Scabies : Identification, Rash Symptoms, Treatment and Procedure

Scabies is a condition which is caused due to the infestation of eight-legged microscopic mite known by the name of Sarcoptes scabiei. These tiny mites attack the outer layer of the human skin and cause an infestation called Scabies. Rather than infection, Scabies is an infestation or simply a skin condition.

The mites excavate the skin and lay their eggs this leads to their infestation in the skin which further results in rashes and intense itching on the surface of the skin. There is a strong urge to scratch, especially at night.

Every year nearly hundreds of people suffer from the problem of scabies irrespective of the socioeconomic status and age. Nearly 300 million people get infected by scabies all around the world.

When a person suffers from scabies, there are pimples like rashes on the skin. It is often confused with acne and mosquito bites as they look quite similar with just a bit of difference in the appearance. What stands scabies apart from other skin diseases is the itching as it is relentless and severe as compared to others.

Given below are some of the key indicators which help in recognizing the scabies skin condition:

1. The rash of scabies looks like a pimple or a blister and they tend to appear in a row.
2. The skin of the individual with scabies would have scaly and red patches.
3. Although the mites of scabies attack the entire body but they are mostly found in the skin around the feet and hands.
4. Besides the red blisters, scabies would cause grey lines to appear on the skin along with blisters.

There are four stages in the life cycle of scabies:

• Eggs: The female Sarcoptes scabiei lays and deposits nearly 2 to 3 eggs as they excavate through the skin. The eggs generally hatch within 3 to 4 days.
• Larva: After the hatching of the eggs takes place the larvae move onto the surface of the skin. The larvae which come out of the egg has only 3 pair of legs.
• Nymph: After the molting of larvae, there are four pairs of legs in the resulting nymphs.
• Adult: The nymphs then molt into adults. The mating between male and female mites happens only once which is sufficient to make the female mite fertile for the rest of the life.

The mite that causes scabies of single type i.e. Sarcoptes Scabiei. However, the infestation these mites cause can be of different types. The types of infestation are:

• Nodular Scabies:

  Itchy, raised bumps or lumps may be developed by these kinds of scabies. These are developed in genital areas, groin or armpits.

• Norwegian Scabies:

  Norwegian Scabies or Crusted Scabies is the other type of scabies can be formed in some people.. The severity of this scabies is a little more than other kinds of Scabies and also, it is extremely contagious.

  A thick crust of skin containing thousands of eggs and mites is developed on the skin in case of crusted scabies.

  Norwegian Scabies can also be formed like:

  • Grey
  • Thick
  • Easily crumbled when touched

  People with weak immunity systems generally develop crusted scabies. This category includes people with HIV or AIDS, people who are going through chemotherapy or someone who uses certain medications or steroids.

• Typical Scabies:

  As the name suggests, it is the most typical and common type of infestation. Itchy rashes are caused on skin, hands, wrists and other common spots on the body. Nevertheless, the face or scalp remains unaffected.

If the person is suffering from the problem of scabies for the very first time then it would take approximately 2 to 4 weeks for the symptoms to appear in the person. However, in patients who have a history of the scabies infestation, the symptoms appear within 1 to 4 days.

The size of the mites is so petite that they are not visible to a naked human eye. These mites can only be seen with the help of a microscope. As scabies are not visible to the human eye thus the condition of scabies is recognized through the rashes which are caused by mites.

After the skin has been exposed to Scabies, the symptom can take up to 6 weeks to appear. People who have had scabies before may develop symptoms a little earlier.

The appearance of Scabies can be rashes and intense itching. It gets worse at night time. Due to itching, people continuously scratch the area where the rash is. It is not recommended as scratching the infected are sores which then become infected.

The signs and symptoms of scabies are inclusive of:

• Rash: when the mites excavate the skin, the tracks of the excavation are formed on the skin in the form of hives, blisters or pimples.
• Itching: it is one of the most common symptoms of scabies and it tends to get worse at night.

Scabies can occur anywhere in the human body.

In adults, Common areas on the body where scabies can occur are:

• In Armpits
• On inner elbows
• Buttock
• Penis
• Soles of the feet
• Area between fingers
• Around the breasts
• Waist
• Inside of the wrists

In the case of babies and toddlers, Scabies can occur on:

• Scalp
• Face
• Neck
• The palm of the hands
• Soles of the feet

In humans, the condition of scabies is caused by an eight-legged mite known by the name of Sarcoptes scabiei. Their extremely small size makes them impossible to be seen with naked eyes. But certainly, their effects can be seen.

From the surface of the skin, they spread to various parts of the body after maturing. The allergic reaction of the mites to the body causes itching on the skin. The mites can be spread to other people when a non-infected person physically comes in contact with an infected person.

Sharing the beds and the clothing of the infected person can also cause scabies to spread. Other ways of spreading mites are:

• Clothes
• Furniture
• Bedding

A simple physical examination by the doctor, inspecting the affected area of the skin can help diagnose scabies. In some cases, the need may occur where the doctor needs to diagnose by removing a mite from the skin with the help of a needle.

If the doctor finds it difficult to spot a mite, the doctor needs to scrape off a small section of the skin to take the sample of the tissue. The sample of the skin is then examined under a microscope and the presence/absence of mites in the skin is confirmed.

Another way is the Scabies ink test aka Burrow ink test. It helps to identify the burrowed trails in the skin created by the mites. To perform this test, the doctors pour a drop of ink on the infested area from a fountain pen. After the test is done, the ink is wiped away.

