Early Scabies, Healthfully

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Early Scabies

If you’ve been infested with scabies, also known as the «human itch mite,» you may not know it for some time 2. According to the Centers for Disease Control, while scabies is more common in conditions where people live close together, such as jails and extended-care facilities, the mite doesn’t discriminate based on race, class, gender or hygiene 2. Being alert to the first signs of scabies allows you to cure this itchy skin condition before you pass the mites on to others 2.

Scabies Life Cycle

The average scabies mite has a lifespan of one to two months and has four life stages: egg, larva, nymph and adult 2. All it takes is one impregnated female scabies mite to result in a human infestation 2. The female mite burrows under the skin, where she deposits two to three eggs every day. After the eggs hatch, larvae emerge and make their way to the surface of the skin for another three to four days. After the larvae molt, they turn into nymphs; after another molting process, the adult female scabies are ready to breed with smaller male mites that linger in small pits in the skin 2. The newly-pregnant female mite creates a new burrow, and the life cycle begins all over again.

Scabies & Human Hosts

Scabies are microscopic and cannot be visualized on your skin 2. Female mites are are 0.30 to 0.45 millimeter in length and 0.25 to 0.35 millimeter in width. Males are roughly half the size of their female counterparts. There is a lag time between the time a human infestation occurs and when signs such as noticeable burrows, rash and symptoms of intense itching begin—typically between two and six weeks, according to the CDC. During this time, someone infested with scabies can still pass the mites onto others through close, skin-to-skin contact 2. Adults typically acquire scabies through sexual contact with an infested partner 2.

Earliest Signs of Scabies

If you have scabies, the first sign you may notice is itching that is more intense at night than during the day 2. Itching gives rise to a red, pimply rash. You may also note the presence of scabies burrows in specific parts of your body 2. In adults, scabies prefer areas of skin that fold or touch each other, so you may note small, slightly raised serpentine ridges in the webbing between your fingers, inside your wrists or elbows, under your breasts or genital area, or between the shoulder blades 2. In children, scabies prefer to take up residence in the neck, scalp, soles and palms 2.

Scabies Treatment

Treating scabies requires a visit to the doctor to first identify the infestation 2. While an experienced dermatologist can often diagnose scabies by noting the presence of burrows, skin culture tests can confirm a scabies infestation 2. Treating scabies requires purchase of a prescription topical medication that contains either permethrin or crotamiton 2. These topical applications are applied all over the body from the neck down and left on for a certain number of hours and then thoroughly washed off. Although this kills the mites and their eggs, many people still experience itching as the remnants of the mites and their feces continue to cause an allergic reaction in the skin for a week or sometimes longer.

Other Preventive Measures

Scabies mites cannot live very long without the blood of a human host—usually no more than 72 hours (three days) 2. An important part of eradicating scabies and preventing a reinfestation is ensuring that all clothing, linens, towels and other personal items are thoroughly washed in hot water and dried on high heat 2. Things that cannot be laundered can be stored in containers or garbage bags and placed outside of the home for three days until the mites die of starvation.

If you’ve been infested with scabies, also known as the «human itch mite,» you may not know it for some time. Being alert to the first signs of scabies allows you to cure this itchy skin condition before you pass the mites on to others. The female mite burrows under the skin, where she deposits two to three eggs every day. Female mites are are 0.30 to 0.45 millimeter in length and 0.25 to 0.35 millimeter in width. Males are roughly half the size of their female counterparts. Adults typically acquire scabies through sexual contact with an infested partner.

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Scabies In Babies: Causes, Signs, Treatment And Remedies

Scabies is a highly contagious, common itchy rash seen in babies and children. When an infant has scabies, you notice several red, fluid-filled, dot-like rashes on the body and thin, white, thread-like lines around the rashes. The baby has an intense itch due to the rash.

In this post, MomJunction tells you about the causes of scabies in babies, its symptoms, treatment, and home remedies.

What Is Scabies And How Is It Caused?

