Scabies is a widespread infection all over the world and affects people of all ages, races and social classes indiscriminately. Contrary to common belief, it is not related to hygiene, but is caused by an infestation of the skin by the scabies mite, whose scientific name is Sarcoptes scabiei. This tiny parasite has eight legs and can only be seen through a microscope. The adult female burrows into the epidermis (the upper layer of the skin) where she settles, eats and lays eggs. It rarely goes beyond the stratum corneum, which is the most superficial layer of the skin. If you are concerned that you have contracted scabies, you can read these simple steps to learn how to recognize it and take the correct steps to diagnose, treat and prevent it in the future.
Steps
Part 1 of 4: Recognizing the Symptoms
Step 1. Pay attention to intense itching
Scabies has many signs and symptoms, but the first and best known is intense itching, due to sensitization (a form of allergic reaction) triggered by the presence of the adult female of this mite, its eggs and its excrement.
The itch tends to be stronger at night and often even disrupts the sleep of infested people
Step 2. Recognize a rash
Along with the itching, you may also notice a rash on the skin; again, it is an allergic reaction to the mites. It is usually described as pimple-like, with inflammation and redness in the surrounding area. Mites prefer to burrow into the skin in certain parts of the body.
- Typical areas where adults may feel itchy due to scabies are the hands, especially in the webbed area between the fingers, the skin folds on the wrist, elbow or knee, buttocks, waist, penis, skin around the nipples, armpits, shoulder blades and breasts.
- In children, the parts of the body that are most easily infested are the scalp, face, neck, palms and soles of the feet.
Step 3. Check the burrows dug under the skin layer
During the infestation, it is sometimes possible to see with the naked eye small subcutaneous tunnels or burrows dug by the mites. These appear as small irregular gray-whitish lines or in your complexion and are slightly raised above the skin surface. They can generally be an inch or longer.
It may be difficult to locate these burrows, as most infested people usually only have 10-15 mites on their bodies on average
Step 4. Pay attention to skin sores
The intense itching caused by scabies sometimes causes sores on the skin, which are likely to become infected easily; often these are a complication of the infestation because they can be easily colonized by bacteria such as Staphylococcus aureus or beta-hemolytic streptococcus, which are present on the skin.
- These bacteria can also cause kidney inflammation and sometimes even septicemia, a bacterial blood infection that can be deadly.
- To avoid this, try to be gentle and not scratch yourself. If you can't control yourself, you should wear gloves or wrap your fingertips in band-aids to avoid damaging your skin yourself. Also, carefully trim your nails.
- Signs of infection include increased redness in the area, swelling, pain, or leaking of pus or other material from the sores. If you are concerned that the rashes are infected, you should see your doctor, who may prescribe an oral or topical antibiotic to treat you.
Step 5. Check for scabs on the skin
There is a form of scabies that has an additional symptom: crusted scabies, also known as Norwegian scabies, which is a severe form of infestation. This is characterized by small blisters and thick scabs on the skin that can also cover large areas of the body. This type of scabies occurs mainly in people who have a weakened immune system. The inadequate immune response allows the mites to reproduce without control, to the point that, in some very serious cases, up to two million specimens are found on the human body.
- However, an inadequate immune response can result in less severe or no itching and no rash at all.
- People who are most at risk of contracting Norwegian scabies are the elderly, those with weakened immune systems, those with HIV / AIDS, those with leukemia, and people who have lymphoma. Individuals who have undergone an organ transplant and those who suffer from certain conditions that limit the itching sensation or prevent scratching are also at risk, for example those who have suffered a spinal cord injury, paralysis, loss of sensation or suffer of mental retardation.
Part 2 of 4: Diagnosis
Step 1. Get a medical check-up
If you suspect that you have a scabies mite infestation, you should see a doctor promptly to get a clinical diagnosis. The doctor can diagnose the infection by examining the rashes and burrows created by the mites on the skin.
