Scabies Treatment

About Scabies

Scabies is an itchy rash caused by mites (tiny bugs) that like to live in people's skin. The scientific name for the mite is Sarcoptes scabiei. Although it's pretty gross to think about something living in your skin, the mites are so small that you can't see them without a microscope.

Getting scabies doesn't mean that you're not clean, and it doesn't mean that you don't take care of yourself. Scabies is easily passed from person to person. It's common for kids to pick it up at day care or school. Children can then pass it to their parents and siblings. It also shows up in nursing homes and other places where people live close together.

Recognizing Scabies

Scabies causes severe itching that is often worse at night. The urge to scratch is often described as "irresistible." A close look at the skin will reveal short, thin, red, straight or wavy lines, plus blisters or bumps. The lines are tracks made by the mites moving underneath the surface of the skin.

The mites seem to prefer skin folds like the armpits or the spaces between the fingers. They might cluster in the crease of the elbows or knees, around the male genitals, or around a woman's breasts. Other common sites are the waist and buttocks. But scabies can turn up anywhere on the body.

Diagnosis

There are other skin conditions that can look like scabies. Your doctor will examine the rash and look for the tell-tale red lines. He may also take a skin scraping to examine under a microscope, to look for the mites. The doctor might also rub a small amount of ink onto the skin, to highlight the burrows. Or, he might use a special light to see if burrows are present.

Treating the Itch

The following over-the-counter medicines can help relieve the itch:

• Antihistamine pills. The itching is caused by an allergic reaction to the mites. Antihistamines help calm allergic reactions.
• Calamine lotion. Calamine can soothe itchy skin.
• Cool baths. Cool water, either in the bathtub or on a cloth, can help calm irritated skin.

Getting Rid of Scabies

Stopping the itch is only a temporary treatment. It takes a prescription medicine to get rid of the mites. Even after scabies treatment, the itch may continue for a few days or for several weeks.

Here are some medicines which are used for scabies treatment:

• Permethrin cream (brand name Elimite). Permethrin is also used to kill lice. For scabies treatment, the cream must be applied to the whole body, not just the affected area, and left on for 12 hours. A second dose one week later may be recommended.
• Lindane (brand name Kwell or Scabene). Lindane is an older treatment. It's no longer considered safe in children because it can affect the nervous system. It may be used as a second-choice treatment in adults.
• Sulfur ointment. Sulfur is sometimes used in pregnant women and very small children because it's thought to be safer than the other choices. Some people are severely allergic to this medicine, so it's important to discuss any allergies with the doctor.
• Crotamiton cream (brand name Eurax). Crotamiton does not seem to work as well as permethrin for treating symptoms and preventing secondary infection.

People who are ill or have weakened immune systems may need additional medicine.

Keeping It from Coming Back

The scabies mites can only live for a few days without a human host. However, that's long enough for them to spread. The best way to keep scabies from returning is to wash all clothes, sheets, towels, and anything else that may have come into contact with the infected person's skin. Fabrics should be washed in hot, soapy water and dried at the "high" heat setting in the dryer.

If something can't be washed, you can kill the mites by starving them. Place the item or items in a plastic bag and seal it. Leave the bag alone for about two weeks. By the time you open the bag, the mites should be dead.

You should also vacuum your home thoroughly and then throw away the vacuum bag.

Scabies Treatment for Family Members

Family members and anyone else who has had close contact with the affected person should be treated, too. The treatment is exactly the same, even if there aren't any symptoms.

It might be inconvenient to apply the cream or to wash all your sheets and towels if you haven't developed the itchy rash. But it's probably better than waking up one morning to find that you have scabies mites living in your skin. Additionally, since scabies is so contagious, getting treatment saves you from passing it along.