Scabies in babies is also called pediatric scabies or infantile scabies. It is caused by the mite Sarcoptes scabiei. The bug is microscopic, about the size of the head of a pin. It belongs to the same family as ticks, another human parasite (1).

The scabies mite burrows into the human skin by making a tiny cut (2). It enters the upper layers of the skin and burrows through it while laying eggs in the tunnels. The eggs hatch into larvae, which later become fully-grown mites, and begin burrowing the skin, thus marking the completion of the first life cycle.

A scabies mite is not naturally found on the human body. This means that the baby gets it from an external source.

How Does A Baby Catch Scabies?

A scabies mite can land on your baby’s skin through:

  • Direct skin-to-skin contact with someone who has scabies
  • Sharing clothing or bedding with an infected person
  • Skin contact with a scabies-infected animal including domesticated animals

Babies who spend a lot of time in daycare centers are at a higher risk as they often come in direct skin contact with other infants (3). Also, if your pet has scabies, then the baby may catch the mite while petting the animal. Once a mite lands on the skin, it burrows within, but symptoms emerge at the end of the first life cycle.

What Are The Symptoms Of Scabies In Babies?

The symptoms of scabies appear four to six weeks after coming in contact with the infected person (4). The baby will have the following symptoms (5):

  • Bumpy red rashes that look like small red dots often located in clusters. In infants, these rashes could appear at folds such as the creases of elbow and knee, inner thighs, between toes and fingers, underarms, buttocks, and genitals. The rash makes an appearance around the diaper’s elastic at the waist. Newborns and young infants may also display rashes on face, neck, scalp, palms, and soles.
  • Intense itching, especially during nighttime. The itching is a result of the body’s allergic reaction to the mites.
  • Short, straight, or wavy lines that appear in pink or white color. You will usually see them joining two clusters of rashes. These lines are burrows dug by the mites.

Rashes and unbearable itchiness are the two fundamental indicators of infantile scabies. It is best to get a diagnosis done by a doctor.

How Is Scabies Diagnosed?

The diagnosis is a two-step process (6):

  1. Visual examination of the rashes: The doctor looks for the pattern, density of rashes, and the presence of white or pinkish lines that indicate burrows. The lesions caused by mite in children below two years of age usually occur on the head, neck, palms, and soles (4).
  1. Microscopic inspection of skin scrapings: Rashes and burrows are gently scraped, and the scrapings are checked under a microscope for the presence of mites and their eggs. Scabies mites live in the external layers of dead skin that have no nerve endings. Therefore, scraping the rash will be painless.

A timely diagnosis might help treat the condition quicker.

Remedies To Reduce Itching

Once scabies is diagnosed, the baby requires prescription medicines to kill the scabies mite. However, the itching can be brought down with the use of some over-the-counter medicines (7):

  • Antihistamine medicines: Babies older than 12 months can be administered over-the-counter antihistamine medicines such as Benadryl or Atarax. Remember to follow the instructions given on the bottle. Antihistamine medicines reduce the intensity of the allergic reaction, making the itch tolerable.
  • Calamine lotion: Apply baby-safe calamine lotion on infants older than six months. Calamine helps reduce skin irritation and inflammation caused by repeated scratching of the skin.
  • Disinfectant baby bathing soap: A baby-safe disinfectant bathing soap may kill the scabies eggs (6) and also affect the egg-laying efficiency of the scabies mite. It could help slow down the spread of scabies to healthier skin.

Some Home Care Tips For Scabies

The following steps let you manage a baby’s scabies at home, while also helping you protect other family members from the condition (8):

  1. Dress the baby in loose clothing, as the baby feels itchy all the time. Loose clothes ensure less friction and irritation to the skin.
  1. Wash the baby’s clothes separately from those of siblings and other family members. Soak them in hot water before washing them with a baby-safe detergent. Dry the clothes in direct sunlight. These steps help neutralize the eggs and scabies mites that found their way to the clothes from the baby’s skin.
  1. Trim the baby’s nails to discourage and prevent itching. Long nails can also trap scabies mites that may get transferred to healthy skin when scratched.
  1. Disinfect and store baby’s bedding in bags for three days. The scabies mites cannot survive outside the human skin for more than three days. For a better rate of disinfection, you can place the bag in direct sunlight for a couple of hours every day.
  1. Keep the house clean to prevent the spread of infection from the baby. Use a vacuum to clean sofa, carpets, and places where the mites can hide, readily waiting to come in contact with skin. Keep hard surfaces clear of dust and use a disinfectant floor cleaner.

