Dermatology A to Z
Scabies is caused by a mite (too small to see) called Sarcoptes scabiei. These mites burrow under the top layer of the skin and cause a very itchy (pruritic) dermatitis. A related mite causes mange in dogs, cats and other animals and can cause skin problems in humans. Scabies is spread from person to person by close (often sexual) contact. The mite can also live for short periods of time off the body in clothing, bedding and linens.
Scabies often affects the wrists, finger webs, sides of fingers, feet, waist, hips and genital area. The typical or characteristic lesion is a linear burrow and the mite is located at the end. The mite can be seen under the microscope in a skin scraping.
The fact that a person has become infected with scabies does not imply any lack of cleanliness or poor hygiene. Often, multiple family members are involved though only one has symptoms. For this reason, the entire family is often treated at the same time.
Several prescription topical medications are available (Lindane, Elimite, Ovide). These are applied to the entire body from the chin down at bedtime. When applying the medicine make sure all cracks and crevasses are covered (i.e. belly button, between fingers and toes, under nails). The medicine should be left in place overnight (roughly 8 – 10 hours). All family members need to be treated at the same time so ping pong infections (passing the mite back and forth) won’t occur. In the morning, after showering off the medicine, take all the bedding and bed clothes and run though the laundry. Any stuffed animals or things that cannot be washed should be sealed in a garbage sack for 2 weeks. Most times a single application is sufficient for a cure. However, sometimes a second application of medicine and washing of linens is recommended one week later.
Itching can persist after adequate treatment. This is expected as the itch is due to your body’s reaction to the scabies mite’s body. The dead mites will remain in the outer layer of the skin until the skin sloughs off in 1 – 3 weeks.
Oral ivermectin is available for treating severe cases. This is typically someone who is immune suppressed or those individuals with a severe infestation.
Pregnant women with scabies should not be treated with the topical medication. Often a sulfur based topical compound is used. If you are pregnant, please inform the nurse or doctor.