Scabies

What is scabies?

Scabies is a skin infestation with a tiny mite, Sarcoptes scabiei. Mites that cause scabies burrow into the skin producing pimple-like irritations. Occasionally secondary bacterial infections may occur. Scabies has become relatively common throughout the general population. It is highly contagious and is spread primarily through sexual contact, although it also is commonly transmitted by contact with skin, infested sheets, towels, or even furniture.

Who gets scabies?

Scabies infestations can affect people from all socioeconomic levels without regard to age, sex, race or standards of personal hygiene. Clusters of cases, or outbreaks, are occasionally seen in nursing homes, day care centers and other institutions.

How is scabies spread?

Mites that cause scabies are transferred by direct skin-to-skin contact. In severe cases indirect transfer from undergarments or bedclothes can occur only if these have been contaminated by an infected person immediately beforehand.

How is scabies diagnosed?

Scabies may be confused with other skin irritations such as poison ivy or eczema. To make an accurate diagnosis, a doctor takes a scraping of the irritated area and examines it under a microscope, to reveal the presence of the mite.

What are the symptoms of scabies?

The most prominent symptom of scabies is intense itching, particularly at night. The areas of the skin most affected by scabies include the webs and sides of the fingers, around the wrists, elbows and armpits, waist, thighs, genitalia, abdomen and lower buttocks. In infants younger than two years old the symptoms are likely to appear on the head neck hands and feet.

How soon do symptoms appear?

After exposure, symptoms will appear from 2 to 6 weeks in people who have not previously been exposed to scabies infestations. People who have had a previous infestation with scabies mites may show symptoms within 1 to 4 days after subsequent re-exposures.

When and for how long is a person able to spread scabies?

A person is able to spread scabies until mites and eggs are destroyed, usually after one effective treatment. Individuals with scabies should not attend school or daycare, nor enter their workplace until the day after treatment is initiated. Except in severe cases inanimate objects such as clothing, bedding or furniture do not spread mites that cause scabies.

What is the treatment for scabies?

As with pubic lice, lindane is an effective treatment for scabies. Pregnant women should consult a doctor before using this product. In severe cases, medication taken by mouth are available through a physician's prescription for the treatment of scabies. Sometimes itching may persist for one to two weeks after treatment, but this should not be regarded as treatment failure or reinfestation. Avoid over-treatment. A hydrocortisone cream or ointment or a soothing lotion may provide relief from itching.

What can be done to prevent the spread of scabies?

Avoid physical contact with infested individuals and their belongings, especially clothing and bedding. In severe cases, clothing and bed linen worn or used by an infested persons in the 48 hours before treatment may be laundered and dried at the highest temperature or stored in a container such as a plastic bag for 5 to 7 days to kill mites and their eggs. Use of environmental pesticides should be avoided. Preventive therapy is recommended for household members of an infested persons or close contacts of persons in nursing homes, day care centers or institutions. Health education on the life cycle of scabies, proper treatment and the need for early diagnosis and treatment of infested individuals and contacts is extremely important.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.