Scabies or itch mite

Symptoms of scabies

The symptoms of scabies include intense itching, especially in the evenings and at night, and a red rash. The rash often appears between the fingers and toes, on the wrists, forearms, and genital areas. Symptoms of scabies can also include thin gray or brown lines on the skin, which are tunnels dug by the itch mite. Scratching can lead to skin infections.

Typical symptoms of scabies include:

• Intense itching, especially in the evenings and at night
• Red or blistering scabies rash
• Thin gray or brown lines on the skin, which are tunnels dug by the itch mite

Incubation period of scabies

The incubation period of scabies varies from 3 to 6 weeks in the initial infection, during which the body becomes sensitized to the itch mite and its secretions. In recurrent infections, symptoms appear more quickly, usually within 1 to 3 days. The larvae of the itch mite develop into sexually mature adults about two weeks after the nymph stage. This rapid development can lead to the quick onset of scabies symptoms.

Transmission of scabies

Scabies is usually transmitted through skin contact when the itch mite moves from one person's skin to another, for example, during handshakes or hugs. Additionally, itch mites can survive for a short time outside the skin, allowing scabies to spread through used clothing or bedding.

Since scabies primarily spreads through direct skin contact, it is particularly prone to spreading in close-knit communities such as schools, care homes, and other places where people are in close contact with each other. In close communities, people often share personal items like towels and clothes, which can facilitate the spread of scabies.

By understanding the ways scabies spreads and the most common conditions where infection is likely, the spread of scabies can be more effectively prevented.

When to see a doctor for scabies?

Scabies usually does not heal on its own without proper treatment, so it is advisable to seek a doctor's appointment to confirm the diagnosis and receive appropriate treatment. If scabies is suspected, it is also recommended to start home treatment with a preparation available from the pharmacy and to follow the treatment instructions carefully.

Seek a doctor's appointment if:

• Itching does not ease with self-care
• Suspected scabies has spread widely
• You are pregnant or breastfeeding
• You suffer from severe itching
• You suspect scabies in a small child
• Symptoms have persisted for a long time

Diagnosis of scabies

Diagnosing scabies is important before starting treatment, as it ensures the correct treatment and prevents the spread of infection. A doctor usually diagnoses scabies based on the patient's symptoms and skin changes. Diagnosing scabies may include the following steps:

• Clinical assessment: The patient's skin is examined for typical signs of scabies, such as small red bumps, blisters, or scratch marks. Skin changes caused by the itch mite are often visible, especially between the fingers, on the wrists, elbows, and waist.
• Skin samples: If the clinical assessment is not sufficient, a skin sample can be taken by scraping the skin. The skin sample is examined under a microscope to look for itch mites, their eggs, or feces.
• Dermatoscopy: A dermatoscope can also be used to assist in examining the skin. A dermatoscope can help detect the tunnels of the itch mite on the skin surface.
  

Early diagnosis of scabies is important to prevent its spread. The sooner scabies is identified and treated, the lower the risk of infecting others and suffering from worsening symptoms.

Scabies can often be diagnosed remotely based on typical symptoms and photographic findings.

Treatment of scabies

A doctor prescribes appropriate treatment for scabies on a case-by-case basis. Scabies is usually treated with topical medications such as creams containing permethrin, sulfur-vaseline, or benzyl benzoate. The cream is applied thoroughly to the entire body, especially to areas where scabies symptoms are most severe. The effectiveness of scabies treatment is based on destroying the itch mites and their eggs. Treatment should be carried out according to instructions, and often the entire family or close circle should start treatment simultaneously.

Scabies medications include:

• Permethrin cream
• Sulfur-vaseline treatment
• Ivermectin tablets
• Hydrocortisone cream to relieve itching

In severe or recurrent cases of scabies, a doctor may prescribe ivermectin tablets, which are oral medications. Ivermectin is often used in combination with topical creams when local treatment is not sufficient or when scabies has spread widely.

Even if scabies treatment is successful, itching may persist for 2-4 weeks due to the skin's inflammatory reaction. If you suspect that scabies treatment has failed, for example, due to inadequate cleaning, or if itching lasts longer than 4 weeks after treatment, seek a doctor's appointment.

Home treatment for scabies

Thorough cleaning of the home and textiles is an essential part of treating scabies and preventing its spread. Itch mites can live for several days in textiles such as clothes and bedding.

Thorough scabies cleaning includes:

• Wash textiles at a minimum of 60°C, freeze at -20°C, or seal in a bag for 7 days
• Vacuum upholstered furniture that cannot be washed in a washing machine, such as mattresses, sofas, and carpets
• Wipe hard-surfaced furniture
• Air or vacuum blankets and pillows
• Change to clean bedding

Prevention of scabies

Key to preventing scabies is adhering to good hygiene practices and avoiding close contact:

Hand hygiene: Good hand hygiene is crucial in preventing the spread of scabies. Hands should be washed regularly with soap and water, especially before eating and touching the face. Hand sanitizer is useful in situations where hand washing is not possible.
Nail care: Keeping nails short and clean can reduce the risk of spreading itch mites through scratching. Long nails can collect dirt and bacteria, which can promote the spread of infection.
Textile handling: Itch mites can survive in textiles such as clothes and bedding for several days. Therefore, it is important to wash all used clothes, bedding, and towels at a minimum of 60°C to destroy the mites. Regular changing and washing of textiles is also recommended.
Avoiding close contact: Scabies spreads easily through close contact, so it is important to avoid direct skin contact with infected individuals. This also applies to sharing common items like towels and clothes.

Common misconceptions about scabies

There are many misconceptions and myths about scabies that can lead to misunderstandings and unnecessary stigma:

1. One of the most common misconceptions is that scabies is caused by poor hygiene. This is not true, as scabies can affect anyone, regardless of personal hygiene. The itch mite spreads primarily through direct skin contact and is not related to how clean or dirty a person is.
2. Another common myth is that scabies is only a problem in densely populated or warm areas. While scabies can spread more easily in densely populated areas, it is not limited to specific geographical areas or population groups. Scabies can occur anywhere where people are in close contact with each other, such as schools, care homes, and families.

It is important to understand that scabies is not a sign of a poor living environment or socioeconomic status. This misconception can increase the shame experienced by people with scabies and prevent them from seeking treatment. Raising awareness about the ways scabies spreads and its prevalence can help reduce stigma and encourage people to seek help and treatment in a timely manner.