People of any age can get scabies, which is caused by the human itch mite. — TNS
Scabies is an itchy rash caused by the human itch mite.
Adults, children and babies can all get scabies.
Many people believe scabies is about cleanliness, but that is not true.
It is easily passed between people living closely with other people.
Let’s discuss how scabies makes you itchy and how to get rid of scabies safely.
Under the skin
The human itch mite is microscopic in size.
It can burrow into the very top layer of the skin (not any deeper), where it can lay eggs and eat.
The mites are so tiny, there is no way to see them with your eyes before the scabies rash starts.
This itchy rash develops in reaction to the mites after a few days or weeks of them living off you.
The scabies rash looks different at different ages.
Babies, toddlers, very elderly people or people with weakened immune systems can have a rash all over the body.
In older children and adults, the rash is mostly on the hands, feet, armpits, belly button and genitals.
It can look like hives (welts), pimples (pus bumps), blisters (tiny areas of fluid-filled skin) or crusty bumps.
But some people do not have a rash at all.
Therefore, it is very common to have one or two people with a rash in the house, and others without.
But it is crucial to note that everyone at home is exposed and needs to be treated.
Scabies is diagnosed by looking carefully at the skin.
The pattern of the rash, along with the story of when it started and who else is itchy, is usually enough for diagnosis.
Sometimes, your doctor may perform a skin scraping to look for the mite or other clues under the microscope.
To get rid of scabies, you have to treat the people and the environment you live in all at the same time.
All the people who come into regular contact with the household need to be treated.
This means everyone who lives with you, as well as regular visitors like babysitters and grandparents.
Applying the cream correctly
How you apply the treatment cream for scabies makes a big difference.
Permethrin 5% cream is the most commonly used medicine to treat scabies in adults, children and infants.
In babies and toddlers under the age of two, the cream is applied to the scalp and body from the neck to the toes.
In older children and adults, the cream is applied from the neck down to the toes.
The cream needs to get into all the body folds, including armpits, belly button, crack of the buttocks, around the scrotum and penis, and spaces between the fingers and toes.
It does not need to be used on the face.
The cream is left on the skin overnight for eight to 14 hours before it is rinsed off the next day.
The treatment needs to be repeated in one week to take care of any eggs that hatched after the first treatment.
Other creams and oral medicines are sometimes needed in specific situations.
Not all medications can be used in very young infants and pregnant women.
Your doctor will help prescribe the right scabies treatment for your family.
Wash cloth items
The mite can live for short periods of time outside the skin on cloth items.
These can be clothes, stuffed animals, bed linens, towels, soft parts of strollers, car seats, furniture and high chairs, to name a few places.
To get rid of scabies from the home, wash clothing, bed linens and towels using hot water and dry using the hot cycle.
Vacuum furniture, carpets, car seats and strollers.
If you can’t wash or vacuum an item due to size or because it will damage it, you can place it in a sealed bag for at least 72 hours.
Where needed, items can be drycleaned.
Your pets do not get human scabies.
And you do not need a special exterminator, just careful cleaning of the bed linens, furniture and other items as listed above.
You can all return to normal activities the day after all household members have started treatment, which means the day after the first overnight application of the permethrin cream.
Sometimes, after the scabies are gone, children and adults can be itchy for several weeks.
It is called “post-scabetic pruritus”, which means “after-scabies itch”.
It can make parents nervous, but it’s very common, especially if your child had a big rash due to scabies.
Other topical medications can be helpful with this problem.
Scabies goes away very well when the treatments and cleaning steps are followed carefully.
But if you, your child or anyone in the house is still getting new bumps two weeks after the last treatment, that person needs to be checked again.
Crusted scabies is when a person has a large amount of scabies mites on their skin and they are present in large crusts.
This is a very contagious version because it has a lot of scabies mites to pass around.
It can occur in people with weakened immune systems.
It has a distinctive appearance and is quite rare in children.
Be sure to ask your doctor if you have any questions or concerns along the way. – By Dr Sarah Asch/American Academy of Pediatrics/Tribune News Service
Dr Sarah Asch is a paediatric dermatologist in Minnesota, United States.
