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Scabies  

What is scabies?

Scabies is a highly infectious skin infestation caused by a tiny mite called Sarcoptes scabiei. The mite, which is a type of arthropod, burrows just beneath the skin in order for the female to lay her eggs. She then dies. The eggs hatch into tiny mites, which spread out over the skin and live for about 30 days only. The mites cause an allergic rash.

How is scabies spread?

The mites are spread from person to person through close personal contact (skin to skin), including sexual contact. They may also be spread through contact with infested clothes or bedding, although this is uncommon. Sometimes the whole family can get scabies. The spread is more likely with overcrowding and sexual promiscuity.

What are the symptoms?

• intense itching, causing scratching
• a red, lumpy rash

The itching is worse with warmth and at night. The scratching may cause sores and scabs. The allergy may result in eczema.

Where does it occur?

It usually occurs on the hands and wrists. Other common areas are the male genitals, buttocks, elbows, armpits, nipples in females, feet and ankles.

How is it diagnosed?

Scabies is diagnosed by its very itchy, lumpy rash. It is rare to find the tiny mites, but it may be possible to find them in the burrows, which look like small wavy lines. When dug out, they are examined under the microscope.

What is the treatment?

• Topical medication
• Adults: benzyl benzoate 25 per cent solution or gamma benzene hexachloride 1 per cent lotion
• Children and pregnant women: benzyl benzoate 25 per cent solution

Where?

Apply to the entire body from the neck down to the tip of the toes (even for genital scabies). Make sure you treat under the nails and the genitals.

How?

First have a hot shower or bath. Use a clean washer and towel, and allow the skin to dry. Paint the lotion on all the skin thoroughly with a brush such as a shaving brush or paint brush. Do not rub your eyes or wash your hands. Put on clean clothes. Leave for 24 hours, then have a shower or bath. (nb.)

How often?

• One treatment is usually enough. It can be repeated in a week if necessary, but check with your doctor.
• Clothing and bedding: Remove pillows and sheets, pyjamas and underwear after the second shower and wash normally in hot water as a separate load.

Note

• The whole family must be treated at the same time, even if they do not have the itch (one
• application is sufficient). Use separate towels and brushes.
• Itching can continue long after successful treatment resist repeated treatments, but check with your doctor.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia