Scabies is an intensely itchy, highly infectious parasitic skin disease caused by the Sarcoptes scabiei itch mite. The mite is usually transferred from one person to another by direct skin contact, especially during sexual activity or while sharing a bed. Far less often it is spread by indirect contact, such as sharing a towel or clothing. This is not typical because the mites do not survive long when not on a human body. To reproduce, the tiny female mite searches for places where the skin is thickest especially the palms and soles. She then burrows tunnels under the skin into which she deposits her eggs, about two a day for two months. The larvae hatch in two to four days, leave their mother’s tunnel, and cluster around hair follicles. The nymphs will mature within two weeks and begin a new life cycle. Hypersensitivity to the eggs, and perhaps to the waste products of the mites and larvae, causes the characteristic itchy rash, which usually begins on the thighs and spreads to most parts of the body, particularly the trunk, hands, feet, armpits, and genital region, but not the face. Itching is intermittent and can be quite severe.
Diagnostic Studies And Procedures
It is difficult to diagnose scabies by visual inspection of the rash because it resembles many other skin conditions. Instead, a doctor will look for burrows on the palms or soles, and scrape away the overlying skin. The female mite clings to the top of her burrow and may be visible to the naked eye. Placing the scrapings under a microscope will clearly show the mite. Even if mites cannot be found, a diagnosis may be based on symptoms and recent contact with someone who had scabies.
Medical Treatments
To destroy the mites and their eggs, doctors have traditionally prescribed very potent parasite killing medications, such as gamma benzene hexachloride, malathion , and lindane , available as prescription creams or lotions. Because these can cause skin irritation and nerve damage, especially in infants and children, milder but equally effective nonprescription drugs such as permethrin (Nix, Elimite) are now preferred. In children under the age of two, a 5 percent permethrin cream or a 5 or 10 percent sulfur ointment might be used. Whichever drug is prescribed, it should be applied to the entire body, completely covering the skin from the neck down. It must be left on for at least 12 hours, or preferably 24 hours, before being washed off. Household members and others who have been in physical contact with the patient should be treated at the same time. All recently used clothing, towels, and bed linens should be laundered in hot water. In most cases, one treatment will kill the mites and their eggs, but a follow up doctor’s visit in a week or two is advisable to see if retreatment is necessary. Itching may persist for a week or two. If it is severe, a doctor can prescribe a topical corticosteroid ointment to be applied twice daily.
Alternative Therapies
While waiting for medical therapy to destroy the parasites, alternative methods can help to ease the itching.
Herbal Therapy
Capsules of a freezedried extract of the stinging nettle plant, with one or two taken every two to four hours, might alleviate the itch.
Hydrotherapy
Topical poultices or bath additives often ease itching. Try cornstarch or colloidal oatmeal, available at your pharmacy or health food store. Alternating cold and hot water sprays may also relieve itching.
Meditation and Self Hypnosis
Because the skin is highly responsive to hypnotic suggestion, meditative practices may help ease itching.
Self Treatment
Make every effort not to scratch this may temporarily relieve itching, but it sets in motion an itch stratch itch cycle that results in increasingly intense itchiness. Also, scratching may open the skin to a secondary bacterial infection. In addition to the alternative therapies suggested above, a nonprescription antihistamine cream may also ease mild to moderate itching. To prevent spreading the infection, avoid physical contact or sharing a bed, towels, linens, or other personal items with anyone until the scabies is completelyeliminated.
Other Causes of Itchy Skin Rashes
Itchy skin rashes may be caused by chickenpox, insect bites, eczema, allergies, and contact dermatitis.
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