- Your doctor will likely use a needle to pick up a small piece of skin which he will examine under a microscope to confirm whether or not there are mites, eggs, or fecal parasite material.
- Keep in mind that a person can have a scabies infestation even if you don't notice the presence of mites, eggs or droppings because, on average, there can be as little as 10 or 15 mites in the whole body.
Step 2. Run the ink test
Your doctor can do this test to find mite burrows or burrows. The procedure is to rub pen ink around an area of skin where you feel particularly itchy or irritated and then use an alcohol-soaked cloth to clean the ink. If there is a mite burrow in that area, some ink will be trapped in it and you will see the burrow as a dark wavy line on the skin.
Step 3. Rule out the possibility of other skin conditions
There are numerous other dermatological diseases that can be mistaken for scabies. The simplest way to tell them apart is to check for burrows, which are not associated with any other skin disease that can be confused with scabies. Ask your doctor to do the proper checks to rule out these other disorders, so you can be sure it's really scabies.
- This infection is sometimes confused with other bites, insect bites or bed bug bites.
- Other skin diseases include impetigo, a highly contagious infection. In this case, the rash, similar to a red pimple, occurs more easily on the face around the nose and mouth.
- It can also be confused with eczema, a chronic skin disorder that causes inflammation. The eczema rash, again resembling a red pimple, is due to an allergic reaction. If people with eczema are infested with scabies, the problem is more serious for them.
- Another dermatological problem is folliculitis, an inflammation usually accompanied by infection, in the area surrounding the hair follicles. This problem causes small pimples with a white center tip and a red base around or near the hair follicles.
- Scabies can also be confused with psoriasis, a chronic inflammatory skin disease characterized by overgrowth of skin cells, resulting in thick, silvery-looking scales and red, itchy, dry patches.
Part 3 of 4: Care
Step 1. Use permethrin
To treat scabies it is necessary to eliminate the infestation with prescription drugs, called scabicides because they kill the mites. To date, there are no over-the-counter drugs to treat this infection, so it is the doctor who prescribes a 5% permethrin cream, the most suitable drug for treating scabies, as it kills both mites and eggs. The cream should be applied all over the body, from the neck down, and rinsed off after 8-14 hours.
- Repeat the treatment within 7 days (1 week). Among the side effects you can find itching or burning.
- Talk to your pediatrician if you need to treat scabies on infants or young children. Permethrin cream is safe for infants who are 1 month old, but most experts also recommend applying it to the head and neck area. When you smear it on your baby, make sure the medication doesn't come in contact with the eyes or mouth.
Step 2. Try a 10% crotamiton cream or lotion
Also in this case a medical prescription is required; the drug should be applied all over the body from the neck down after bathing. Apply a second dose 24 hours after the first and wet 48 hours after the second application. Repeat both doses within 7 to 10 days.
This active ingredient is considered safe, when used as prescribed by the doctor. However, it is often not very effective and is not always able to eradicate the infection; this means that it is not the most effective remedy and is not used often
Step 3. Get a prescription for 1% lindane cream
This lotion is similar to other scabicides and should always be applied from the neck down all over the body and rinsed off after 8 to 12 hours in adults and after 6 hours in children. Repeat the treatment within seven days. Lindane should not be given to children under the age of two, pregnant or breastfeeding women and immunosuppressed individuals.
It is potentially neurotoxic, so it means it can cause damage to the brain and other parts of the nervous system. The drug should only be prescribed for those who have not achieved positive results with other previous treatments or who cannot tolerate other drugs with minor side effects
Step 4. Take ivermectin
In this case it is a drug to be taken orally and has been shown to be effective and safe in the treatment of scabies; it is prescribed in a single dose of 200 mcg / kg to be taken with water on an empty stomach.
- Repeat the dose within 7 to 10 days. Ivermectin is prescribed in patients who have not solved the problem of the infestation with previous treatments or who cannot tolerate topical medications to treat scabies.