It is best to consult a doctor before using a home remedy for a baby younger than six months. These home remedies could provide symptomatic relief from the condition. Take the baby to a pediatrician for getting the infection treated.

How Is Scabies Treated?

The pediatrician may follow one of these methods of treating scabies infection in infants.

  1. Permethrin 5% cream (for babies older than two months): It is the first choice of treatment to eradicate scabies mites and their eggs. Permethrin is an insecticide that is safe for babies older than two months. It has a 95% cure rate but carries some toxicity that only seems to affect babies younger than two months (9).

The cream is applied throughout the body from the scalp to the toe, including the inside of the navel and earlobes, to ensure all the mites and their eggs are killed. The cream is left on the body for 8-14 hours, depending on the doctor’s recommendation. After this period, the baby is given a bath. The application is repeated a week later.

  1. Sulfur 7% cream (for babies younger than two months): Infants under two months are administered a sulfur 7% cream. The method of application is the same as the permethrin cream. The ointment is less potent than permethrin and may have to be applied more frequently. On the bright side, it has no side effects and is safe even for very young infants and pregnant and lactating women (10).
  1. Oral drug: In severe cases, the doctor may recommend oral drug Ivermectin and some oral antibiotics.

The itching and rashes subside within a couple of days of the first application of medicines (11). However, you need to continue the medicine for the complete period as recommended by the doctor. A slight itch may persist for two weeks after the mites are eliminated, but that is normal. Overall, the baby would be cured in about four weeks after the initiation of treatment (1). Home management is essential to get the maximum benefit from the treatment.

As this is an infectious condition, all the members of the family should be treated simultaneously. The mother may apply Permethrin 5% in the palms even if she is not infected. Clothes of the infected child, as well as the bedsheet, should be washed in warm water with scabicide to kill the live parasites.

Scabies treated well in time seldom lead to any major issues. However, if not acted upon promptly, it might result in some complications.

What Are The Complications Of Scabies In Babies?

Untreated scabies can lead to the following complications (12):

  • Secondary bacterial infection: The repeated scratching of the skin can cause tiny wounds that get invaded by bacteria such as staphylococcus and streptococcus. It can cause the formation of pus and infections such as impetigo that lead to the creation of bacteria-infested sores.
  • Chronic skin inflammation: Since the baby is scratching all the time, the skin would mostly stay red and inflamed. It causes a lot of discomfort and irritation to the baby, which may interfere with daily activities such as feeding and playing.
  • Norwegian scabies: In babies with compromised immunity caused by HIV or cancer, the population of scabies mites multiply at a rapid rate producing large scales or crusts on the skin. Such a form of scabies, called Norwegian or crusted scabies. It is hard to treat it since the skin contains hundreds or even thousands of scabies mites compared to 15-20, usually found on the skin during normal scabies (8).

To avoid these complications, the sooner the treatment begins post-diagnosis, the better it is for the baby.

The immune system does not develop any resistance against the scabies mite. It means that re-infection is possible even once cured and even when the baby is otherwise healthy. Prevention is thus vital.

How To Prevent Scabies In Infants?

Prevention of scabies is simple and requires you to observe a couple of precautions. Here is what you must do to prevent your baby from catching scabies:

  1. Keep distance from those with scabies: Direct skin-to-skin contact is the principal mode of scabies transmission. If someone in the family has scabies, then the baby must be kept away from the person and their personal items. Do not let the baby play with other infants that have scabies.

If the mother develops scabies, then she must avoid skin-to-skin contact as well. Breastfeeding can be a challenge during such moments. Therefore, express milk for feeding and let a healthy family member handle the baby.

