Scabies
Human itch mite: This female mite, shown magnified 100 times, is full of eggs. She will burrow into human skin to lay her eggs.
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.
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.
Who needs treatment?
The person diagnosed with scabies and everyone who has had close contact with that person need treatment. Even people who do not have any signs or symptoms must be treated. This is the only way to prevent new outbreaks of scabies weeks later. People who should be treated include:
- Everyone who lives with the person.
- Recent sexual partners.
Most people can be cured with a medicine that they apply to their skin. These medicines are often applied to all skin from the neck down. Infants and young children often need treatment for their scalp and face, too. A dermatologist will provide specific instructions to follow.
Most medicine is applied at bedtime. The medicine is then washed off when the patient wakes up. You may need to repeat this process one week later.
It is important to follow your dermatologist’s instructions. Treating the skin more often than instructed can worsen the rash and itching.
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.
When scabies infects many people at a nursing home, extended-care facility, and other institution, ivermectin may be prescribed to everyone who has a risk of catching scabies.
Other signs and symptoms: Some patients need other treatment, too. Your dermatologist may prescribe:
- Antihistamine: To control the itch and help you sleep.
- Pramoxine lotion: To control the itch.
- Antibiotic: To wipe out an infection.
- Steroid cream: To ease the redness, swelling, and itch.
Outcome
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.