Scabies treatment usually entails complete elimination of the infestation with the help of prescribed ointments, medicines, creams or lotions.

The patients are usually instructed to apply the prescribed medicines at night as the mites are most active at night time. Once the mites attack the skin (any area of it), the medicines need to be applied to the whole body i.e. from neck to toe. It can be washed off in the morning.

The treatment is required to be repeated after seven days. The ways of applying medicine must be consulted by the doctor.

Given are some medicines used to treat scabies:

• Permethrin Cream: This topical medication kills the mites and their kids. This medication can be used in pregnant women, adults, and children above 2 months of age.
• Lindane Lotion: This lotion is usually prescribed for treating scabies in adults. This lotion is not safe to be used on kids less than 10 years of age.
• Ivermectin: This is an oral medication and is generally prescribed to people who have a compromised immune system. This medication is not recommended to be given to patients who are pregnant, or children who weigh less than 15 kilograms.
• Crotamiton Cream
• Benzyl Benzoate Lotion
• Sulphur Ointment

Statutory warning: Please consult a doctor before opting out for self medication. Doctor guidance is suggested for utmost care.

Generally, Scabies can infest your body for up to two months if not treated on time. But if the person is on medication, it won't last for more than 3 days. One can go in their social life post 24 hrs of medication.

To avoid any form of spread, try not to go around people for at least 3-4 or until the mites have fully gone from your body.

Summary: Even on mediation, the patient with Scabies can be contagious to others. The medication is contagious for at least 3 months.

The treatment for scabies concentrates on the getting rid of the mites infestation. The doctors usually prescribe topical medications to provide relief in the symptoms of scabies.

Normally the doctor would recommend the patient to apply the topical medication on the whole body below the neck region and leave it for approximately 8 to 10 hours.

Due to the simple fact that scabies is a highly contagious disease the doctor may recommend the treatment of scabies to all the member of the family of the infected person.

Here are certain steps which are required to be taken to get rid of scabies:

• On the day the treatment for scabies starts the entire house inclusive of all the rugs, upholstery, and carpet must be vacuumed.
• All the clothes, towels, linens must be washed thoroughly by using hot soapy water. In order to starve the mites, the items which cannot be washed must be sealed in a plastic bag and kept away.
• Physical contact with the infected person must be avoided at all cost.
• The treatment for scabies must not be skipped until the doctor gives permission to stop the treatment.

Scabies infestation is curable. If treated right and the infested person has a good prognosis, both eczema and itching resolve.

Avoiding direct contact with the person infested should be avoided. It is prescribed to avoid using unwashed clothing or bedding of the person having scabies.

After falling off the human body, scabies can live up to 3-4 days, so precautions must be taken to prevent other infestation on the same person or other people living there.

Washing off clothes is important, but one important point is to make sure that everything is water is warm and the temperature is about 50°C. Following should be prioritised in your laundry bucket:

• Pillows
• Bedding
• Clothing
• Towels
• Furniture
• After washing everything should be dried in a dryer on a high temperature for 10-30 minutes.

If not treated on time, Scabies can be damaging to individual skin. Frequent itching can cause open wounds which can make your body more vulnerable to external infections. These infections may include impetigo, resulting in worsening skin conditions.

Summary: If not treated on time, Scabies can be damaging to individual skin. Frequent itching can cause open wounds which can make your body more vulnerable to external infections.

Even though rubbing alcohol can remove mites from hard surfaces, it is not recommended for individuals. It should only be used under professional observation as alcohol in high concentrations can burn your skin, which can worsen the overall skin health. It is advised to use alcohol on your skin to kill Scabies.

Summary: Alcohol for the treatment of Scabies on the skin is not recommended. It can damage your skin causing more damage to the infected skin.

In general, Scabies mites only live on a person’s skin for 2-4 days. So they will die eventually without any medication, however, it will take at least 2 months to fade completely without any medical support. It is important to seek medical advice or treat Scabies as they can cause severe damage to the skin.

Summary: In general, Scabies mites only live on a person’s skin for 2-4 days. However, it will take at least 2 months to fade completely without any medical support.

Apart from the usual treatment for scabies involving topical applications and medication an infected person can also opt for some home remedies to provide relief in the condition. Some of the home remedies which can be used for the treatment of scabies are:

• Neem: Neem trees have been best known for its healing properties. Using creams, soaps and oil containing neem can be very useful in the treatment as neem is known for its antibacterial, analgesic, and anti-inflammatory properties. As per a study conducted in the year 2008, the active ingredients of neem are good enough to kill scabies.
• Aloe vera gel: The use of aloe vera gel on the scabies infected area provides a soothing and healing effect. The gel is not only good enough to kill scabies but it also provides relief in itching.
• Clove oil: Topical application of clove oil can be very advantageous in the treatment of scabies as it has antioxidant, anesthetic, and antimicrobial properties. It is also a known and effective insecticidal. According to a study conducted in the year, 2010 clove oil is good enough to kill scabies.
• Cayenne pepper: The topical application of the cayenne pepper not only provides relief from the itching symptom but it is also effective in killing the mites of scabies.
• Tea tree oil: Topical application of the tea tree oil provides a very promising solution to the problem of scabies due to its anti-inflammatory, antipruritic, antibacterial, and acaricidal properties. Topical application of tea tree oil is a scientifically proven solution to the problem of scabies.