Babies can catch scabies by coming in contact with clothing and bedding of an infected person, but according to the American Academy of Pediatrics (AAP), this is very rare (2). Nevertheless, keep an infant from all contaminated items.

  1. Maintain cleanliness and general hygiene: Scabies mites are microscopic and drift in the air. They can land on surfaces, waiting to make contact with healthy skin. Therefore, maintain general cleanliness and hygiene around the baby. Keep dust at bay by cleaning surfaces, vacuuming, and placing bedding under direct sunlight periodically.
  1. Keep the infected pets away: If the pet is infected, do not allow the baby to touch it.

The irritation and itch from scabies are excruciating. But treatment provides a definite cure. Managing the disease at home is also easy, while prevention is simple. Staying clear of those around with scabies and some simple daily personal hygiene is all the baby needs to live a life free of itchy scabies.

If you have any more tips on preventing scabies, then tell us in the comments section below.

www.momjunction.com

Symptoms and Signs of Scabies

Doctor’s Notes on Scabies

Sacbies is a contagious skin disease caused by an infestation of the skin by a mite known as Sarcoptes scabiei. It is transmitted from person to person by direct skin contact with an infested person. Sexual contact is also a common means of transmission.

Signs and symptoms of scabies include itching that can become very severe, especially at night. There is an associated rash that appears to resemble pimples. The rash of scabies is most commonly seen around the wrists, armpits, elbows, between the fingers and toes, around the nails, and in areas of skin skin usually covered by clothing including the buttocks, belt line, nipples, and penis. Another associated symptom is the presence of «burrows,» which are thin gray, brown, or red lines on the skin that lead away from the bumps.

Scabies Symptoms

Symptoms occur from two to six weeks to appear after exposure. They include severe and continuous itching, especially at night.

  • The skin may show signs of small insect-type bites, or the lesions may look like pimples, bumps, or blisters, especially around the wrist, elbow, knee, underarm area, groin, or finger webs. The skin may also have redness, rash, or have sores (welts, bumps or nodules, especially in children, termed nodular scabies) due to scratching of the area. Large nodules of 2-20 mm in diameter may appear in infants unable to scratch.
  • A burrow (a short S-shaped track that indicates the mite’s movement under the skin) may also be visible, especially in the webs of fingers and toes. Burrows may be small enough to be overlooked. Thus, scabies also should be considered whenever there is intense itching and/or scratching, even without an obvious rash, bite, or burrow. Ulcers are not frequently formed.
  • Scabies frequently occur in the crevasses of the body such as between the fingers and toes, the buttocks, the elbows, the waist area, the genital area, and under the breasts in women. The face, neck, head, scalp, palms, soles of the feet, and lips are usually not affected, except in infants or very young children.
  • Risk factors such as immune suppression or old age may predispose patients to more extensive disease. In crusted (Norwegian) scabies, the body of the infested person is covered with a thick, dry, and scaly rash. The rash of crusted scabies may or may not itch, but it contains thousands to millions of mites. Crusted scabies is the most contagious form of scabies and the hardest to treat.
  • Many other skin rashes may look like scabies, including allergic drug reactions, contact dermatitis, and viral rashes such as shingles.

Scabies Causes

Scabies is caused by an eight-legged mite (Sarcoptes scabiei var. hominis) that is less than 0.5 mm long. Worldwide, about 300 million people are infected each year. In the U.S., there were outbreaks of scabies in 10 schools in Texas and in hospital workers in Charlotte, N.C., in 2015.

What Is Scabies? Rash, Treatment, Symptoms, Pictures Slideshow

Scabies is a skin condition caused by an infestation of the human itch mite called Sarcoptes scabiei. These microscopic mites burrow into the skin and cause symptoms of itching and rash.

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Kasper, D.L., et al., eds. Harrison’s Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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What Is Scabies, and How Does It Spread? Causes, Symptoms, Treatment, and More

Medically Reviewed by Ross Radusky, MD

Scabies is caused by the human itch mite (Sarcoptes scabiei), a tiny, eight-legged mite that burrows into the upper layer of the skin in order to feed and live. Female mites also lay eggs here. (1) When this happens, the skin often breaks out into an itchy, pimple-like rash in an allergic reaction to the mites, their eggs, and their waste. (2)

Though scabies is pretty unpleasant to think about, the good news is that it’s very treatable. Scabies treatment involves topical remedies and, depending on the severity of the infestation, oral medication. All these medications are currently available only by prescription, so it’s vital to see your healthcare provider in order to solve the problem.

Once treatment is started, and the mites are eliminated, the itching and scabies rash symptoms should resolve within a few weeks. (1)

Prevalence of Scabies, and Who It Affects

According to the World Health Organization (WHO), an estimated 130 million people are affected by scabies at any given time. (3) Infections happen in all parts of the world, though the WHO notes that the highest rates of scabies and scabies-related secondary infections occur in hot, tropical climates, especially in overcrowded communities.

But scabies can happen to anyone, regardless of geographic location, socioeconomic status, race, gender, or age. Some people, though, are particularly susceptible to scabies. According to the American Academy of Dermatology, this includes: children, mothers of young children, sexually active young adults, elderly people who live in nursing homes, and hospital patients. (4) People whose immune systems are compromised, and people who have had organ transplants, are also at greater risk.

Scabies outbreaks affect residents of facilities such as nursing homes and rehabilitation centers, dormitories, and prisons — basically any institutional setting where close body contact is frequent. (1) Environments such as childcare centers and camps are also at risk for outbreaks. (5)

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Scabies Signs and Symptoms

Scabies typically causes intense itching, which can be worse at night and potentially so persistent it keeps you from sleeping. This itching is the earliest and most common symptom of scabies. (6)

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Scabies can occur anywhere on the body, but the mites tend to prefer certain areas, including: the hands (especially in the skin between fingers and around the nails), armpits, elbows, wrists, and areas of skin that are usually covered by clothing, such as shoulder blades, the groin area, breasts, the area around the beltline, and the buttocks. Skin that’s covered by jewelry such as watches, bracelets, or rings is also often affected. (7)

In young children and infants, itching and rash may affect the head, face, neck, palms, and soles of feet, but this typically doesn’t occur in adults and older kids. (1) Scabies rashes in infants and young children might appear redder or include larger blisters. (5)

What Does Scabies Look Like?

Not everyone infested with mites has a scabies rash, but many people do. The rash consists of small, red bumps that may look similar to pimples or small insect bites , and the bumps are often in a line . These aren’t “scabies bites” so much as an allergic reaction the skin has to the presence of the mites. This reaction can also resemble other rashes, but your doctor or dermatologist can determine whether it’s scabies. Some people infested with the mites have scaly patches that look like eczema. (7)

You may also notice tiny, snaking, raised lines — about a centimeter long — that are caused by the female scabies mite burrowing under the skin. These burrows are grayish-white or skin-colored, and while they can be difficult to find, they tend to appear in the webbing between fingers; in the folds of the wrist, knee, or elbow; and in the groin area, breasts, and shoulder blades. (6)

In someone who’s never had scabies, it can take as long as four to six weeks before symptoms begin to appear, although symptoms typically develop three to four weeks after you’ve had contact with a mite. It’s important to be aware that a person is capable of spreading mites during this period even when they show no signs of scabies. (1)

Symptoms in people who have had previous scabies infestations tend to show up much more quickly, within one to four days.

How Is Scabies Spread, and How Can I Avoid It?

Scabies is contagious, and it’s usually spread by having direct, prolonged skin-to-skin contact with an affected person. (2) The exposure generally has to be sustained: As the CDC notes, a handshake or hug typically doesn’t spread the mites, but holding hands for 5 or 10 minutes can. (The exception is crusted scabies, where even very brief contact with an infested person can transmit the mites.) In adults, scabies is often spread through sexual encounters. (1) And it’s easily spread within households.

