The skinny on scabies

Date: March 10, 2012

Author: Marsha Donals

Scabies is an ancient disease that still occurs worldwide. Evidence from Egypt and the Middle East suggests that scabies was present as early as 494 BC. The ancient Greek philosopher Aristotle reported on "lice that escape from little pimples if they are pricked." Scholars believe this was actually a reference to scabies.

Infestation is caused by the microscopic human itch mite (Sarcoptes scabiei var. hominis), which burrows into the upper layer of the skin where it lives and lays eggs. Scabies affects all social classes, races and ages. Institutions such as extended care facilities, prisons and daycare facilities appear to have greater risk for infestation.

Scabies is typically spread by direct, prolonged, skin-to-skin contact, or by sharing items such as articles of clothing, towels or bedding used by the infested person. A quick handshake or hug will not usually spread scabies.

Symptoms of scabies may occur from one day to six weeks following initial exposure, depending on the frequency and intensity of exposure. Predominant symptoms are a pimple-like rash that itches, with the itching typically more intense at night. The rash may include tiny blisters (vesicles) and scales. Scratching the rash can cause skin sores; sometimes these sores become infected with bacteria leading to a more serious secondary infection. The rash and itching may affect much of the body or be limited to common sites such as the wrist, elbow, armpit, waist, belt-line, buttocks, genitals or webbing between the fingers. The head, face, neck, palms, and soles are often involved in infants and very young children.

There are many different types and causes of rashes. Only your doctor can determine the type of rash and proper treatment. If scabies is the diagnosis, all members of the household and anyone who has had prolonged skin-to-skin contact with an infested individual should be treated at the same time to avoid re-exposure.

Scabies do not live off of the body for more than 48 - 72 hours and die when exposed to high heat (122 degrees Fahrenheit). Bedding, clothing and towels used by the individual during the past three days should be laundered in hot water and dried on the hottest setting. Any items that cannot be laundered should be placed in a plastic bag, tied and left for three days or more.

The recommendation from the Centers for Disease Control is that children and individuals can return to school or work the day after treatment is complete. It is very important to follow treatment directions, including completing all steps, even after symptoms subside. If itching persists longer than 2 - 4 weeks after treatment, or if a new rash occurs, contact your doctor. More information on scabies can be obtained from your health care provider, school nurse or the health department.

Author Information: Marsha Donals is a registered nurse and the director of nursing for the Cowley City-County Health Department.