an extremely itchy rash caused by a
tiny mite that burrows into the skin. Although the mite is only slightly larger
than the head of a pin and only burrows a short distance into the skin, it
causes an intense itching. The condition is very widespread and although anyone
can catch scabies, it is much more common in young children. Often children will
bring the mite infection home and spread it to family members. It is also common
in individuals who live close together, such as those in nursing homes and
extended care facilities. The infection is transferred from person to person.
Fortunately scabies is easy and quick to treat. It is not a dangerous infection
and does not usually lead to permanent damage. Excessive scratching, however,
can cause the scabies rash to become infected with bacteria. This bacterial
infection may lead to serious cellulitis and scars. Therefore prompt and correct
treatment is necessary. Physicians are able to make the diagnosis by close skin
examination. Occasionally the tiny mite can be seen, but in most cases it is
necessary to painlessly scrape the skin. This will bring the mite onto a slide
for microscopic examination.
With Your Diagnosis
The itchy rash of
scabies can occur almost anywhere on the body. Because it is an allergic
reaction, there may or may not be mites in the rash site. The rash is often
identified by its linear nature, following the burrow of the mite. It consists
of little red bumps, bites, or pimples often in a row. The most common areas of
the body for infection by the mite are in the body creases or where straps and
bands constrict the skin. These areas are primarily the hands, wrists, ankles,
groin, waist, and arm pits. Nonetheless, because the rash is allergic, it can
appear anywhere. The earliest and most common symptom of scabies is nighttime
itching, even before the rash appears.
standard treatment of scabies consists of applying an insecticide lotion on the
skin, such as permethin, lindane, crotamiton, or sulfur. These lotions require
total body application and must be left on for a specific length of time (varies
depending on lotion). The lotion is then washed off. The lotion must cover the
entire body below the face including the genital area, hands, breasts, and feet.
These medications are usually safe, but caution is especially important with
infants younger than 2 years and with pregnant women. All such medicine should
be used under a physician’s supervision. All close family contacts should
be treated at the same time. Careful washing of all clothes, bedding, and toys
with hot, soapy water is required. You do not have to boil clothes or bedding.
The itching usually disappears rapidly within a week or two of treatment. If
symptoms do not go away, retreatment may be needed. The severe itching may be
treated with antihistamines or topical emollients and/or steroids. If it is
determined that a secondary bacterial infection has occurred, you will need to
be treated with antibiotics.
• See a physician
immediately. Anyone can get scabies. It is not a reflection on your personal
• Wash clothing, bed
linens, towels, and toys in hot, soapy water and machine
• Vacuum entire house and
dispose of bag.
• Follow precisely
your physicians directions for use of lotions and medications; wash off
thoroughly when time is up.
hands frequently to avoid spreading the
• Don’t treat
with home remedies such as detergents, scrubbing, or kerosene; these often make
• Don’t use steroid
creams unless prescribed by your
• Try to avoid scratching
heavily or picking at the rash.
to Call Your Doctor
• The rash
shows signs of infection (redness, pus, swelling, or pain) after
• Persistent itching or
pain 1–2 weeks after
• New unexplained