While the mites live for one to two months on human skin, they can survive for up to four days in inanimate objects such as bed sheets, clothing, and towels. Less commonly, scabies can occur through contact with an infested item. This kind of indirect infection more frequently occurs in people who have crusted scabies. (1)

Scabies are not spread to people from pets. Pets can become infested with animal mites, and these can be passed along to humans. But animal mites can’t reproduce on a person, and even if they get under a person’s skin, they’ll die within a couple of days. (1) It’s important to treat your pets, though, if they acquire mites.

According to the CDC, getting scabies from swimming in a pool is “extremely unlikely.” In most cases of scabies, excluding crusted scabies, an infested person only has 10 to 15 mites on their body, and the chances that a mite would emerge from beneath wet skin are very low. (1) Still, although uncommon, you could spread scabies by sharing a towel with an infested person.

What Is Crusted Scabies, and How Is It Different?

Crusted scabies, also known as Norwegian scabies, is a severe form of infestation found almost exclusively in those with severely weakened immune systems. It’s much less common than regular scabies, but more contagious. Most people who get scabies have about 10 to 15 mites in their skin. Crusted scabies is an infestation with an extremely large number of mites — sometimes up to 2 million, according to the Centers for Disease Control and Prevention (CDC). (6)

It affects people whose bodies can’t develop resistance to the mites; the mites multiply quickly. This includes people who have a weakened immune system, such as people with HIV or chronic leukemia, as well as elderly people. (1,8)

People with crusted scabies may not show the typical scabies rash or itch so intensely, but they’re highly contagious to other people. Thick, grayish crusts develop on their skin that tend to crumble easily when touched. These are especially common on folds of the skin, such as in the armpit, groin, and finger-web spaces. (7) But these crusts, filled with mites, can also fall off. The mites can live inside the crust for up to a week without human contact, which is part of what makes crusted scabies so contagious in certain environments. (4)

Diagnosis: How Can I Be Sure I Have Scabies?

Related Conditions

If you suspect you have scabies, you must get checked out by a healthcare provider in order to treat the condition properly and avoid spreading it. A doctor will perform a visual exam, looking for the scabies rash on your body and for burrows. Reactions to certain drugs can mimic a scabies rash, (1) and other conditions can produce skin reactions that look similar. To be sure it’s scabies, your doctor may want to confirm the presence of a mite, its eggs, or its fecal matter. This can be done by taking a scraping of skin to examine under a microscope, or by using a needle to extract a mite from its burrow. (9)

What Are the Treatment Options for Scabies?

Successful treatment of scabies means eradicating the mites. This involves using a medication known as a scabicide. While some over-the-counter creams and products might help reduce or alleviate symptoms like itching, they won’t kill mites. Scabicides are currently only available by prescription. (1)

For common, non-crusted scabies, patients may be prescribed a topical medication.

Permethrin cream (Elimite) is the most commonly prescribed. Crotamiton lotion, crotamiton cream (Eurax, Crotan), sulfur ointment, or Lindane lotion may also be considered, depending on the needs of the patient. (10) These are applied to the entire body, from the neck down, on clean, dry skin and left on for about 8 to 14 hours before being washed off. (11) You usually need to repeat this process a week after the first treatment to get rid of any newly hatched mites.

Treatment of crusted scabies calls for an oral antiparasitic medicine, Stromectol (ivermectin), along with topical medication. Depending on the severity of the infestation, these pills are taken in three, five, or up to seven doses. (10)

In conjunction with a scabicide, your doctor may prescribe an antihistamine or steroid cream to help reduce itching and inflammation of the skin. (13) After treatment, even if all the mites have been killed, you may have residual itching for up to a few weeks. If the itching lasts more than two to four weeks, or if you notice new burrows or the pimple-like scabies rash, you might need retreatment.

A review of studies published in February 2016 in the American Journal of Tropical Medicine and Hygiene (14) examined the potential of tea tree oil, which has antibacterial, anti-inflammatory, and anti-itching effects, as a possible remedy for scabies. Study authors noted a growing resistance to current standard treatments like ivermectin and permethrin, and called for more research into the topic.

Adults can usually go back to work, and children to school, the day after treatment. (15)

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