Scabies

What is scabies?

Scabies is a very contagious but treatable skin disease. A very small bug (mite) causes it. The mites burrow into the skin, causing a very itchy rash.

How does it occur?

Scabies mites live in human skin. They spread from person to person through direct contact or from clothing and bedding.

What are the symptoms?

The main symptom of scabies is a very itchy rash. It appears as tiny blisters or bumps, which break easily when scratched. The blisters are usually in a thin line.

Although the rash can start anywhere, it often starts on the hands, between the fingers or in a crease of the wrist. Other common areas for the mites are the nipples, waistline, and male genital area. After the rash begins, it can spread within a few days to the whole body.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and whether you have been exposed to someone who has scabies. Your provider will examine your rash. He or she may get a scraping from your skin to look for mites under the microscope.

How is it treated?

Your healthcare provider will prescribe a skin cream that has an insecticide in it. Usually the instructions for use of the cream are as follows:

• After a bath or shower, put the cream on your whole body, from the top of your head to the soles of your feet. Put the cream under your fingernails and toenails with a toothpick. Make sure you don't get the cream in your eyes.
• Leave the cream on your body for 8 to 14 hours and then wash it off. Your healthcare provider may recommend that you repeat the treatment in 1 week.
• If you wash your hands or another part of your body during the 8 to 14 hours after you first put the cream on, put more cream on the area you washed.
• It's easiest to put the cream on before bed and then wash it off in the morning.

The instructions for use of medicines for scabies vary somewhat, so be sure to check and follow the instructions that come with your medicine.

If you are pregnant, ask your healthcare provider what treatment you should use.

Your healthcare provider may prescribe an oral antihistamine medicine, such as Benadryl, Claritin, or Zyrtec, to help relieve the itching. You can also soothe itching by putting 1% hydrocortisone cream on your skin.

The treatment will not be successful unless everyone infected in your home is treated. All household items that may have mites on them must also be disinfected.

How long will the effects last?

You will have itching and a rash for 2 to 4 weeks after your treatment with the cream prescribed by your healthcare provider. Continuing to have the rash does not mean that the treatment didn't work or that it needs to be repeated. The symptoms will not go away until your body sheds the layers of skin that contain the bodies of the mites, their eggs, and their droppings. Keep taking antihistamines as long as you have itching.

You may need a second treatment if:

• You have symptoms 4 weeks or more after your treatment with the cream.
• Your symptoms get much worse after your first treatment.

Scratching the scabies rash can cause skin infection. If your rash gets worse, with more redness, more tenderness, or a yellow crust, see your healthcare provider to see if you have a bacterial skin infection and need antibiotics.

What can I do to help prevent the spread of scabies?

• To prevent reinfection or spread of scabies, everyone living in your home may need to be treated at the same time.
• When you start treatment, wash all the clothing, bedding, and towels that you have used in the past 2 days in hot water. Put items that can't be washed into plastic bags. You need to keep them in the bags for 1 to 2 weeks to kill the mites.