by John Toscano

Created on: May 08, 2008   Last Updated: May 12, 2008

WHAT IS SCABIES?

Scabies is a highly contagious skin infection caused by tiny mites which burrow under the skin and lay eggs. Their presence causes the characteristic itchy scabies rash, which gradually develops over a 4-6 week period following infection. The itching worsens as the skin becomes sensitive to the mite and an allergic response develops. This can be further worsened by scratching, which can lead to inflammation, secondary infection and scabs.

Scabies can affect people of any age but is especially common in children and young adults.

HOW IS IT CONTRACTED?

Scabies mites are easily spread by physical contact with an infected person. People living together in the same house are likely to infect each other, especially if they sleep in the same room. The mites have no special preference for who they infect and scabies infections are not a sign of poor hygiene. The infection spreads very easily between children playing together and touching each other.

SYMPTOMS OF SCABIES

The main symptoms are bumps and small reddened pimples on the webs between the fingers, the underside of the wrist, the elbows, armpits, buttocks and around the groin. These are accompanied by intense itching, which gets steadily worse over time and is usually most severe at night. Infections in children can also affect the face and scalp, whilst in babies they can spread across the soles of the feet and palms.

A scabies infection can be confirmed by microscopic examination of skin scrapings, which will show mites and their eggs. Proper diagnosis is important, because scabies can be confused with other skin conditions, such as eczema and hives.

HOW TO TREAT SCABIES

No amount of washing will remove a scabies infection. An effective scabies medicine is 5% Permethrin lotion, which is applied to the entire body from the neck down. With infants under two years it may be necessary to apply it to the face and scalp. Permethrin is considered safe and has few side-effects but it should be handled with caution and care taken to avoid it being accidentally swallowed. The lotion needs to be left on the skin for up to twelve hours before being washed off. Another popular scabies treatment, the oral drug Ivermectin, has not been established as safe for use in children and should be avoided.

Permethrin usually kills the mites quickly but itching may persist or even worsen after treatment and can take up to two weeks to clear up. Antihistamine drugs or calamine lotion can relieve itching during this period.

Treatment needs to be done for all family members in close contact with the infected person. The mites can survive for two days away from their human hosts, so bed linen, towels and clothes should be well-laundered at the time of treatment. Although treatment is usually effective, it is hard to remove every single mite in a home and it may be necessary to repeat treatment after an interval of a week.

WHAT CAN PARENTS DO TO PREVENT SCABIES?

Scabies can be unpleasant for children and the itching can disrupt their sleep but it is easily treated and the symptoms can be relieved. Preventing scabies is difficult, as children playing together will always be at risk of infection. Parents need to be on the look-out for any outbreaks of itching and take prompt action if scabies is suspected.

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