- A potential side effect of this active ingredient is an increase in heart rate.
Step 5. Treat skin irritation
To reduce or eliminate symptoms and skin lesions, it can take up to three weeks after eliminating the mites with scabicidal drugs. If the problem does not go away within this time, you should undergo a new treatment, as the former may not have been fully effective or there may have been a new infestation. You can reduce itching by cooling the skin. Soak in a tub of cold water or apply cold compresses to irritated areas to find some relief.
- Add some oatmeal or baking soda to the tub for a more soothing effect.
- You can also try applying a calamine-based lotion, which is easily found in drugstores without a prescription, because it has been shown to be effective in relieving itching caused by skin irritation. A good option is a moisturizer like Aveeno. Avoid applying any product containing perfumes or dyes, as they further irritate the skin.
Step 6. Purchase topical steroids or oral antihistamines
Both of these medications can relieve the nagging itching sensation associated with scabies, which is actually an allergic reaction to mites, eggs, and fecal material. Steroids are very effective inhibitors against itching and inflammation, including betamethasone and triamcinolone.
- Since itching is an allergic reaction, you can also take over-the-counter antihistamines, such as Benadryl, Clarityn, Zyrtec, and fexofenadine-based ones. They can be particularly useful during the night to reduce itching, so you can sleep peacefully; Benadryl also acts as a mild sedative for many people. You can eventually get a prescription for antihistamines such as Atarax.
- You can purchase a 1% hydrocortisone topical cream which often proves effective against itching.
Part 4 of 4: Prevention
Step 1. Be careful not to expose yourself to mites
Transmission of scabies occurs more easily through direct contact with the skin of a sick individual. The longer the contact time, the more likely you are to get scabies. Although rarer, scabies can be transmitted through objects such as blankets, clothing and furniture, not least because the mite can survive 48 - 72 hours without human contact. In adults, it can often be contracted through sexual activity.
Some overcrowded conditions are a fairly common cause of scabies outbreaks. In fact, environments such as prisons, barracks, kindergartens, facilities for the elderly and schools are places rather at risk. Keep in mind that scabies can only spread to humans, not animals
Step 2. Pay attention to the incubation period
In a person who is first infested with scabies mites, it can take up to 2-6 weeks for signs and symptoms of the disease to develop. Be aware that an infested person can transmit scabies to other people even if the disease is not yet overt.
In a person who has already had a previous infestation, the signs and symptoms develop much faster, usually within 1-4 days
Step 3. Assess your chances of risk
There are some groups of people who are more likely to infest each other. These include children, mothers of young children, sexually active young adults and residents of nursing homes, nursing homes and long-term care facilities.
The main factor that determines an increase in risk among people belonging to these categories is the direct contact with the skin
Step 4. Clean and disinfect the house
Several measures should be put into practice simultaneously to avoid possible new exposure or infestations and to keep the disease under control. This is especially important to protect other family members who live in the same environment and are in close contact with, including sexual partners.
- When you start your scabies treatment, all clothing, sheets and bedding, towels and anything else you have used in the last 3 days should be washed in hot water and placed in the dryer on the hottest drying cycle possible; or, alternatively, take all the items to a dry cleaner. If you can't do either method, put all the fabrics in a plastic bag, seal it tightly, and wait at least seven days. Scabies mites can only survive for 48 to 72 hours away from human skin.
- The day you start your treatment, vacuum all the rugs, carpets and furniture in the house. After cleaning, discard the appliance bag and wash the container thoroughly (if you have a bagless vacuum cleaner). If the filter is not removable, wipe it with a damp paper towel to get rid of any remaining mites.
- Don't treat pets. The scabies mite that infests people cannot survive on animals, just as animals do not transmit scabies to humans.
- Know that it is completely useless to try to disinfect the environments against scabies using spray products or vaporizers; their use is not recommended.
